term capacity building and technical support for the Global Fund during the past 2 years. These liaisons “support Global Fund grant implementation and oversight and [. . .] improve coordination between U.S. Government bilateral programs and Global Fund-financed disease programs” and can provide broad assistance for areas mentioned above or narrower technical assistance, such as with the Global Fund’s financed laboratory program, and they communicate monthly with OGAC about issues in their respective countries (NCV-20-USG) (OGAC, 2012b).

The USG-supported Grants Management Solutions (GMS) project was used to provide shorter-term or more urgent technical assistance and grant management support to primarily the Country Coordinating Mechanisms (CCMs) and the Principal Recipients (PRs) in countries with current Global Fund grants (OGAC, 2012b).26 The purpose of this urgent attention was “unblocking bottlenecks and resolving systemic problems that hinder the response to AIDS, tuberculosis, and malaria. GMS provides this support in four technical areas: CCM governance and oversight; PR organizational and financial management; procurement and supply management; and monitoring and evaluation” (OGAC, 2012b). This headquarters-funded technical assistance can augment rather than duplicate support already provided by USG teams through the USG bilateral programs for the three focal diseases of the Global Fund, which can include development of future Global Fund proposals as well as overall longer-term systems strengthening and capacity building (OGAC, 2012b). The GMS program is coming to an end and is being replaced with another iteration that will continue to focus on addressing these issues (NCV-20-USG).

OGAC senior leadership recognizes the importance of the Global Fund as a large-scale financing mechanism for the three diseases, especially where large-scale bilateral assistance is not available in countries. However, the United States is leveraging its contributions to the Global Fund from other donors to “multiplying impact beyond what U.S. dollars could do alone” and for the two initiatives to discover new and complementary ways of doing business (Goosby et al., 2012b, p. S162). Within the past few years, OGAC has developed a more strategic approach to the use of PEPFAR-funded support for technical assistance to maximize the performance of the Global Fund overall. Other PEPFAR-supported efforts to improve their collaboration and communication includes an appointed HQ-level liaison from OGAC to Global Fund headquarters in Geneva beginning in 2011; the use of PEPFAR technical working groups and field expertise to provide ef-

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26There are some exceptions to the eligibility for technical support for focus countries under PEPFAR I in which PEPFAR teams are instructed to address their technical support needs though their COPs or for countries that are listed by the U.S. Department of State as sponsors of terrorism (USG, 2011b).



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