I. Why does the Global Fund matter?
The Global Fund is the largest global donor to the HIV, tuberculosis, and malaria response. Since it was first created in 2002, the Global Fund partnership has contributed to cutting the combined death rate from AIDS, TB and malaria by 61% and has saved 65 million lives. For communities most affected by the three diseases, engaging with the Global Fund is an important way to make sure these health programs are impactful and reach the people who need services most.
The Global Fund operates differently than many other funders, in that it has a strong focus on community leadership and engagement. There are several ways this is achieved:
- The Global Fund supports at least $700 million per year in community-focused programs.
- The Global Fund funds community-led organizations worldwide to implement health programs.
- The Global Fund's Board has three delegations for civil society representatives, including one for communities.
- Decision-making at the country level is made by the Country Coordinating Mechanisms, which have community members sit on their board.
The Country Coordinating Mechanism, or CCM, is one of the most important ways for communities to engage in decision-making about Global Fund programs. Additionally, since CCMs are multi-sectoral bodies that include government representatives, bilateral funders, implementing organizations, and technical partners, these spaces are good opportunities to advocate for community priorities with every stakeholder in public health.
When communities do not engage with the CCM, there is a high risk that public health programs won't work. The voices of healthcare services users and key and vulnerable populations are essential to make sure that governments and implementers are accountable, that programs are impactful, and that decision-making is transparent to all stakeholders.
What is the purpose of this guide?
Engaging with the CCM and advocating to the Global Fund can be very difficult. While it is valuable that the CCM is a space with many different stakeholders, oftentimes the power imbalances and country politics can make it difficult for communities to do strong advocacy. This is even more challenging in contexts where key and vulnerable populations are criminalized and may not feel safe in the CCM space.
The way that the Global Fund works is also complicated. At first, the discussions at the CCM can be difficult to understand, since there are many technical terms, acronyms, and jargon. Without already understanding the Global Fund model, it can be difficult to know enough to participate.
The purpose of this guide is to provide communities with the information they need to get started engaging with the CCM. The goal is to give an in-depth primer of how the CCM works, what communities' role is, and what to do when things go wrong. By understanding their rights and learning the "Global Fund language", community members will be better able to be strong advocates for their needs.
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II. How to Use This Guide
Who is this guide for?
This resource is designed to support CCM representatives, and in particular those who represent communities and key and vulnerable populations. While it is oriented toward community priorities, the resource may also be useful for CCM members from other sectors.
In addition, the resource is intended to help advocates and community members who are not on the CCM to understand how to advocate to their CCM. It may be useful for those who are supporting advocates and CCM members, such as technical partners or technical assistance providers.
This resource has two ways to learn:
- Guide Mode (current view): Read comprehensive sections that provide context, explanations, and in-depth information about CCM engagement. FAQ blocks appear throughout the guide to address specific questions related to each topic.
- FAQ Mode: Switch to FAQ mode using the toggle at the top of the page to browse all frequently asked questions in one searchable library. You can filter by topic, search for specific terms, and quickly find answers to common questions.
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III. How Does the Global Fund Work?
Where are the Global Fund offices?
The Global Fund's headquarters, or Secretariat, is based in Geneva, Switzerland. Unlike many other international organizations, the Global Fund does not have any offices in the countries where it works. As a result, nearly every member of the Global Fund staff is based in Geneva.
However, the Global Fund does contract Local Fund Agents (LFA), which are usually local accounting firms, that perform some specific tasks on behalf of the Global Fund Secretariat. These activities include assessing the capacity of the Principal Recipient(s) to deliver the grants and conducting grant oversight (including site visits and reviewing progress updates).
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Geneva, Switzerland. Source: visualsoflukas
Where does the Global Fund receive its money from?
In the language of the Global Fund, there are two types of countries: "donor countries", which provide funding to the Global Fund, and "implementer countries", which receive the funding in order to provide healthcare services to people living with and affected by HIV, tuberculosis, and malaria.
Every three years, the Global Fund hosts a Replenishment conference, or summit, where all donors come together and announce how much funding they will give to the Global Fund. The vast majority of these donors are governments, but some are private sector organizations, foundations, or other non-governmental organizations. While most governments that pledge to the Global Fund are high income countries, many implementer countries also make solidarity pledges during the Replenishment.
