2017-2022 Corporate KPI Framework: Initial Proposal For Board Constituency Review Jan 2016

2017-2022 Corporate KPI Framework: Initial proposal for Board Constituency
review
22th Jan 2016
Doc No.: KPI/bc02
Developing the 2017-2022 Corporate KPI Framework

1
Status of framework development
Context & guiding principles for framework revision
Framework overview
Indicator proposals
Annex
Status update of framework development

The KPI Framework for the new strategy has been in development with technical and operational teams
since April 2015 with brief updates provided to SIIC over this period
The 2017-2022 Strategic Framework was approved by the Board at its 34th meeting in November 2015
providing the firm basis on which this first draft KPI framework has been designed
Overview
Five MEC & Steering Committee meetings since the autumn provided strong guidance on Gender, RSSH,
Key populations, Human Rights, Domestic investments indicator development
Technical partners have been engaged in reviewing the technical soundness of indicator proposals
Preliminary feedback from the OIG audit of the current KPI framework has showed good level of
acceptance of framework design
This document and the accompanying narrative sets out the preliminary first draft of the proposed
framework for Board constituency input
Written feedback is requested from constituencies which will then be reviewed and summarized by the
Secretariat (see accompanying form)
Next Steps
Consultation meetings with constituencies will be held to resolve differing viewpoints on major issues
This input will be integrated into the second draft of the proposals for review by the Board Committees 8/9th
March 2016
After Board approval of Corporate KPI framework, Secretariat will fully develop the framework of
cascaded Operational KPIs
2
Developing the 2017-2022 Corporate KPI Framework

Proposals are being developed with significant input from internal and external stakeholders
1
Committee
update
Technical
development
June Oct 2015
April 2015 - ongoing
Constituency
review
Jan 22nd 2016
High level
framework design
shared with June
SIIC
All proposals developed

in partnership with
technical teams (60+
staff involved)
Full framework will

be sent to Board
Constituency
groups
Example KPI
development
thinking shared with
October SIIC
Ongoing consultation
with technical partners
Written feedback will

be requested, and
every point raised
will receive a
response
No presentations
yet made to FOPC
(or AEC)
Five MEC & Steering

Committee meetings
over autumn provided
strong guidance on:
Gender
RSSH
Key populations
Human Rights
Domestic
investments
Areas of contention
will be discussed
during the planned
consultations with the
implementer and
donor groups
Consultation
meetings
Jan Feb 2016
One-on-one
meetings with
constituency groups
Implementer group
meeting (date TBC)
Civil society meetings
Jan 19th & Feb 11th
Donor group meeting
(date TBC)
Review &
approval
March 8th 9th
Review of second draft of
framework incorporating
constituency feedback by
Board Committees
April
Final revisions will be
incorporated into submission
to Board for approval
May - November
Final methodological
development, baseline &
target setting for Board
approval
Full development of
cascaded Operational KPIs
3
New framework design draws from best practice structures and guiding principles
Leveling
indicators
Thematic
reporting
Variance
analysis
Best practice from comparable organizations
Lesson learned
Performance management framework includes

multiple levels of KPIs targeted to different
audiences: global trends, contributive and
attributive indicators, as well as operational
monitoring and management data
Strategic and activity-level KPIs will track Global

Funds contribution to mission, while additional
monitoring from operational KPIs and
management information will provide deeper
analysis, in particular on levers for action
Tracking and reporting on strategic themes are

consistently provided to fill information gaps at
goal-level tracking
Corporate indicators will be directly underpinned by

operational KPIs, consistent management
information, and thematic reporting for each strategic
objective
Clear concise analysis is required to link and

contextualize results and enable target
audiences to better understand and use
performance information for strategic decision
making
Increased clarity will be provided on the levers for

management action available, accountability for
action and how information across and between the
different levels links together
Current focus
2
Hierarchy of performance management framework

A few, measurable, results-oriented KPIs covering the life of the Strategy
Corporate
level
KPIs focused on global

targets & impact
KPIs to enable Board/

Committee oversight for
governance on key activities
for strategy goals
More granular measures

measuring management
performance at entity levels
of the Global Fund
Strategic KPIs
Activity specific KPIs

2022
2017
Secretariat
level
Operational KPIs
Principles guiding revision of the framework have been updated

Principles used to guide development
of the 2014-2016 KPI Framework
Additional principles
Align the framework with the 2012-2016 Strategy
Set the Framework for the lifetime of the Strategy
Define a clear hierarchy with logical links between the

levels
Activity specific KPIs should measure the overall effect of the

Strategic Objectives and not the specific effect of each subobjective
Reduce the number of KPIs and increase focus
Indicators should be measured on a meaningful number of

countries
Complement the KPI framework with a regular Quarterly

Dashboard of other specific indicators
Accountability should be clear and interpretation defined

accordingly
Ensure indicators are visible and measurable
Secretariat-level information will complement Corporate level KPIs

Corporate
level
current
focus
Strategic KPIs
2017
2022
KPIs to enable Board/ Committee

oversight for governance on key
activities for strategy goals

2017
Secretariat
level
to be fully
developed
once the
corporate
level KPI
framework is
approved
Operational KPIs
Thematic Reporting &

Management Information
KPIs focused on global targets &

impact
More granular measures measuring

management performance at entity
levels of the Global Fund
Example Operational KPIs provided
in this document for illustration
Routine tracking at management level should
provide underpinning analysis. Important
gaps currently exist here, and the proposed
performance management framework will fill
these gaps, notably on programmatic
investments, activities, results and impact
7
Proposed change to the current framework

Strategic goals
Strategic KPIs
Strategic
Objectives
Activity specific
KPIs
Evolve the
funding model
4 Efficiency of
7 Access to
Global Fund
funding
investment
decisions
5 Health system 8 New Funding
strengthening
Model
transition
6 Alignment
with national
reporting
systems
Retain
Revise
Delegate to operational
Drop
Strategic targets
1 Performance against strategic

goals
Invest more
strategically
4
4
6
2
2 Quality and coverage of

services
Actively support grant Promote and
implementation
protect human
success
rights
9 Effective
operational risk
management
10 Value for money
11 Grant expenses
forecast
3 Performance against strategic service

delivery targets
Sustain the
gains, mobilize
resources
Strategic enablers
Implementing
operational excellence
Enhance partnerships
12 Human rights 13 Resource

protection
mobilization
15 Efficiency of grant
management
operations
14 Domestic
financing for
AIDS, TB &
Malaria
16 Quality of
management and
leadership
Transition out more operational measures and

replace with fewer, but more strategic measures
8
Initial view on the 2017-2022 framework
4
4
4
Retained
Revised
Addition
Strategic targets
Strategic KPIs
Strategic
Objectives
Strategic vision
Activity specific
KPIs
1 Performance against impact targets

Maximize Impact Against Build resilient & sustainable
HIV, TB and malaria
systems for health
Invest funds to maximize

portfolio impact
Improve the performance of

strategically important
components of national systems
for health
2 Performance against service delivery targets

Promote and protect human
rights & gender equality
Mobilize increased resources
Reduce human rights

barriers to service access; &
Reduce gender and age
disparities in health
Increase available resources for

HIV, TB & Malaria; &
Ensure availability of affordable
quality-assured health technologies
3 Alignment of
investment & need
6 Strengthen systems for

health
8 Gender & age

equality
10 Resource mobilization
4 Investment efficiency
7 Fund utilization
9 Human rights
11 Domestic investments
5 Service coverage for

key populations
12 Availability of affordable
health technologies
9
The guiding principles were used to examine the proposed indicators

