During implementation, revisions allow the PR to adjust investments according to the changing context and other needs. This ensures continued effective and efficient use of Global Fund resources to achieve maximum impact in line with National Strategic Plans and the Global Fund’s Strategy. As part of revisions, changes can be made to the implementation period end date, to the Performance Framework, to adjust or reallocate the approved Grant Funds.

A Programmatic Revision (formerly referred to as a “Reprogramming” or “Program Revision”) refers to changes in the scope and/or scale of a Global Fund grant within already approved funding ceiling and current implementation period resulting in changes to the modules, interventions and/or targets in the Performance Framework:

1. Changing the scope is the process of (i) adding or deleting goals and/or objectives, or (ii) changing key interventions (including those related to RSSH, Human Rights, and Gender Equality) either at the level of a grant, or at the level of the Global Fund supported disease or RSSH program. Changes in the scope may result in the addition or removal of indicators in the Performance Framework.
2. Changing the scale is the process of increasing or decreasing targets for one or more indicators.

Triggers of Programmatic Revisions

There are a number of potential scenarios which might trigger a Programmatic Revision, such as:

• Changes in the epidemiological pattern of the disease or the trajectory of the disease in the country, resulting in changes to relevant national strategies and key interventions
• Release of new scientific evidence and/or changes to the normative guidance for disease control in the country;
• Changes in implementation arrangements
• The scale-up of effective interventions and innovative approaches, introduction of new health products and removal of health products
• Implementation of interventions to reflect identified capacity gaps and risks;
• Allocation of additional funding to the program;
• Changes in the funding landscape, and/or legal, political and socio-economic environment;
• The need to accelerate the adoption of revised partner technical guidance to ensure patient safety and program efficacy.
• Changes in unit costs, and/or cost of activities;

These scenarios may result in changes to the Performance Framework (adding or deleting goals and objectives, and/or changing key interventions, and/or increasing or decreasing targets).

A Programmatic Revision may be either initiated by the Country Coordinating Mechanism (CCM) and/or Principal Recipient (PR) or the Global Fund Country Team.  It can be proposed anytime during grant implementation if warranted by the programmatic context and needs to be completed maximum three calendar months after initiation.  All revisions have to be endorsed by the CCM. The Global Fund Country Team may require Local Fund Agent (LFA) review of the request. The scope of the LFA review is to be agreed between the Global Fund and the LFA. The approval process of the Programmatic Revisions is differentiated based on whether the revision requires the TRP review or not.

Once approved, a Programmatic Revision is reflected in the Grant Agreement through an Implementation Letter. The Implementation Letter is signed by the PR and the Global Fund. For Programmatic Revisions that involve time sensitive changes to the Performance Framework with implications to the performance rating and results rating (such as increasing or decreasing targets or adding missing targets), a Notification Email can be issued to capture PR and Global Fund agreement on the Performance Framework changes and enable Performance Framework updates in the Global Fund system. The Performance Framework changes are formalized with an Implementation Letter at a later stage.