Front row from right to left: Lars Klingbeil, Vice Chancellor and Minister of Finance of Germany; Jonas Gahr Støre, Prime Minister of Norway; Peter Sands, Global Fund Executive Director; Cyril Ramaphosa, President of South Africa; Dr. Aaron Motsoaledi, Minister of Health of South Africa; Sir Keir Starmer MP, Prime Minister of the United Kingdom; Lady Roslyn Morauta, Global Fund Board Chair; and Micheál Martin, Taoiseach, Prime Minister of the government of Ireland. Source: The Global Fund/Thabang Radebe.
The amount of money raised during the Replenishment determines the amount that will be available to countries in their grants. Over the next three years, donors transfer their pledged amounts to the Global Fund. This is called 'pledge conversion'.
In the past, pledge conversion was a relatively straightforward process. However, in Grant Cycle 7 (2023-2025), several donor countries stopped transferring their pledged amounts to the Secretariat on time. Because of this, the Secretariat implemented a 'reprioritization' exercise in 2025, in which countries were informed that their approved grants would need to be cut.
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Which countries receive funding from the Global Fund?
The first step in deciding who gets funding is the Eligibility List. Every year, the Global Fund publishes a list of every country's eligibility for support. Eligibility is specific to a disease, so your country could be eligible for HIV but not malaria, for example.
Eligibility is calculated using a formula, which is mostly based on each country's income level (for example, low income or lower-middle income) and the epidemiological disease burden for each of the three diseases (high or not high).
A Deeper Look: Is my country eligible for Global Fund funding?
Every year, the Global Fund publishes a list of every country's eligibility for support. Eligibility is specific to a disease, so your country could be eligible for HIV but not malaria, for example. Keep in mind that eligibility doesn't guarantee that you will receive funding, but eligibility is the first step.
→ Eligibility List
→ CCM Dashboard
What about eligibility transitions? When a country's disease burden drops, or if their national income level grows, they may become ineligible for additional funding. If you want to see if your country is likely to transition, you may review the Global Fund's report on projected transitions.
In general, every Low Income or Lower-Middle Income country is eligible for Global Fund funding. Upper-Middle Income countries are only eligible if they have a "high" disease burden, and High Income Countries are not eligible. There are a few other special rules or criteria; for example, countries become ineligible for malaria funding once they have officially eliminated malaria.
Importantly, eligibility doesn't actually determine if your country receives any funding. Your country could be eligible, but the Global Fund could still decide not to give (or 'allocate') any funding to your country. This is because the Global Fund does not have unlimited resources, so they cannot fund every country that is technically eligible. On the other hand, a country that is ineligible for funding could still receive funding as part of a multi-country grant, as long as they are grouped with other countries that are eligible.
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How much funding does my country receive from the Global Fund?
Eligibility is an important step toward receiving funding. However, the decision about which countries will receive grant funding is decided during the calculation of country allocations.
After the Replenishment is finished, the Global Fund's Board will approve the Sources and Uses of Funds for the three-year cycle. This decision point formally communicates how much of the total pool of funding will be used for country allocations, for catalytic investments, and for the operating expenses (OPEX) of running the Global Fund Secretariat itself.
The Global Health Campus (GHC) in Geneva where the Global Fund has its offices. Source: Guilhem Vellut.
Once the total funding for country grants has been approved, the Secretariat calculates how much will be available to each country and each component. This calculation happens in three steps:
- Global Disease Split. First, the total Global Fund resources are divided between HIV, tuberculosis, and malaria.
- Formula-Derived Amount.Secondly, the amount per country and component is calculated using a quantitative formula, which is based primarily on each country's economic capacity and disease burden. As part of this step, the amounts are adjusted to make sure that the amount per country isn't disproportionately large or small, relative to other countries. The amounts are also adjusted for other sources of funding each country has for health. Adjustments are also made for countries where funding is being scaled up or gradually reduced.
- Qualitative Adjustments.Finally, this calculated amount is modified based on 'qualitative adjustment factors', which allow the Secretariat to adjust the amounts based on each country's context. While this decision-making process is not publicly transparent, the Secretariat does report to the Board any time the country allocations are qualitatively adjusted by more than 15%, or by more than USD 5 million.