Dimensions
Definition
Accountability
Contribution: Global Fund is one actor among many contributing to results achieved
Attribution: Global Fund can largely attribute results to its actions
Data availability
Data may currently be available in an existing system; collected in a structured

manner (but not available in an existing system); or not yet available at Secretariat
level and/or country level
Actionable & reliable results
Results are replicable, reliable and guide Global Fund decision-making
Coverage
What segment of countries, donors, etc., is represented in result
Projections available
Is it possible to forecast this KPIs results, thus enabling the Secretariat to take action
to mitigate potential future underperformance
Frequency of reporting
Given the frequency of data collection, or the size cohort sampled, how often will
meaningful KPI results be produced? (eg. Annually, quarterly)
A summary by indicator is provided on the next page

10
KPI Proposals
Accountability
Data
availability
Actionable &
reliable results
Coverage
Projections
available
Frequency
of reporting
Performance against impact targets
Contribution
Structured
Full portfolio
Annually
Performance against service delivery

targets
Contribution
System
Full portfolio
Semi
annually
Alignment of investment with need
Attribution
System
Full portfolio
Quarterly
Investment efficiency
Contribution
Structured
Portfolio segment
Semi
annually
Key population service coverage
Contribution
Not yet
available
Portfolio segment
Annually
Resilient & sustainable systems for

health
Mix
Not yet
available
Portfolio segment
Annually
Fund utilization
Mix
System
Mix
Mix
Quarterly
Gender & age equality
Contribution
Structured
Portfolio segment
Annually
Human rights
Mix
Not yet
available
Portfolio segment
Mix
Annually
Contribution
System
Full portfolio
Quarterly
11 Domestic investment
Contribution
Structured
Full portfolio
Annually
Mix
Structured
Mix
Mix
12 Availability of affordable health

technologies
Annually 11
Key issues and Secretariats proposed approach
Accountability
Data
Challenges
Time lag to
ascertain
measurable
effect
Challenge
Proposed approach
Most corporate indicators report on a contribution

basis. Because many are outcome/impact
measures, Global Fund is one of many actors and
cannot be held solely accountable for results
Framing of accountability and available levers for action

should be made clear. Operational indicators and
management information will be more attributable to the
Global Fund. Initial thinking on potential more
attributable operational KPIs for each Strategic
Objective are outlined in this document for information
Many indicators will require significant

development of data collection systems/processes,
only some of which will be covered by Project AIM.
Retain the ambition of what we aim to achieve, and

invest in data systems where feasible; operational
progress towards longer term achievements should be
reported until data is available to measure proposed KPI
For some indicators, there will be important time

lags before expected scale up effects will be visible
on the ground
Acknowledge that for outcome/impact indicators, a

time lag to measurable effect will always exist.
e.g. 5th Replenishment starts 2017; first new grants

signed end-2017; first data from new grants
available mid-2018; 6th replenishment 2019
Accurate projections of expected future performance and

KPI target setting should reflect expected lag
12
Indicator proposals by Strategic Objective

Each Strategic Objective section includes:
Outline of Strategic Objective
Proposed Corporate KPIs for discussion and input
Analysis of each proposal (data availability, accountability, etc.)
Examples of potential Operational KPIs as illustration of tracking information that is more
attributable to the Global Funds management and operations
13
Investing to End Epidemics: Strategic Targets 2017-2022
Strategic targets
Impact
targets
Under development with partners
Service delivery targets
Global Plans
HIV /
AIDS
TB
Malaria
Global Fund
leading targets
Indicators for other

selected services
Rapidly reduce HIV mortality and incidence

through scaling up universal access to HIV
prevention and treatment in line with the
UNAIDS Fast Track and WHO Global Strategy
Rapidly reduce TB, TB-HIV and MDR-TB

incidence and related mortality through
universal access to high quality care and
prevention in line with the End TB Strategy and
Global Plan to End TB
Under development with partners
Scale up and maintain interventions to reduce

Malaria transmission and deaths and support
countries to eliminate Malaria, in line with the
Global Technical Strategy and AIM
14
Strategic Targets
KPI 1
Maximize Impact Against

HIV, TB and malaria
Build Resilient & Sustainable

Systems for Health
Promote and Protect

Human Rights & Gender
Equality
Mobilize Increased
Resources
Strategic Vision
Measure
Invest funds to maximize portfolio impact
a)
b)
Aim of indicator
Limitations & mitigation actions
Measures the extent to which Strategic Objectives are

achieving high level goals of lives saved (or reduction
of deaths) and reduction of new infection/cases.
Given limitations inherent in modeling methodology,
data timeliness, and projection reliability, this indicator
provides a high level view on overall progress.
However, coupled with KPI 4, cascading these targets
down to regional/country level will increase
accountability and help to close the loop.
The measure should be interpreted with these
limitations in mind or reported separately as a high
level tracking measure rather than a KPI.
Estimated number of lives saved or reduction in deaths

Reduction in new infections/cases
Estimates produced by WHO/UNAIDS use standardized

models and country-specific data with variable quality and
availability. Country-level impact modelling is being undertaken
for select countries
Decision required on whether impact measures should be
expressed in terms of lives saved or reduction in deaths.
Numerical targets will be aligned with the investment case
modelling which has been developed with partners
Data is available with a one-year lag, and is sensitive to
changes to the modelling methodology and changes to
historical data
15
Strategic Targets
KPI 1

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Indicator dimensions
Dimension
Accountability
Data availability
Actionable & reliable

results
Coverage
Projection available
Comment
Contribution
Structured
Data is sourced externally. Global Fund contribution to overall impact is

estimated in-house
Indicator works as more of a high level tracker. Target setting will be

informed by the replenishment result and allocation model assumptions.
Disaggregation of targets to region/country levels will inform analysis of
performance along with results for KPIs 2, 3, 4 & 7.
Full portfolio
Sophistication of the projection methodology is being improved. Targets will

require periodic recalibration to take into account changes to modelling
methodology and historical data
Annually
Data is reported with a one-year lag due to partner data collection schedules
16
Strategic Targets
KPI 2

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Performance against service delivery targets
Strategic Vision
Measure
Invest funds to maximize portfolio

impact
a)
b)
c)
d)
# of people alive on ARV therapy

# of TB cases treated according WHO end TB strategy
# of LLINs distributed
# of bacteriologically confirmed drug resistant TB
treated with a 2nd line regimen
Aim of indicator
Measures extent to which the Strategic Objectives are
achieving the high level service delivery targets.
Services tracked as part of the measure will be
reviewed with technical partners to ensure alignment.
As projection methodology is strengthened and results
forecast is institutionalized, the indicator will drive
portfolio performance management in conjunction with
ITP project.
e)
f)
g)
# males circumcised
# of IRS services delivered
# of people who received HIV testing
& counseling and know their results
Validity: Global Fund share of national results will be based on a

contribution model
Availability: Data reported with a 6 month lag

Reliability: Country- and secretariat-level data/system limitations
Work with partners to ensure consistent application of reporting
guidance (eg. Reporting of full national results)
Accurate projections will be key: An operational KPI tracking forecast
accuracy will embed results forecast into Secretariat decisions
Data Management for Impact initiative & Project AIM will improve
data and systems for reporting internally and at country level
17
Strategic Targets
KPI 2

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Performance against service delivery targets
Dimension
Accountability
Data availability
results
Coverage
Frequency of
reporting
Comment
Contribution
It is proposed that all grants will report national results, however, the Global Fund
share of national results will be determined based on a contributive model
System
Target setting will be informed by the replenishment result and allocation model
assumptions. KPI performance is affected by expected levels of service delivery
being signed into grants and intervention level grant performance.
Full portfolio
Countries representing 90% of investment will report semi annually with annual
reports from whole portfolio. Projections could fill gaps for semi-annual reporting
Semi
annual
Data is reported with a six-month lag
18
Strategic Targets
Op-KPI

