deputy principals group within OGAC that basically provide a lot of recommendations to Ambassador Goosby that he then makes on behalf of the program. But because our health programs are so integrated in many countries we realize that we all need to go hand in hand, so we can’t have a country ownership agenda for PEPFAR that USAID’s maternal health program isn’t also considering. So we all came together, we actually came together not just as PEPFAR, our dialogue has included MCC as well who have a lot of good practices in country ownership, and tried to have a common message that we could present to partner governments around country ownership and what it is U.S. government means.” (NCV-9-USG)

Technical Assistance and Longer-Term Capacity Building for the Global Fund

Despite the continuum of rate-limiters for capacity building efforts at any level, PEPFAR’s method for technical assistance with on-the-ground personnel could engage multiple stakeholders and country leadership at different levels with its larger and longer-term capacity building for and technical assistance to the Global Fund. As discussed in the funding chapter (Chapter 4), there is collaboration and cooperation between the Global Fund and PEPFAR. Given that they are the two largest sources of external funding in nearly every country, their existence and collaborative relationship affect the performance of each. They have been described as having different and complementary models of assistance from their very beginnings. With country leadership, the new paradigm for the future response entails more joint planning and cognizance of their shared responsibility to people who need their services, to donor countries, and to the U.S. taxpayers to be assured of effective and efficient use of their resources (Goosby et al., 2012b). There are two main channels by which the USG provides technical assistance (TA): through a centrally funded TA portfolio and through the USG bilateral programs. All efforts are made to ensure that the two streams of TA complement and coordinate with one another” (USG, 2011a, p. 14). The U.S. Congress permits OGAC “to withhold up to five percent of the Foreign Operations appropriation of the U.S. contribution to the Global Fund to provide TA to alleviate grant implementation bottlenecks and improve grant performance” (USG, 2011a, pp. 14–15). “From FY 2005 through FY 2010, the Coordinator has made over $160 million available for centrally-funded TA activities for Global Fund grants” (OGAC, 2012a). As previously discussed in the chapter on Health Systems Strengthening, there are 19 USG-supported Global Fund Liaisons, requested by the mission teams, placed into key bilateral and regional missions as part of the longer-



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