After the allocation amounts have been calculated, the Secretariat sends each country an Allocation Letter. These letters include several important pieces of information, including:
- The allocation amount for each eligible component;
- The exact dates of the three-year cycle when the funds may be used (this is called the Allocation Utilization Period);
- Whether the country is eligible for any Catalytic Investments;
- The 'co-financing' requirements, including guidance about how domestic resources should be spent;
- Guidance from the Secretariat about the types of activities or approaches that should be included in the Funding Request(s);
- The application and review approach that the Secretariat has decided that the country must use. This can be Full Review, Program Continuation, or Tailored for Transition.
The Global Fund does not publish Allocation Letters online. However, you may be able to find your Allocation Letter on the Global Advocacy Data Hub's GC8 Documents Hub. You may also find data on your country's Allocation amounts over time on the CCM Dashboard.
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Who decides how Global Fund funding is used?
After countries receive their Allocation Letters, the country must decide how the funds will be used. The first phase of planning how to use Global Fund funds is the development of the Funding Request. The Funding Request is a series of documents that are completed by the CCM, through a consultative process that includes civil society, and that are submitted to the Secretariat.
The following Funding Request documents are required from all countries:
- The Funding Request Form;
- The Performance Framework;
- Funding Landscape Table;
- Prioritized Above Allocation Request (PAAR);
- National Strategic Plans;
- CCM Statement of Compliance;
- CCM Endorsement of Funding Request
For countries that will be going through "Full Review", the following documents are additionally required:
- Detailed Budget (only a Summary Budget is required for other countries);
- Programmatic Gap Tables;
- Funding Priorities from Civil Society and Communities;
- Assessment of Equity, Human Rights and Gender Related Barriers to Health Services (mandatory for High Impact countries only).
Finally, countries undergoing "Transition / Focused" review are required to submit Sustainability and Transition Documentation.
Funding Requests are submitted to the Secretariat on a rolling basis, with countries able to choose between several review "windows" that will allow them to finish the grant-making process before their previous grants end.
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What happens after the Funding Request is submitted?
Once the Funding Request has been submitted, a Technical Review Panel (TRP) will review all of the submitted documents. The TRP is a group of reviewers with scientific, academic, or lived experience in the areas of HIV, tuberculosis, malaria, human rights and gender, health systems, and sustainable financing. The TRP operates as an impartial and independent review body and its members are not employees of the Secretariat.
During its review of the Funding Requests, the TRP assesses the "strategic focus, technical soundness, potential for impact of funding requests and the extent to which programs are poised for sustainability." After it completes its review, the TRP may either request the Funding Request to be re-submitted, may recommend it for grant-making, or may recommend changes and/or clarifications to be addressed during Grant Making or grant implementation.
Once the country receives its feedback from the TRP, Grant Making begins. Grant Making is the process of converting the information from the Funding Request into grants, which will form the basis for the legal agreement between the Secretariat and the Principal Recipient(s) (PRs). During this phase, most discussions take place directly between the Global Fund Secretariat and the PR(s). The finalized grant materials are recommended by the Grant Approvals Committee (GAC) and then approved by the Global Fund's Board. At the very end of the process, the Secretariat and the PR signs an official agreement, and grant implementation can begin.
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Documents referenced in this section:
- The Global Fund. The Global Fund Eligibility Policy. As approved by the Global Fund Board November 2024. Available online at : https://www.theglobalfund.org/media/7443/core_eligibility_policy_en.pdf
- The Global Fund. Allocation Methodology 2023-2025. Available online at: https://www.theglobalfund.org/media/12080/core_allocation_methodology_en.pdf.
- The Global Fund. Operational Policy Manual. 19 November 2025. Available online at: https://resources.theglobalfund.org/media/qtwnsbk3/cr_operational-policy_manual_en.pdf
- The Global Fund. Terms of Reference of the Technical Review Panel. May 2025. Available online at https://resources.theglobalfund.org/media/3qmgjjq0/trp_technicalreviewpanel_tor_en.pdf
IV. Who receives Global Fund funding?
Who can receive funding from the Global Fund?
The Global Fund does not implement its own programs. Instead, it provides funding to one or more Principal Recipients (PRs) in each country, which are responsible for implementing the grant activities.