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Strategic targets
Examples of more attributable Operational KPIs that aim to monitor whether:

Strategic level service delivery targets are built into grant agreements
Programs are able to deliver the expected levels of service
Programs are able to expend the funds budgeted for service delivery
Examples of potential Operational KPIs
Aim
Percentage of expected service delivery targets:

i. Built into concept note submissions;
ii. Signed into grant agreements
Portfolio level targets of KPI 2 will be aggregated from estimates of

country level service delivery. The first step in ensuring these
targets will be achieved will be to ensure that expected service
delivery is built into concept notes and grant agreements
Percentage of program level service delivery targets

achieved
This will enable service delivery performance to be disaggregated

and more effectively tracked at the regional & country level
Intervention level absorptive capacity

(grant expenditure / grant agreement budget)
An early warning of potential underperformance on service delivery

will be underspending in grants at the intervention budget level
19
Investing to End Epidemics strategic objectives
Build Resilient
& Sustainable
Systems for
Health
Maximize Impact
Against HIV, TB
and malaria
Mobilize
Increased
Resources
Promote and
Protect Human
Rights & Gender
Equality
1. Maximize Impact Against HIV, TB and malaria

Innovative approaches to meet diverse country needs are essential to accelerate the end of the epidemics
a) Scale-up evidence-based interventions with a focus on the highest burden countries with the lowest economic capacity and on key and
vulnerable populations disproportionately affected by the three diseases
b) Evolve the allocation model and processes for greater impact, including innovative approaches differentiated to country needs
c) Support grant implementation success based on impact, effectiveness, risk analysis and value-for-money
d) Improve effectiveness in challenging operating environments through innovation, increased flexibility and partnerships
e) Support sustainable responses for epidemic control and successful transitions
20
Strategic Targets
KPI 3

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Strategic Vision
Further improve alignment of investments with
country need
Aim of indicator
The measure tracks the extent to which the Global
Fund is able to rebalance the grant portfolio to
effectively invest funds in the countries where need is
greatest.
The current replenishment period has seen a major

improvement in rebalancing, providing a solid basis
for further improvements going forward.
Measure
Alignment between investment decisions and country "need"; with
need defined in terms of disease burden and ability to pay
Accuracy of target setting will be determined by the Mid-Tem Plan

three year financial forecast
Country need is determined by the allocation model. The feasibility

of revising the disease burden metric of the model is being assessed
GNI has limitations as a measure of ability to pay in the health and
development context relevant outcomes of the Equitable Access
Initiative may be considered by the SIIC as it reviews the allocation
methodology, specifically with respect to economic capacity
Performance is driven by the design of the allocation

model and the ability of countries, particularly those
with high burden and low economic capacity, to use
allocated funds.
21
Strategic Targets
KPI 3

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Dimension
Accountability
Data availability
results
Coverage
Comment
Attribution
System
Illustrates extent to which grant expenses are committed to countries with most
need, and not necessarily those with best absorption. Provides a control for KPI7
Fund utilization
Full portfolio
Based on Mid-Term Plan commitments forecast
Quarterly
22
Strategic Targets
KPI 4

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Strategic Vision
Increase the efficiency of program design to
maximize impact of fund investments
Aim of indicator
Measure
Improvement in cost per life saved or infection averted from
supported programs
Increased use of disease impact models to improve the

design of country-level programming will increase value
for money of grant investments this indicator will track
the these gains
The indicator will close of the loop by linking grant level

programmatic targets and investments with strategic
targets which will be set using partner supported
disease impact models
The indicator provides a strong link to the objective on

strengthening national strategic plans, and provides an
opportunity to link this modelling effort to cost-effective
service modalities (e.g. community based care models)
and the work on program level quality
Limited partner capacity currently available to support country

level modelling
A new regional approach to providing country support is being
implemented through the Value for Money Special Initiative
Costing data needs to be improved for this exercise to become
effective
A Cost consortium partnership with the Gates foundation has

recently started with aims to address these gaps
23
Strategic Targets
KPI 4

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Dimension
Accountability
Data availability
results
Coverage
Comment
Contribution
Focus is on the national strategic plan, not Global Fund specific
Structured
Building disease modeling into grant processes will increase data availability
Close country engagement during modelling process will increase scope for
taking action
Portfolio
segment
Semi
annually
Initial focus on high impact portfolios, but there is also a demand for modelling in
UMICs
The KPI result is already a projection

Countries will mostly use disease models during Concept Note and/or NSP
development there may be one data point every 3 years per country assessed
24
Strategic Targets
KPI 5

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Service coverage for key populations
Strategic Vision
Measure
Reduce the number of new infections in key and

vulnerable populations disproportionately affected
by the three diseases
Coverage of comprehensive prevention services in key populations
Aim of indicator
Indicator will track provision of comprehensive HIV

prevention services to specified key population groups
These groups face the double burden of low coverage of
prevention services and high rates of infection. Increased
coverage of preventions services will be essential to
accelerate the end of the epidemic
Indicator builds on work undertaken during the current

strategy to measure the size of key populations in 55
countries
Proposal has close links to the strategic objectives in SO3
on removing barriers to accessing services, SO2 on data
systems
Considerable data limitations: Advice from technical partners

indicates that data on new infections is not readily available or
may lack in sufficient quality to use to track HIV incidence in key
populations, and treatment provision to key populations is not
tracked
Technical partners suggest to track service coverage for these
population groups
A number of issues are currently being addressed: methodology

of coverage measurement; how to bridge data gaps between
surveys; potential risk of harm to these populations and
minimization of that risk; country coverage
Indicator focuses on HIV only
New Global Plan for TB has a focus on key populations, but work
remains at an early stage of development
25
Strategic Targets
KPI 5

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Service coverage for key populations
Dimension
Accountability
Data availability
results
Coverage
Comment
Contribution
Not yet
available
No routine data collection exists at country level either through surveys or

programmatic monitoring
Portfolio
segment
?
Annually
Countries will be selected from the 55 expected to have key population size
estimates by the end of 2016 (HIV only)
If baseline coverage data available, projections may be possible based on
availability of service delivery targets in Performance Frameworks focusing on
key population interventions
Each reporting period will include few new data points as countries may only
conduct surveys every 2-3 years
26
Strategic Targets
Op-KPI

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Maximize impact against HIV, TB & malaria

Disease impact modelling is being used to inform national program design
Programs are adequately investing in and delivering services targeting key populations to maximize impact
against the three diseases
Aim
Percentage of prioritized countries where country level

modelling has been employed to maximize the impact of
program design
Percentage of prioritized countries with a comprehensive
package of interventions for key populations built into
program design
Percentage of program level key population service
delivery targets achieved.
Absorptive capacity for key populations interventions
and population groups
Country disease impact modelling, with full engagement of country

level actors, will ensure that program design is informed by the best
available evidence
Tracks roll out of key population programming across the portfolio
This will enable service delivery performance to be disaggregated

and more effectively tracked at the regional & country level
An early warning of potential underperformance on intervention
coverage for key populations will be underspending in grants on
these services
27
Build Resilient
& Sustainable
Systems for
Health
Maximize Impact
Against HIV, TB
and malaria
Mobilize
Increased
Resources
Promote and
Protect Human
Rights & Gender
Equality
2. Build Resilient and Sustainable Systems for Health

