Stop TB Partnership

Grant Monitoring Process

In principle, GDF support is given to countries for three years subject to availability of resources and satisfactory compliance with GDF conditions of support which include annual independent monitoring. All recipients of GDF grants for first-line tuberculosis drugs agree to regular assessment. The areas on which assessment is based are:

• Adherence to GDF terms and conditions of support;
• Programme management (including case detection and treatment outcome), financial management and drug management;
• Estimated drug needs for the next year of GDF support; and
• Follow-up on recommendations made by the Technical Review Committee (TRC) and by pre-delivery country visit and/or a previous monitoring visit.

Six months after GDF grant drugs have arrived in the country, a monitoring mission arrives composed of independent TB programme and drug management experts. The majority of these experts are affiliated with members of the STOP TB Partnership while some are independent consultants. The monitoring mission submits a report to the GDF Secretariat, together with information on GDF drug arrival, customs clearance, drug registration, quarterly reports on case findings and treatment outcomes and annual WHO TB data collection form. This information, known as a monitoring dossier, is then sent to GDF’s external auditors, who are selected through a transparent competitive process.

The external auditor reviews the monitoring dossier for completeness, consistency and credibility. The auditor must also decide whether the information in the monitoring dossier is sufficient to enable the TRC to assess whether GDF terms and conditions of support as well as other monitoring requirements have been met.

Once cleared by the auditor, the monitoring dossier is submitted to the TRC which can then recommend continued GDF support to the relevant grantee. The TRC has two options for the second year of support: a green light signifies that support can continue while an orange light signifies there are problems. If these problems remain unresolved in the second year, a red light can be given for the third year. This means that the country will not receive GDF support in the final year of the three-year grant. If the GDF monitoring mission gives a green light for continuation of the grant then the TRC is not required to review the dossier. In this case, the auditor decides whether the information provided in the monitoring dossier is sufficient and valid and fulfils the GDF criteria.

If the mission members find there are major concerns in regard to programme performance or terms and conditions of GDF support then a TRC review is required.