The Country Coordinating Mechanism (CCM) is responsible for nominating the PR(s). To make this decision, the CCM is required to have a documented process for choosing PRs, whether it is re-nominating an existing PR or choosing a new one. This process must be transparent and must have a clear process for managing conflicts of interest (COI).
Health extension worker Tizta Shibru with Marden Tesfaye and her three-year-old daughter Nuhmai in the Debre Abay neighbourhood in Addis Ababa. Source: The Global Fund.
The selection of the PRs is made at the start of the three-year cycle, so that the PR names can be submitted at the same time as the Funding Request. However, the CCM is responsible initiating a change to its PRs if there are consistent performance issues.
In most countries, the PR will be a government agency like the Ministry of Health. In some countries, particularly those under the Additional Safeguard Policy (ASP), a nongovernmental organization will serve as a PR. Countries may have either one single PR for all Global Fund grant funding, or may choose to have one or more PRs responsible for different tasks (called 'dual track financing').
Nearly all PRs sub-contract to other organizations to deliver the activities in the grants. These sub-recipients (SR) and sub-sub-recipients (SSR) can be government agencies, nongovernmental organizations, or community-led organizations.
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Can my organization receive funding from the Global Fund?
In nearly all countries, Global Fund-supported programs is implemented by a mix of government partners, nongovernmental organizations (NGOs), and community organizations or networks. These organizations are contracted to become sub-recipients (SRs) or sub-sub-recipientts (SSRs) of the Principal Recipients (PRs), and are paid to deliver the services and activities that were agreed upon in the country grants.
In order to receive Global Fund funding, there are three main pathways:
- Become a Principal Recipient.
- Become a sub-recipient or sub-sub-recipient
- Receive funding directly from the Secretariat.
Who can become a Principal Recipient?
Becoming a PR is a difficult process with major hurdles, particularly for commmunity organizations. In nearly all countries the primary PR is a government agency (such as the Ministry of Health) or, for countries under the Additional Safeguard Policy, a United Nations agency or other large NGO.
While it is possible for a country to also have a community PR, there are eligibility requirements that would be very challenging for many community organizations. These include:
- The ability to demonstrate "effective management structures and planning."
- Organizational capacity and systems to manage and oversee sub-recipiens.
- Internal control systems in place to preven and detect misuse of funds or fraud.
- Effective and accurate financial management systems.
- Data capacity, tools, and routine reporting systems in place for monitoring performance of the program.
- In the case of PRs involved in distribution of health products, must have warehousing capacity, good storage practices, effective distribution and transportation systems, and the ability to comply with quality requirements.
- Additional requirements imposed by the CCM, which will vary by country.
The CCM is responsible for choosing the PR(s) at the beginning of each three-year cycle. A key exception is for countries under the Additional Safeguard Policy (ASP). For these countries, the Global Fund may be responsible for deciding the PR(s).
The PRs are normally selected before the Funding Request(s) are submitted to the Global Fund. This means that in order to become a PR, it is important to engage with the CCM as early as possible; ideally, several months before the Funding Request development process begins. This is because the Local Fund Agent (LFA) must take several steps to review the organization's eligibility and to avoid delays with the grant's implementation start date.
Under the Global Fund's CCM Policy, the CCM is required to nominate PRs (new and existing) using a transparent process using clearly defined and objective criteria. The CCM is also required to document conflicts of interest (COI) that could impact the nomination process. This means that the CCM must be able to share with you the documented process whereby PRs are chosen.
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Who can become a Sub-Recipient?
The selection of sub-recipients (SRs) is done by the Principal Recipients. While the selection process should take place in consultation with the CCM, it is the PR and not the CCM that is responsible for the performance and management of all SRs.
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Documents referenced in this section:
- The Global Fund. The Global Fund Eligibility Policy. As approved by the Global Fund Board November 2024. Available online at : https://www.theglobalfund.org/media/7443/core_eligibility_policy_en.pdf
- The Global Fund. Operational Policy Manual. 19 November 2025. Available online at: https://resources.theglobalfund.org/media/qtwnsbk3/cr_operational-policy_manual_en.pdf
V. What Is the CCM?
What does the CCM do?