Strengthening systems for health is critical to attain universal health coverage and to accelerate the end of the epidemics
a) Strengthen community responses and systems
b) Support reproductive, womens, childrens, and adolescent health, and platforms for integrated service delivery
c) Strengthen global and in-country procurement and supply chain systems
d) Leverage critical investments in human resources for health
e) Strengthen data systems for health and countries capacities for analysis and use
f) Strengthen and align to robust national health strategies and national disease-specific strategic plans
g) Strengthen financial management and oversight
28
Strategic Targets
KPI 6

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Strengthen systems for health
Strategic Vision
Increase the share of countries with resilient and
sustainable national systems for health that meet
standards for use by Global Fund programs
Aim of indicator
Indicator should provide portfolio-level view of national health
system strength based on explicit risk, functional and quality
standards
Measure
Share of the portfolio that meet expected standards for:
a) Procurement and supply chain systems
b) Financial management systems
c) Data systems and analytical capacity
Limitations & mitigation measures
Measure should improve alignment between risk assessment

and systems strengthening investments
Indicator provides a common metric for comparing quality of
systems differentiated standards for systems would align with
aid effectiveness and IHP+ principles and could link to strategic
objectives on sustainability and transition
This measure will aggregate data from a number of linked
operational KPIs (see slides 33-45) providing a more granular
assessment for each of the three sub-systems
Agreement will be needed internally and with relevant partners on

expected functional and quality standards
Careful consideration will be needed to ensure that definitions and
standards are relevant to country context, in particular for
procurement systems where potential incentives to exit pooled
procurement will need to be countered
Data collection mechanisms do not yet exist or will require
considerable revision for the linked operational KPIs
A clearly defined control structure for signing off systems as compliant
would need to be developed and implemented to limit potential
gaming
29

HIV, TB and malaria
Strategic Targets
KPI 6

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Strengthen systems for health
Dimension
Accountability
Data availability
results
Coverage
Frequency of
reporting
Comment
Contribution
Not yet
available
Systems do not yet exist for some of this data. Health facility assessments & PQR
may provide some data
Measure represents aggregate measure for strategic level reporting. Operational

indicators should drive performance improvement in each focus area
Portfolio
segment
Annually
Cohort of countries sampled may differ across the three focus areas
Likely no projections will be available for forecasting system improvements
Each reporting period may include few new data points for some elements, as
countries may only conduct health facility assessments every 2-3 years
30
Strategic Targets
KPI 7

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Fund utilization
Strategic Vision
Increase the rate at which countries effectively absorb
allocated funds
Aim of indicator
A resilient and sustainable system for health should be able to
effectively use the full allocation of funds to deliver services to
increase program impact. This will be measured in two ways:
a) Allocation utilization provides high level view on the
extent to which:
countries can use their allocation, and
the Secretariat can optimize portfolio level investments
b) Absorptive capacity measures whether programs can
spend the budgeted funds
measure will focus on the 20 ITP countries with strong
links to Supply Chain Investment work and other
absorption related initiatives
Measure
a) Allocation utilization
Grant Expense (actual + MTP) / Allocation
b) Absorptive capacity
Cum. expenditure / Cum. grant agreement budget
The Allocation utilization indicator risks two negative incentives:

1. Over-commitment to meet allocation
Risk controlled by indicators tracking absorption and cash

balance (absorptive capacity, fund absorption rate, cash
balance)
2. Re-direction of funds through portfolio optimization from

portfolios with the greatest need to portfolios better able to
absorb funds without dealing with underlying health system
constraints
Risk controlled by KPI-3 on alignment between investments

and need
31
Strategic Targets
KPI 7

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Fund utilization
Dimension
Accountability
Data availability
Comment
Mix
System
Allocation utilization: attribution; Absorptive capacity: contribution
Sourced from existing systems for grant expense actuals and forecasts, as well
as Enhanced Financial Reporting systems to provide expenditure data

results
Directly highlights absorption problems as they arise and guides portfolio

optimization efforts
Coverage
Mix
Allocation Utilization will cover whole portfolio, while Absorptive Capacity will
cover only selected countries
Mix
Allocation Utilization will be forecast as part of the Mid-Term Plan, but Absorptive
Capacity is based on country expenditures and cannot be forecast
Quarterly
32
Strategic Targets

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Example Operational KPIs for RSSH

Note: The proposed Corporate KPI 5 Strengthen systems for health has been designed to
aggregate the results of a series of operational KPIs. For that reason these operational KPI
proposals have been further developed as set out in this next section. This information
would be complemented by expenditure tracking for each of the RSSH three focus areas.
33
Strategic Targets
Op-KPI

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Strengthen systems for health: a) procurement
Strategic Vision
Measure
Countries have sufficient procurement capacity to achieve

improved procurement outcomes
Improved outcomes for procurements conducted

through countries national systems:
a) Price; b) OTIF delivery; c) Administrative lead time
Aim of indicator
Ensure that procurement capacity is actually delivering

improved outcomes in terms of prices, on-time delivery
and lead time
PQR could be primary data source, but this would mean delays
in data reporting (sometimes up to one year)
May be challenging to track administrative lead time without
additional data request to country
Outcomes can be impacted by factors outside the procurers
control (e.g. changes in market conditions for API can impact
price or OTIF)
Focus procurement capacity-building efforts on

delivery of results, rather than delivery of service
Should lead to OIG country audits identifying
procurement activities as major area of concern is
decreasing
Could consider amending trigger for data entry to PQR

Compare country outcomes to international benchmarks
34
Strategic Targets
Op-KPI

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Strengthen systems for health: a) procurement
Dimension
Accountability
Data availability

results
Coverage
Comment
Contribution
Not yet
available
Currently data systems only exist for countries participating in PPM. Price data,
OTIF and Lead Time could be sourced through PQR, though with up to one-year
lag
Portfolio
segment
Countries that participate in procurement and capacity building programs. Issue

also of considerable relevance to UMICs
Projected prices may be available, OTIF and Lead Time forecasts may not be
possible
Annual
Data points available at each reporting period may be limited given PQR and
OTIF data coverage
35
Strategic Targets
Op-KPI

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Strengthen systems for health: b) supply chains
Strategic Vision
Measure
Health facilities have the tracer medicines and diagnostics

required to deliver high quality services for AIDS, TB &
Malaria
a) Percentage of health facilities with tracer medicines available

on the day of the visit
b) Percentage of health facilities providing diagnostic services
with tracer items on the day of the visit
Aim of indicator
To measure the extent to which investments in

strengthening the different components of health
product management systems contribute to the
uninterrupted availability of essential health products at
service delivery points
This is based on the mean availability score for 10 -15

tracer items, and aligned with the recommendations of
the interagency task force.
Diagnostic services readiness (i.e. the capacity of the

health facility to provide laboratory diagnostic services)
based on a list of tracer lab items
Health facility assessments would provide data every two years,

other systems may exist in country but data quality is uncertain
Range of tracer items is country specific, may include items for
programs other than HIV, TB and malaria
Stock out on the day is a Y/N; not a measure of stock-out days
Harmonize indicator measurement (guidance on tracer items &
calculation of availability)
Exploring potential option to collect additional, more frequent
measures (stock outs, expired medicines) through sentinel
surveillance as part of Assurance Model to complement health
facility assessments every 3 years
36
Strategic Targets
Op-KPI

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Strengthen systems for health: b) supply chains
Dimension
Accountability
Data availability
results
Coverage
Comment
Contribution
Not yet
available
Some data may be available through health facility assessments, but likely not
at the frequency required for this indicator to be useful
Depending on system developed for data collection, results should reveal

where supply chains are in need of strengthening
Portfolio
segment
Likely data will only be available from countries conducting health facility
assessments or similar surveys
tbc
37
Strategic Targets
Op-KPI

