Using Global Fund Evaluation Scores to Bolster Grant Oversight

With over 450 programs in more than 130 countries (and counting), the Global Fund certainly has its work cut out for it on monitoring and evaluation (M & E). An article (pdf) published last week in The Lancet by CGD senior fellow Steve Radelet and former CGD staff member Bilal Siddiqi provides some important data that could help the Fund further strengthen its M & E system going forward. Radelet and Siddiqi's research centers around grant evaluation scores -- ie., scores that are assigned by the Global Fund to each grantee after the first two years of a new grant ("phase one"). Scores are assigned using three criteria: 1) results achieved, 2) country contextual information that may have affected the results, and 3) a series of assessments submitted to the Fund's secretariat by a "Local Fund Agent" (typically an accounting firm like PricewaterhouseCoopers). Radelet and Siddiqi explore the correlation between these evaluation scores and various characteristics of the grant itself (e.g., type of recipient), the health sector (e.g., physicians per capita) and the country (e.g., income level). Among their many interesting findings are:

• Programs implemented by non-governmental recipients receive higher scores than those implemented by the government.
• Evaluation scores are higher in countries with more physicians per capita and high immunization rates.
• Grants in countries with fewer donors or where Global Fund grants are a larger share of donor funding receive higher scores.

Radelet and Siddiqi note that "the results should not be used to influence the distribution of funding, but rather to allocate resources for oversight and risk management." The Global Fund could use the authors' results, for example, to allocate more time and money for oversight of grants that are likely to receive lower evaluation scores.The Global Fund has demonstrated a commitment to "learning by doing," adjusting its policies and procedures as new data or circumstances arise. A five-year evaluation is being conducted with oversight from the Technical Evaluation Reference Group (TERG), so staff from the Fund are likely to look at the data provided by Radelet and Siddiqi closely to determine how best to use the authors' findings within this overall effort.Some of Radelet and Siddiqi's suggestions are already being considered, or even adopted, by the Global Fund. Take, for example, their finding that non-governmental recipients seem to perform better than governmental ones. The authors explain:

This result does not suggest that the Global Fund should have a bias against programmes with government recipients, but rather that it should encourage countries to facilitate programmes with non-government actors alongside government programmes.

The Global Fund's Board has recently decided (.pdf) to do exactly that, by adopting a new grant approval process that would encourage grant applications with governmental and non-governmental recipients working in concert (ie., "dual-track financing"). The Fund's willingness to learn from its experiences is an encouraging signal that it will continue to use research such as that by Radelet and Siddiqi to bolster all aspects of its operations.