Every country that receives Global Fund financing is required to have a Country Coordinating Mechanism (CCM). The CCMs are multistakeholder partnerships, which means they include representatives from both the government and outside of the government. Together, the CCM members are responsible for making decisions about which activities the Global Fund grants will support and making sure the grants are performing. In some countries, the CCMs are formed from existing national structures (for example, National AIDS Councils, Roll Back Malaria Committees, or National Steering Committees) or they may be a standalone structure. The Global Fund does not require for CCMs to be legally registered or incorporated.
The CCM is made up of individuals from the sectors involved in the HIV, TB, and malaria response. The members of the CCM are selected to participate in the CCM on behalf of their constituencies, which means they are not hired as individuals, but rather as representatives. Each CCM member has a defined constituency who they represent (for example, men who have sex with men, or the Ministry of Health, or PEPFAR).
The CCM members are responsible for transparently and inclusively working together to fulfill the five core functions of the CCM:
- Coordinating the development and submission of Funding Requests (FR);
- Nominating the Principal Recipient(s) (PR) who will implement the grants, and monitoring their performance;
- Overseeing the implementation of Global Fund-supported programs, including the grant closure process;
- Endorsing any program’s revision request (as defined in Global Fund operational policies); and
- Ensuring linkages and consistency between the Global Fund financed programs, and other national health and development programs
There are two exemptions to the CCM rule. First, countries that only receive funding through a multi-country regional grant may be part of a Regional Coordinating Mechanism (RCM) or a Regional Organization (RO) instead of a CCM.
The second exemption is for countries in certain exceptional circumstances where forming a CCM would not be possible. This includes countries that do not have a legitimate government; where a conflict, emergency, or natural disaster has been declared; or countries where civil society is actively suppressed and not acknowledged by the government
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What are the requirements for how a CCM should operate?
While CCMs have some flexibility in how they are organized and how they do their work, there are six Eligibility Requirements for CCMs. These requirements mandate that all CCMs and RCMs must:
- Develop Funding Requests, with community engagement;
- Nominate and oversee Principal Recipients;
- Manage grant oversight;
- Include as members people living with and affected by the three diseases;
- Hold transparent selection processes for non-government members, and
- Maintain high standards of ethics and integrity
These requirements are nonnegotiable: if any CCM does not meet these requirements, they are not eligible for funding from the Global Fund. When the Funding Request is submitted, compliance with these requirements is assessed. In addition, requirements 3-6 are also measured on an annual basis throughout the three-year cycle. The only exception to this rule is if the Additional Safeguard Policy (ASP) has been invoked.
A Deeper Look: What is the Additional Safeguard Policy?
The Additional Safeguard Policy (ASP) is a Global Fund policy that may be applied to a country, or a disease component, in certain exceptional cases. These include countries where there is significant political instability, serious problems with civil society participation, a lack of a transparent process for Principal Recipient (PR) selection, fraud or misuse of funds, or conflict within the CCM that is blocking the selection of PRs.
Depending on which type of challenges are present, the ASP can mean that the Global Fund Secretariat is responsible for choosing the PR or the sub-recipients (SRs). In other cases, it may involve greater reporting requirements, requiring the pooled procurement of commodities, or disbursing smaller amounts of money. The decision to invoke, and revoke, the ASP is taken by the Global Fund’s Executive Director.
Most commonly, the United Nations Development Programme (UNDP) is selected as the PR in ASP countries.
CCMs are also expected to operate in accordance with seven principles of coordinating mechanisms. These are not formally evaluated by the Global Fund, but should guide all CCM activities.
- Partnership: CCMs should bring together key stakeholders; actively seek engagement across geographies, genders, expertise, and sectors; and ensure effective representation;
- Engagement of key populations: Each CCM should establish a mechanism to engage key populations, people living with or affected by diseases and civil society, throughout the grant life cycle, in a way that allows their voices to be heard;
- Oversight: CCMs should oversee the performance of the PRs to ensure that agreed targets are met;
- Build on national structures: CCMs should make efforts to proactively coordinate activities with other development planning mechanisms in the country;
- Sustainability and transition: CCMs should work to strengthen the sustainability of the Global Fund financed programs and prepare for transition towards domestic financing;
- Good governance: CCMs and CCM Secretariats should timely, equal, and comprehensive sharing of information, ensure that all CCM members are equal partner with equal rights to decision-making and expression, accountability for good performance, and management of conflict of interest to ensure decisions are objective and credible, and
- Differentiation: CCMs can and should tailor their focus and expectations to their country contexts.