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Strengthen systems for health: c) financial management
Strategic Vision
Measure
Implementer financial management systems in key

countries are sustainable and meet standards for use by
Global Fund programs
a) Number of public financial management transition efforts in high priority

countries completed
b) Number of countries with financial management systems meeting defined
standards for optimal absorption & portfolio management
Aim of indicator
Financial management is a critical process and enabler in

delivering program impact from investments. The indicator goals
are as follows:
Indicator (a): will focus on use of country systems (i.e. elements

of public financial management system) and will measure #/% of
PFM system components used by GF in concert with development
partners under the IHP+ framework in 15 high priority countries
Indicator (b): will address routine financial management capacity
gaps outside PFM scope in indicator (a) and will measure #/%
qualified audits; #/% of timely & accurate financial reports (AFR,
quarterly expenditure reports); #/% of qualified finance personnel
Partner buy-in for use of country systems may not be forthcoming

Effective engagement within IHP+ to influence other partners and foster
harmonization
In-country capacity, ownership and co-ordination is a challenge for public
financial management initiatives
Mobilize IHP+ partners to conduct Joint Financial Management Capacity
Assessments (JFMAs) with consolidated action plans; and engagement of
CTs for follow up of action plans
Establishing baseline data for PFM performance may be a challenge
Co-ordination with IHP+ including in-country studies to collect required data
Weak PR capacity & coordination in capacity building
Co-ordinate approach to provision of financial management technical
assistance & provide clarity on requirements (e.g. financial management
handbook for implementers)
38
Strategic Targets
Op-KPI

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Strengthen systems for health: c) financial management
Dimension
Accountability
Data availability
results
Coverage
Mix
Not yet
available
Portfolio
segment
Indicator a: Contribution; Indicator b: Attribution

System to track this information is not yet available
Assessment of national system strength should guide investment and system
strengthening focus in the 15-20 selected countries
15-20 priority countries will be targeted
Semi
Annually?
Each reporting period will include few new data points as 15-20 countries may
only conduct assessments periodically (tbc)
39
Strategic Targets
Op-KPI

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Strengthen systems for health: d) HMIS coverage
Strategic Vision
Well functioning HMIS enables better decision making and
ultimately better programs
Measure
Percent of high impact countries with fully deployed (80%
of facilities reporting for combined set of indicators),
functional (good data quality per last assessment) HMIS
Aim of indicator
While many Global Fund supported countries can now

report on key indicators for HIV, TB and malaria, many are
still reliant on survey data or global estimates. To really be
able to use data for program improvement, data need to be
available routinely. Significant investments are being made
to building these routine HMIS and this indicator measures
the success of these investments
The indicator is designed to measure two key aspects of an

HMIS system that have proven problematic in the past
coverage (fully deployed) and functional (defined in terms of
data quality)
This also aligns with international priorities set out at the
Measurement Summit in June by Global Health Leaders
This indicator does not measure data use directly, rather the
completeness and functionality of the information systems needed for
facilities/districts to have access to the data and tools to use the data
This aligns well with the significant GF investments into deploying and
improving these systems, as well as with international priorities
This KPI options alignment with investments and priorities, and its
feasibility to measure and reflect change, make it a preferred option of
for this KPI. However, the data are still more likely to be available for
high impact and core countries than focus countries
Strengthening HMIS is a priority workstream of the Global
Collaborative from the Measurement Summit, and specific tasks are
planned around this
40
Strategic Targets
Op-KPI

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Strengthen systems for health: d) HMIS coverage
Dimension
Accountability
Data availability
results
Coverage
Contribution
Not yet
available
Portfolio
segment
HFAs and HMIS desk review are proposed as primary data sources
Assessment of HMIS coverage and data quality should guide investment and
data system strengthening focus in the countries monitored
Data will be more prevalent in High Impact and core countries
Annually
41
Strategic Targets
Op-KPI

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Strengthen systems for health: e) ability to report on key indicators
Strategic Vision
Countries are able to report on the minimum set of outcome
and impact indicators to enable country monitoring and
meet international commitments
Measure
The percent of high impact and priority countries that were able to
report on core set of HIV, TB, Malaria and RMNCH indicators
Aim of indicator
Mobilize Increased
Resources
A set of high level indicators have been selected for each

diseases/program area that measure key aspects of the
program in terms of measuring performance. It is critical that
GF-supported countries have this minimum set of data for their
own purposes to understand the epidemic and their programs,
as well as for Global Fund (and other donors) to understand
basic performance and any changes to the epidemiology
The indicator will include the ability of countries to report data
disaggregated by age and sex, and to report on selected key
populations indicators
Gaps remain even within the High Impact countries ability to
report on these indicators. This indicator aims to bring attention
to this issue for PRs and key stakeholders
Establishing data systems or a survey to produce data is a longer-term

process. This indicator may not show rapid change, but should show
progress over time
In the short-term, having the basic data is important, but this indicator
doesnt demonstrate the source of the data. A country may be reliant on
a survey or modelling for some data values, when quality routine data is
preferable for program utility
A comprehensive mapping has been done by country and by indicator in
the High Impact and other priority countries to specifically identify gaps
and resource needs
GF is investing significantly in routine HMIS systems through grants
42
Strategic Targets
Op-KPI

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Strengthen systems for health: e) ability to report on key indicators
Dimension
Accountability
Data availability

results
Coverage
Contribution
Structured
Indicator will use existing grant performance frameworks complemented by

additional data collection on key indicators. Current systems do not track
countrys ability to report data disaggregated by age and sex
Portfolio
segment
Indicator will likely assess High Impact and core countries
Annually
Cohort of countries assessed at each reporting period will change depending on

expected update schedule
43
Strategic Targets
Op-KPI

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Strengthen systems for health: f) use of data
Strategic Vision
Measure
Countries not only have data available, but also use those
data to improve planning, budgeting, allocation process
and quality improvement
Number of countries that are using WHO DQR or PRISM

tools to analyze their data, and/or are putting into place
quality improvement monitoring
Aim of indicator
To track the extent to which countries have the data systems
and the capacity for analysis and decision making to improve
the efficiency and effectiveness of service provision
Ethiopia, Rwanda and Senegal cited as examples to inform
development of this strategic objective
Indicator does not measure true use of data, but rather the countrys
use of data quality and data use tools
Periodic surveys would provide data on this KPI every two years, and
for only a portion of the portfolio
As a complement to this KPI, evaluations every three years on

data use for in-country decision making may provide additional
information beyond the use of tools
There are current discussions of harmonizing and incorporating data
use measurement into the WHOs Data Quality Review tools which the
Global Fund is supporting - this would provide an option for measuring
data use across high impact countries in the long term
44
Strategic Targets
Op-KPI

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Strengthen systems for health: f) use of data
Dimension
Accountability
Data availability
results
Coverage
Comment
Contribution
Not yet
available
Portfolio
segment
Annual desk reviews and PR interviews will provide indicator data
Results should guide future investments in health systems
Evaluations would be rolled out only in High Impact portfolio, for example
Annual
Additional outcome evaluations on data use for decision-making could provide

information on the efficiency and effectiveness of program management
45
Build Resilient
& Sustainable
Systems for
Health
Maximize Impact
Against HIV, TB
and malaria
Mobilize
Increased
Resources
Promote and
Protect Human
Rights & Gender
Equality
3. Promote and Protect Human Rights and Gender Equality

Promoting and protecting human rights and gender equality is required to accelerate the end of the epidemics
a) Scale-up programs to support women and girls, including programs to advance sexual and reproductive health and rights
b) Invest to reduce health inequities including gender- and age-related disparities
c) Introduce and scale-up programs that remove human rights barriers to accessing HIV, TB and malaria services.
d) Integrate human rights considerations throughout the grant cycle and in policies and policy-making processes
e) Support meaningful engagement of key and vulnerable populations and networks in Global Fund-related processes
46
Strategic Targets
KPI 8

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Strategic Vision
Reduce gender and age disparities in health
Aim of indicator
HIV infection rates among young women are twice as high
as among young men in some regions. The indicator will
track the extent to which an enhanced programmatic
focus on women and girls results in a reduction in new
infections in selected countries with large disparities in
incident infections
This objective is closely linked to other strategic objectives
focused on scale-up of programs supporting women and
girls; advancing sexual and reproductive health and
rights; support to womens, childrens, and adolescent
health; and removing barriers to access
Measure
HIV incidence in women aged 15-24
Considerable data limitations: Advice from technical partners

indicate that current modelled data on numbers of new infections can
indicate a trend but not a statistically significant change attributable to
an enhanced focus on women and girls
Technical partners recommend use of improved sex and age
disaggregated models that are currently under development and
should provide data from 2017. Any targets approved in 2016 may
need to be recalibrated in 2017
Data are reported with a one year lag
Projection models would need to be developed to enable effective
tracking
47
Strategic Targets
KPI 8

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Dimension
Accountability
Data availability

results
Coverage
Comment
Contribution
Structured
Sourced from UNAIDS, modelled data of new incident cases, reported with a one
year lag
Portfolio
segment
?
Annually
Cohort of countries to be defined based on where disparities are greatest

Projections will be required if performance on this objective is to be effectively
managed
With a one year lag emphasizing the need for good projections and
complementary data
48
Strategic Targets
KPI 9

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Human rights: a) Reduce human rights barriers to services
Strategic Vision
Measure
Human rights barriers to services are reduced, resulting in

improved uptake of and adherence to treatment and
preventions programs
# of priority countries with comprehensive programs aimed at

reducing human rights barriers to services in operation
Aim of indicator
With a focus on 15-20 priority countries this indicator will

measure the extent to which comprehensive programs to
tackle human rights barriers to access are established
Human rights interventions to reduce barriers to service are well

defined for HIV, but more work is needed for TB & Malaria (Malaria
will be conducted as a second phase in 2017)
The programs will be designed around the 7 key interventions

to reduce stigma and discrimination and increase access to
justice of UNAIDS
Specific indicators to track progress beyond those proposed by WHO

need to be defined and tracking systems to collect the relevant data
will have to be established in countries
Where available, established WHO indicators for assessing

enabling environments will be used to track progress in
operationalizing the interventions
The in-depth evaluations will use mixed-method assessment of

human rights barriers and interventions that reduce barriers. This is
a relatively new idea with respect to health programs, but a solid and
program-relevant assessment method could set a useful precedent
for such assessments for policy-makers and program practitioners
The aim is that these programs will contribute to a meaningful

reduction in human rights barriers to services and that
increased access will lead to increased impact. This will be
measured through in-depth evaluations as baseline in 2016, at
mid-term in 2019 and at the end of the strategy period in 2022
The Global Fund has a key niche as the major funder of interventions
aimed at removing legal barriers to access. There is strong backing
from partners for this work WHO, UNAIDS, OSF, Ford
49
Strategic Targets
KPI 9

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Human rights: a) Reduce human rights barriers to services
Dimension
Accountability
Data availability

results
Coverage
Comment
Contribution
Not yet
available
Portfolio
segment
The global fund has a key niche role as the major funder of interventions aimed at
removing legal barriers to access, but partner support remains key
Considerable work will be required to build the necessary tracking systems
The country dialogue and Concept note development stages will be key, as will be
using the time before then to start building capacity and partnerships. After these
stages of the funding process, building human rights programs into grant design
will become increasingly difficult
Countries will be selected across different epidemic, burden, conducive
environment and barrier contexts
tbc
50
Strategic Targets
KPI 9

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Human rights: b) key populations and human rights in middle income countries
Strategic Vision
Increase programing for key populations and human
rights in middle income countries
Measure
Percentage of country allocation invested in programs targeting
key populations and human rights barriers to access in middle
income countries, for:
i) Generalised epidemics
ii) Concentrated epidemics
Aim of indicator
To ensure a successful transition, comprehensive

programs for key populations and human rights will
have to be established in middle income countries
before they reach this stage
These plans would have to be integrated in to funding,

eligibility and domestic investment policies
This objective could be operationalized by enhancing

the focus of stipulations in funding policy that a set
percentage of the allocation for countries be invested
in programs targeting key populations and human
rights barriers to access
51
Strategic Targets
KPI 9

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Human rights: b) key populations and human rights in middle income countries
Dimension
Comment
Accountability
Attribution
Data availability
Structured

results
Coverage
Portfolio
segment
A KPI will not be required if funding policy is sufficiently specific and rigorously
enforced
Middle income countries
A projection should be possible when new grants, subject to these stipulations,
come into force
Quarterly
52
Strategic Targets
KPI 9

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Human rights: c) key populations and human rights in transition countries
Strategic Vision
Upper middle income countries in transition take over
programing for key populations and human rights
Measure
Percentage of funding for programs targeting key populations and
human rights barriers to access from domestic (public & private)
sources
Aim of indicator
To measure the extent to which, in upper middle

income countries transitioning out of Global Fund
support, governments recognize that support to
services for key populations is essential and
increasingly take over responsibility for and funding of
these services
This would allowing remaining external funding to be

used to support initiatives that support effective
transition
These plans would have to be integrated into funding, eligibility

and domestic investment policies
Initiatives that support effective transition will be defined in early
2016 and tracked at the operational level
Criteria would be required to define countries in transition e.g.

transition expected within 10 years
In some countries, even sustained efforts are unlikely going to
lead to governments to take over funding of services for key
populations and human rights programs
53
Strategic Targets
KPI 9

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Human rights: c) key populations and human rights in transition countries
Dimension
Accountability
Data availability
results
Coverage
Comment
Contribution
Portfolio
segment
Tracking may be possible through UNAIDS sources and through counterpart

financing and willingness to pay mechanisms
If suitable policy levers to enforce compliance can be introduced
Cohort of countries to be defined. HIV and TB programs only
Formal projections are unlikely to prove accurate, but risk of non-compliance

could be tracked on a more qualitative basis
Annually
There will be a lag of 24-30 months after the start of the replenishment period
54
Strategic Targets
Op-KPI

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Promote and Protect Human Rights & Gender Equality

Interventions to tackle gender and age disparities and human rights barriers to access are being rolled out
in prioritized countries
Aim
Percentage of females at higher risk, in target districts of

priority countries, who completed a standardized HIV
prevention intervention during the reporting period
A measure of service coverage for districts where the

Global Fund is a significant funder of interventions
targeting women & girls
Absorptive capacity for interventions targeting:

i. removing human rights barriers to access
ii. women & girls
An early warning of potential underperformance on

human rights and women & girls will be underspending
in grants on these services
Note the planned in-depth country-level evaluations of human right barriers to access proposed for 2016, 2019 & 2022 will
provide an additional source of information to understand the performance of the Global Fund in this area
55
Build Resilient
& Sustainable
Systems for
Health
Maximize Impact
Against HIV, TB
and malaria
Mobilize
Increased
Resources
Promote and
Protect Human
Rights & Gender
Equality
4. Mobilize Increased Resources