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Documents referenced in this section:
- The Global Fund. Country Coordinating Mechanism Policy Including Principles and Requirements. As approved by the Global Fund Board on 10 May 2018. Available online at : https://www.theglobalfund.org/media/7421/ccm_countrycoordinatingmechanism_policy_en.pdf
- The Global Fund. Operational Policy Manual. 15 May 2024. Available online at : https://www.theglobalfund.org/media/3266/core_operationalpolicy_manual_en.pdf
VI. How can I engage with my CCM?
The CCM is meant to represent the national priorities of your country and to serve all people living with and impacted by HIV, tuberculosis, and malaria nationwide. However, the CCM can only act on your behalf if you are engaging with your representative(s).
The CCM has an important role: it decides which public health programs should be implemented in your country, it decides who will be in charge of implementing these programs, and it ensures that the programs are working well. As someone outside of the CCM, you may find it useful to work with the CCM for several reasons, including advocating for the funding and implementation of programs that are priorities for you and your community, making sure that programs are serving your community's needs, and sharing community monitoring data and evidence with decision-makers.
There are two main ways you can work with your CCM:
- Participate in consultations with your CCM representative. By meeting with your representative, sharing feedback and information with them, and participating in consultations and feedback sessions, you can learn about Global Fund grants and share your needs, experiences, and priorities.
- Become a CCM representative on behalf of your community. This will allow you to work directly with the other CCM members from the government and other sectors, as well as the Global Fund itself, to advocate for community priorities.
When does the CCM consult with communities?
The Global Fund operates on a three-year cycle, which begins with the Replenishment. Once the Global Fund has calculated how much is available, an Allocation Letter is sent to each country. The Allocation Letter includes important information including how much funding will be available for the three-year cycle for each disease, whether the country will receive any catalytic funding (for example, matching funds), and the exact dates for the three-year cycle when the funds may be used.
After receiving its Allocation Letter, each country must develop its Funding Requests. The Funding Request is an application form that describes how the country proposes to use the Global Fund support. The application includes a detailed budget, performance targets, and several additional annexes to describe the country context.
Claim Your Rights!
If you are a person impacted by or affected by HIV, tuberculosis, or malaria, you are a stakeholder of the Global Fund and the CCM. This means that you have a right to know who the members of your CCM are and who represents you.
The list of all CCM representatives is not available online. However, you may find the names and contact information of your CCM’s administrative focal points, as well as the name of the CCM Chair and Vice-Chair. You may reach out to them and request that they put you in contact with your relevant representative.
If you have tried reaching out to the CCM Focal Point, and have failed to receive a response, you may also reach out to your country’s Fund Portfolio Manager in Geneva. Their email address is also publicly available.
Under the CCM Eligibility Requirement 1, the CCM is required to consult broadly when developing the Funding Request. Specifically, this consultation must include people who are on the CCM and people outside of the CCM. The process for this consultation, or Country Dialogue, must be “transparent and documented” and must include both receiving input and sharing activities for review. In addition, the CCM must document its efforts to engage key and vulnerable populations. This requirement applies to all Funding Requests.
If you would like to participate in community consultations, first find out when your country will be submitting its Funding Request. This information is available on the Global Fund's website (once your country has registered for a TRP Review Window) or on the CCM Dashboard. It is important to contact your CCM representative several months before the Funding Request is due, to make sure you don't miss opportunities for community consultation and to make sure you don't begin engaging after decisions have already been made.
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What can I do during community consultations?
The most important thing that you can do during community consultations is to bring evidence of which Global Fund-supported programs are working well, and which need to be changed. In order to be effective with your advocacy, there are several things that you can do to prepare.
The first thing you can do is to understand what the Global Fund is funding in your country. You can find data about which types of activities are being funded on the CCM Dashboard or on the Global Fund's Data Explorer. It is important to understand which programs are already being funded and which organizations are implementing these activities.