Increased programmatic and financial resources from diverse sources are needed to accelerate the end of the epidemics
a) Attract additional financial and programmatic resources for health from current and new public and private sources
b) Support countries to use existing resources more efficiently and to increase domestic resource mobilization
c) Implement and partner on market shaping efforts that increase access to affordable, quality-assured key medicines and technologies
d) Support efforts to stimulate innovation and facilitate the rapid introduction and scale-up of cost-effective health technologies and
implementation models
56
Strategic Targets
KPI 10

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Resource mobilization
Strategic Vision
Increase the financial resources available to the
Global Fund for investment in programs to tackle
the three diseases
Measure
a) Actual pledges as a percentage of the replenishment target
b) Pledge conversion rate. Actual 5th replenishment
contributions as a percentage of forecast contributions
Aim of Indicator
A key objective of the Global Fund is to mobilize

resources for health from current and new public and
private sources
The indicator directly measures the volume of new

pledges made, and the extent to which these pledges
are fulfilled as contributions
The 5th replenishment launch is scheduled before the KPI framework

for the new strategy comes in to force. Therefore part a) will only be
measured in 2019
The current measure tracks pledge conversion on an annual basis,
which makes it sensitive to time shifts in contribution schedules
Improved forecasting methodology, developed during the current
replenishment period, will enable the measure to by tracked on a
three year basis maintaining accuracy but reducing the potential for
over-interpretation of small time shifts
57
Strategic Targets
KPI 10

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Resource mobilization
Dimension
Accountability
Data availability
results
Coverage
Comment
Contribution
System
Joint responsibility between Global Fund and donors to fulfil contribution

agreements
Directly sourced from Hyperion Pledge cube
Full portfolio
All donors are included in tracking
Quarterly
58
Strategic Targets
KPI 11

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Domestic investments
Strategic Vision
Measure
Domestic investments in programs for HIV, TB &

malaria continue to increase over the replenishment
period
Percentage of domestic commitments to programs supported by

the Global Fund realized as expenditures
Aim of indicator
An increase in domestic investments in programs

for HIV, TB and malaria are required to accelerate
the end of the epidemics and to foster sustainable
programs
The Global Fund directly supports these aims

through advocacy and access to funding policy
This indicator directly measures the extent to which

domestic health commitments are fulfilled to meet
this need
Current policies on eligibility, counterpart financing and

willingness to pay, including levers to drive performance need
to be strengthened
Internal roles and responsibilities on advocacy, monitoring and
accountability for performance need to be clarified and aligned
with expectations
The indicator focuses on conversion of commitments into
expenditures, not the scale of commitments
Policy in this area is under review with the aim to align and
streamline
Data on domestic commitments will be tracked as management
information
59
Strategic Targets
KPI 11

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Domestic investments
Dimension
Accountability
Data availability
results
Coverage
Comment
Contribution
Structured
No system exists currently to track this data, but this will be addressed by Project
AIM
Policy levers may need to be enhanced
Full portfolio
Annually
60
Strategic Targets
KPI 12

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Availability of affordable health technologies: a) Availability
Strategic Vision
Measure
A stable supply of key quality-assured health

products sufficient to meet country demand
Percentage of a defined set of products with more than two

suppliers that meet Quality Assurance requirements
Aim of indicator
Ensure that supply is available from multiple qualityassured manufacturers, reducing risk of supply disruption
Ensure a balance between decreasing prices and

maintaining a secure, stable supply base
Even with more than two suppliers, manufacturing capacity may

still be insufficient to meet demand, especially during peak times
Manufacturing capacity is estimated / self-reported by suppliers
and difficult to validate (as is global demand)
Promote competition between suppliers for key products

Align with Expert Review Panel requirements and
processes
Estimated manufacturing capacity vs. forecast annual demand

(GF and global) will be monitored as management information
61
Strategic Targets
KPI 12

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Availability of affordable health technologies: a) Availability
Dimension
Accountability
Data availability
results
Coverage
Comment
Contribution
Structured
Underlying data is currently tracked, but requires manual synthesis
Where risks are identified, a number of actions can be taken, such as: proactive
outreach to potential new suppliers, targeting ERP, reserving volumes for new
entrants in PPM tenders, employing mechanisms to incorporate new entrants in
existing PPM tenders
Full portfolio
As a global indicator, all countries will be included; however, only select products
will be tracked
Annually
62
Strategic Targets
KPI 12

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Availability of affordable health technologies: b) Affordability
Strategic Vision
Measure
Market shaping efforts reduce prices for PRs accessing

PPM framework agreements, yielding savings which can
be used to support unfunded programmatic needs
Annual savings achieved through PPM Framework Agreements on

a defined set of key products (mature and new), compared to the
prior year
Aim of indicator
Captures effectiveness in increasing the affordability of

key medicines and technologies
Reflects achievement of target savings based on tenders

conducted in the prior year and forecast demand
Takes into account market conditions for different

products in the PPM portfolio (e.g. anticipate greater
savings on new product strategies or recently introduced
products)
The measure does not capture affordability of products in countries

that do not access PPM framework agreements
Operational KPIs measuring RSSH achievements will provide
information for these countries
Cost avoidance (slowing the rate of cost increases) is not covered
due to difficulties in validating estimates
If considered alone, the indicator could lead to negative incentives for

product availability - driving reduced supplier base and reduced
investment
Benchmark reference prices for key products will be tracked as
management information
KPI 12a will be used to control for potential negative effects on
availability; management information will also track additional risk
indicators
63
Strategic Targets
KPI 12

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Availability of affordable health technologies: b) Affordability
Dimension
Comment
Accountability
Attribution
Data availability
Structured

results
Coverage
Underlying price data is captured via current systems, but requires manual
analysis. Forecast volumes are not captured via current systems
Target setting will be closely linked to anticipated volumes by product from PPM,
e-marketplace and other channels
Portfolio
segment
Countries that access PPM framework agreement prices as part of PPM, emarketplace or through other channels
This should be feasible with development of data capture system for LoHPs
Annually
Framework agreements are typically negotiated for a multi-year period and

therefore, little value added by more frequent reporting. In addition, large orders
in particular quarters can skew results if reported partway through the year.
64
Strategic Targets
Op-KPI

HIV, TB and malaria

Systems for Health
Promote and Protect

Equality
Mobilize Increased
Resources
Mobilize Increased Resources

Funding policy is supporting countries to increase domestic resources for HIV, TB & malaria
Supported programs are able to access affordable, quality-assured key medicines and technologies
Aim
Percentage of priority countries with national health

financing strategies
National health financing strategies will be developed with

prioritized countries to better understand their capacity to increase
funding to HIV, TB & malaria programs
Percentage of budgeted unit prices within expected

benchmarks for targeted products
This indicator measures extent to which reference prices are

disseminated and grants are taking advantage of price reductions
achieved by the Global Fund, including grants purchasing outside
of PPM
Percentage of demand forecasts for key products with

acceptable variance to actual demand
This indicator assesses the Global Funds ability to predict

demand for health products, which enables lower prices and more
consistent product availability
65
Annex
66
Timeline to Board Approval for the Corporate KPI Framework
End November:
Nov-March:
21 December:
11 January:
22 January:
Jan-Feb:
29 February:
Feb-March:
End-March:
Early April:
May-August:
Autumn:
Agreement internally on expectations for all SOs

Consultations with technical partners
1st MEC review and revision
2nd MEC review and revision
Circulate draft framework for constituency input
Consultation meetings with donor and implementer groups
3rd MEC review
Revision and review of pre-final proposal by Committees
4th MEC review
Final revisions to indicator selection & submission to Board
for approval
Finalization of indicator methodology, baselines and targets
Submission of full final framework to Board for approval
67
KPI Framework follows a logic model from inputs to impact
Attract funding
Invest efficiently
10: Resource
mobilization
3: Alignment of
investment with need
11: Domestic
investment
4: Investment efficiency
Bridge
investments to
services
6: Resilient &
sustainable systems
for health
Address key
challenges
5: Key population
service coverage
1: Performance against
impact targets
8: Human rights
2: Performance against
service delivery targets
7: Fund utilization
12: Availability of
affordable health
technologies
Deliver impact
9: Gender & age

equality
This alignment, complemented by Operational indicators, should provide early warning system for
tracking performance and taking management action
68
Focus the KPIs on needs for strategic level oversight

Strategic goals
Strategic
KPIs
Strategic
Objectives
Activity
specific
KPIs
Operational
KPIs
Strategic targets
2-3 KPIs measuring programmatic results and impact

HIV, TB and malaria
Build resilient &

sustainable systems for
health
Promote and protect

human rights & gender
equality
Mobilize increased
resources
8-9 KPIs tracking progress on strategic objectives
10 more granular measures guiding management action
Rationalize, standardize and align routine reporting to MEC, the Committees and the Board
69
Corporate KPI development is one component of a larger

exercise to measure performance at multiple levels
Element
Aim of measure
Main audience
Reporting
Corporate KPIs
12 indicators, including Strategic KPIs to measure

progress towards the impact targets, and activity specific
KPIs to measure progress against the Strategic Objectives
Board;
Committees;
MEC
Compiled 1-4
times per year
Operational KPIs
10 indicators to measure progress towards meeting

Corporate KPIs
MEC;
Secretariat
Compiled 4 times
per year
Thematic reporting
Metrics and qualitative reporting for elements out of KPI

scope of measurement; ideally drawn from management
information package
Board;
Committees;
MEC
Compiled
biannually
Management
information
Package of data reviewed at division and team level to

better understand performance on day-to-day basis
Secretariat;
MEC as
necessary
Regular
monitoring at
divisional level
Current
Focus
Corporate KPIs are only the leading edge of structured routine reporting
70
Existing standard reporting
Zoom in on Management Information & Thematic Reporting

Strategic corporate
KPIs
Strategic
Objectives
Corporate KPIs
1 Performance against impact targets

HIV, TB and malaria
3 Alignment of
investments & need
4 Investment efficiency
(as recently submitted to
SIIC/FOPC)
5 Service coverage for key

populations
2 Performance against service delivery targets
Build resilient & sustainable

systems for health
Promote and protect human

rights & gender equality
6 Strengthen systems for

health
7 Fund utilization
a) Allocation utilization
b) Absorptive capacity
9 Gender & age equality
Human rights
Mobilize increased resources

11 Domestic investments (current
OKPI)
12 Availability of affordable health
technologies
Indicators tracking progress towards Corporate indicators

Available to Board through corporate dashboard
To be developed to align with approved corporate framework in 2016
Operational KPIs
Management
Information &
Thematic
Reporting
Example gaps in standard reporting
Portfolio Report (pipeline,

investments, results, impact)?
Financial oversight
Human rights report?
Resource mobilization update
Key population report?
RSSH report?
Gender report?
Market Shaping report?
Regular updates: Risk management; Human Resources updates
Standardized thematic reporting under each Strategic Objective should provide consistent, quantitative & qualitative
information complementary to KPI Framework Major reporting gaps currently exist
71
Pyramidal hierarchy is in line with other development organizations
AfDB/AsDB uses four levels of

indicators to track performance
Levels 1 & 2 correspond to the
Strategic and Activity specific
levels of Global Funds pyramid,
and levels 3 & 4 correspond to
operational KPIs and
management information
Corporate
level
2017
2022
Strategic KPIs

Secretariat
level
Operational KPIs
Thematic Reporting &

Management Information
GAVI uses 3 mission indicators

and 11 Goal-Level KPIs to report
performance against Strategy
Pyramidal Monitoring & Evaluation
strategy fills operational-level
information gaps by monitoring
progress at country level
72
Global Funds Pyramidal KPI approach is aligned with other development organizations
Global Fund
Development Banks
GAVI
Strategic KPIs measure Global Funds progress against the

highest level impact targets: Lives Saved; Infections
Averted; Services delivered
Level 1 monitors development progress against

the two overarching goals: inclusive
growth and the transition towards green growth
Mission indicators measure progress towards overall

mission: save childrens lives and protect peoples
health by increasing access to immunization in poor
countries
Activity-specific KPIs capture the Global Funds progress

towards achieving the four Strategic Objectives: Maximize
Impact against the diseases; Build resilient & sustainable
systems for health; Promote and protect human rights &
gender equality; Mobilize increased resources
Level 2 captures the Banks five main channels

to deliver its work and improve the quality of
growth in Africa: infrastructure development,
regional integration, private sector
development, skills and technology, and
governance and accountability
Goal-level indicators capture progress towards

achieving the organizations four Strategic Goals:
Accelerate uptake; Strengthen capacity of systems;
Increase financing sustainability; Shape vaccine
markets
Operational
Operational KPIs tracking mostly input-level and MEC-level

indicators to ensure higher level indicators are met
Level 3 tracks the quality and effectiveness of

the Banks operations
Management
Information
Regular management reporting should fill information

gaps by providing consistent, rationalized reporting to MEC,
potentially Board-level. Examples: Risk report; HR
updates; Financial reporting; Priority Project updates
Level 4 measures progress in important areas

of internal reforms: decentralisation,
engaging and mobilising staff, and improving
cost-efficiency
Management information, like the Global Funds

Operational KPIs and internal management
information, is not publicly available. Pyramidal
Monitoring & Evaluation framework provides countryand portfolio-level progress measurement
Strategic
ActivitySpecific
73

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2017-2022 Corporate KPI Framework: Initial proposal for Board Constituency

Developing the 2017-2022 Corporate KPI Framework

Status of framework development

Context & guiding principles for framework revision

Status update of framework development

Developing the 2017-2022 Corporate KPI Framework

June Oct 2015

April 2015 - ongoing

All proposals developed

Full framework will

Written feedback will

Five MEC & Steering

Best practice from comparable organizations

Performance management framework includes

Strategic and activity-level KPIs will track Global

Tracking and reporting on strategic themes are

Corporate indicators will be directly underpinned by

Clear concise analysis is required to link and

Increased clarity will be provided on the levers for

Hierarchy of performance management framework

KPIs focused on global

KPIs to enable Board/

More granular measures

Activity specific KPIs

Principles guiding revision of the framework have been updated

Align the framework with the 2012-2016 Strategy

Set the Framework for the lifetime of the Strategy

Define a clear hierarchy with logical links between the

Activity specific KPIs should measure the overall effect of the

Reduce the number of KPIs and increase focus

Indicators should be measured on a meaningful number of

Complement the KPI framework with a regular Quarterly

Accountability should be clear and interpretation defined

Ensure indicators are visible and measurable

Secretariat-level information will complement Corporate level KPIs

KPIs to enable Board/ Committee

Activity specific KPIs

Thematic Reporting &

KPIs focused on global targets &

More granular measures measuring

Proposed change to the current framework

1 Performance against strategic

2 Quality and coverage of

10 Value for money

3 Performance against strategic service

12 Human rights 13 Resource

Transition out more operational measures and

Initial view on the 2017-2022 framework

1 Performance against impact targets

Invest funds to maximize

Improve the performance of

2 Performance against service delivery targets

Mobilize increased resources

Reduce human rights

Increase available resources for

6 Strengthen systems for

8 Gender & age

5 Service coverage for

The guiding principles were used to examine the proposed indicators

Data may currently be available in an existing system; collected in a structured

Actionable & reliable results

Results are replicable, reliable and guide Global Fund decision-making