A Deeper Look: Understanding grant budget data
Detailed grant budget data are available online on the CCM Dashboard or on the Global Fund's Data Explorer. When you are looking at these data, here are some questions you can ask:
- Are there any activities planned for the interventions or populations that I care about?
- Are there any activities being implemented by a government Principal Recipient (PR) that would be better implemented by a civil society PR? Why?
- Are there any budgeted areas where the PR is not spending ('absorbing') the money? Are there certain activities that are absorbed at higher rates than others?
Budget data won't be able to tell the full story of Global Fund activities. However, they can help you to ask the right questions to your CCM or to the PRs.
Would you like some support understanding and analyzing grant data? Contact us!
In addition to understanding the Global Fund's own data, community consultations are important spaces to bring community data. This can be data from community-led monitoring programs (CLM) in your country, or other forms of community-owned data and testimonies. The most effective data are those that clearly show which Global Fund-supported programs are not reaching the people who need them.
If your country will go through "Full Review", the CCM is required to submit a Funding Request annex called the "Funding Priorities from Civil Society and Communities" (sometimes called the Community Annex). This is a document that is completed by communities, people living with and affected by the three diseases, and key populations and that describes civil society's top priorities for the Funding Request. Make sure that your community's priorities are included in this document!
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Documents referenced in this section:
- The Global Fund. Country Coordinating Mechanism Policy Including Principles and Requirements. As approved by the Global Fund Board on 10 May 2018. Available online at : https://www.theglobalfund.org/media/7421/ccm_countrycoordinatingmechanism_policy_en.pdf.
- The Global Fund. Guidance on CCM Eligibility Requirements 1 and 2. July 2022. Available online at : https://www.theglobalfund.org/media/5551/fundingrequest_ccmeligibilityrequirements1-2_guidance_en.pdf.
- The Global Fund. Applicant Handbook: 2023-2025 Allocation Period. October 2022. Available online at : https://www.theglobalfund.org/media/4755/fundingmodel_applicanthandbook_guide_en.pdf.
VI. Who can be a CCM representative?
Which sectors are part of the CCM?
According to the Global Fund, the CCM should include representatives from all sectors involved in the response to the diseases. This can vary by country, but in general this includes academic institutions, civil society, faith-based organizations, government, multilateral and bilateral agencies, nongovernmental organizations, people living with the three diseases, the private sector, and technical agencies.
A Deeper Look: Key and vulnerable populations
Who is considered to be part of a key and/or vulnerable population (KVP)? According to the Global Fund, KPs can include the following groups:
- KVPs in the HIV response: Gay, bisexual and other men who have sex with men; people who inject drugs, people who are sex workers; and all transgender people
- KVPs in the tuberculosis response: Prisoners and incarcerated populations, people living with HIV, migrants, refugees and indigenous populations
- KVPs in the malaria response: Refugees, migrants, internally displaced people and indigenous populations in malaria-endemic areas
Each country has the flexibility to design its own CCM, including deciding which sectors should be involved. The Global Fund does not provide rules about how seats on the CCM are allocated, which means that decisions about the CCM structure may or may not happen in a transparent or democratic way.
No matter how it is organized, every CCM must comply with the following requirements in order for the country to be eligible to receive funding:
- Must fulfill the six Eligibility Requirements, including Eligibility Requirement 4 (see text box)
- Must be able to fulfill the five core functions for the CCM
- Must operate in a way that is guided by the seven principles for CCMs: partnership, engagement of key populations, oversight, building on national structures, sustainability and transition, good governance, and differentiation
This means that if a CCM is organized in such a way that it cannot fulfill those requirements, the structure must be changed, or the country risks being ineligible for future funding.
A Deeper Look: Eligibility Requirement 4
“The Global Fund requires all CCMs, based on epidemiological as well as human rights and gender considerations, to show evidence of membership of:
- people that are both living with and representing people living with HIV;
- people affected by and representing people affected by tuberculosis and malaria; and
- people from and representing Key Populations.”
What does this mean?
If your country has grants for HIV, your CCM must:
- Include a member who is living with HIV (PLHIV). This member’s responsibility is to represent all PLHIV in your country, which means they can’t also represent another constituency (for example, a PLHIV employed by the Ministry of Health cannot represent the government and also be the PLHIV representative);
- Include one or more members who are part of a Key Population affected by HIV. The KP members should reflect which populations have the highest risk in your country, and should also take into account which populations are most vulnerable due to human rights (for example, stigma or criminalization) and gender; and
- If the country context makes it impossible for key populations to safely serve as members, the Secretariat can waive the requirement for KP members.
If your country has grants for malaria and tuberculosis, your CCM must:
- Include member(s) who have lived with these diseases in the past, or who are members of communities where transmission and infection is common; and
- Include one or more members who are part of a key population affected by tuberculosis and malaria.
In 2018, the Global Fund launched a pilot program called CCM Evolution, which was designed to strengthen the functioning of CCMs. While the pilot ended in 2019, CCM Evolution continued as one of Global Fund’s Strategic Initiatives in Grant Cycle 6 (2020-2022). As part of this initiative, the Secretariat created a methodology for reviewing CCM performance, which it called the Integrated Performance Framework.
One of the indicators that are tracked in this framework is whether at least 40% of CCM seats are held by non-state sectors, which can include civil society, academic, private sector, or any other sector that is not the government. Although the Secretariat's CCM Hub tracks this indicator, it is not a formal eligibility requirement.
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What if my sector is not represented on the CCM?
After reviewing the list of CCM representatives and the sectors they represent, you may feel that your particular sector or population is not properly represented on the CCM. Or perhaps you do have a representative, but you feel that they are not adequately advocating for your constituency’s priorities.
As part of the Eligibility Requirement #4, the Global Fund requires that all CCMs show evidence of the representation of key and vulnerable populations (KVP) on the CCMs. If the CCM does not have any KVP representatives, or if they have been removed from the CCM, this should be escalated to the Secretariat in Geneva. You may first try reaching out to your Country Team, and additionally may choose to escalate to the Office of the Inspector General (OIG). The CCM should not be able to continue receiving grant funding if they are unable to fulfill this requirement.
There is only one possible exemption for this requirement, which is a scenario where key and vulnerable populations are criminalized or otherwise stigmatized to such an extent that they may not be able to safely participate in the CCM. In such a case, the Global Fund Secretariat may “waive the requirement of representation of key populations as it deems appropriate to protect individuals.”
If you speak to your CCM or Country Team and are informed that this special scenario is in effect, you may still request to participate in dialogues in non-traditional ways. In some countries, this can be through anonymous messaging boards, virtual meetings, and other hybrid approaches. You may also request support from us or choose to request support from the Community, Rights and Gender team in the Secretariat.
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How can I become a CCM representative?
The Global Fund does not have any global rules for how community representatives are selected. Instead, in each country, civil society designs its own rules and procedures for how to elect (or select) representatives.
This means that you will need to understand your country's procedures, including when the current CCM representatives' terms end, when the nomination deadline is, whether candidates are voted on (and by whom), and who is eligible to be a CCM member.
While each country can set its own rules, the Global Fund does require that the processes for selecting (or electing) CCM members must be ethical, well-documented, widely published, transparent, and based on good governance principles. As such, your CCM must have a documented procedure for choosing members and must be able to share it with you, if you are a member of a sector represented by the CCM.
Your first step in becoming a CCM member is to request this guidance. From there, you will be able to see if you are eligible to become a CCM member and you will see the steps for submitting your application.
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Documents referenced in this section:
- The Global Fund. Country Coordinating Mechanism Policy Including Principles and Requirements. As approved by the Global Fund Board on 10 May 2018. Available online at: https://www.theglobalfund.org/media/7421/ccm_countrycoordinatingmechanism_policy_en.pdf
- The Global Fund. Key Populations Action Plan 2014-2017. Available online at: https://www.theglobalfund.org/media/1270/publication_keypopulations_actionplan_en.pdf
- The Global Fund. CCM. Integrated Performance Framework. 2022. Available online at: https://resources.theglobalfund.org/media/12364/ccm_integrated-performance_framework_en.pdf
- The Global Fund. Country Coordinating Mechanism Guidance Note: Engagement. Annex 1 – CCM Member Guidance to Meaningfully Engage. March 2021. Available online at: Annex 1 – CCM Member Guidance to Meaningfully Engage .