Roll Back Malaria Change Initiative
Prior to the Roll Back Malaria Change Initiative, the Partnership had been reviewed on two occasions since it was established in 1998 – first through an internal evaluation by members of the Roll Back Malaria Partnership Secretariat and, subsequently, through an external evaluation led by Professor Richard Feachem. Some of the critical recommendations from those assessments had been implemented, such as the formation of a governing Board. However, there remained a lack of clarity and consensus as to the Partnership’s purpose and, as a result, to the specific roles of the Board, Secretariat and other Partnership bodies such as Working Groups and Sub-Regional Networks. This lack of clarity also limited the availability of funding for Partnership operations, which further impeded the ability of these bodies to be effective.
At the 9th Roll Back Malaria Board Meeting in November 2005, these issues precipitated a series of discussions questioning the need for the Partnership’s continued existence in its then-current state. The RBM Board responded with a statement reaffirming the need for partnership in malaria control, and agreed to engage a management consultancy to lead a comprehensive initiative to redesign the Partnership for effectiveness.
The change initiative commenced with a two-day retreat in Abuja, Nigeria in early February 2006, facilitated by The Boston Consulting Group and attended by a subset of the RBM Partnership Board, serving as the Sub-Committee for Immediate Action. The discussions from the retreat focused on defining the nature of the change required. Paired with a series of Board interviews, the retreat created the content for a case for change, which was used to generate the financial support and commitment required to proceed with the change initiative.
Based on the terms of reference developed by the Board and the change initiative approach proposed by BCG, the next phase of work involved a diagnosis of the Partnership as a whole, and of the Board, Secretariat, and Partners as represented by Sub-Regional Networks, Working Groups and other convening bodies. In addition, BCG defined the potential strategy for the RBM Partnership by developing a model of the malaria control value chain and its gaps, as well as a framework for applying the core competencies and various versions of "partnership"p to those gaps.
In addition to this top-down approach to defining the appropriate strategy for the Partnership, BCG also created a bottom-up analysis based on a series of conversations with seven institutions central to the Partnership. These partner value mapping discussions defined the individual institutional activities for each and, based on those, the areas in which external consensus or support was required for them to be effective. In addition, the team used two August meetings involving significant participation from endemic countries – ESARP Meeting in Harare and Ministers’ Regional Committee Meeting in Addis Ababa - to facilitate small group discussions on that constituency’s specific priorities and needs related to the Partnership.
In thinking about the structures and the processes required for an effective RBM, BCG benchmarked other global health partnerships to identify how they fulfilled key design principles. The analyses and discussions around the appropriate structures and, subsequently, systems for RBM took place over the course of many months, with the outcomes reflected in the Partnership framework; a Memorandum of Understanding with WHO, the current host of the RBM Secretariat; and a Secretariat handbook.
In addition to analyses led by BCG on issues related to the infrastructure of the Partnership, the Board led analyses around critical malaria control issues that were presented and discussed at the 10th Meeting and 11th Meeting of the RBM Partnership Board in July and November 2006 respectively. In particular, these analyses included:
- Work to define how global institutions can best support individual endemic countries has led to the formation of the Global Harmonization Working Group and a series of specific initiatives to help countries strengthen their capabilities.
- A framework for Partnership advocacy, developed by the Global Advocacy Task Force with representation from a wide cross-section of Partners, which will guide collective efforts to mobilize resources and political support.
- There has also been significant commitment and work to identify the specific ways in which the Partnership can help create efficiencies in procurement and supply management through global mechanisms and coordinated technical support to help countries improve their own capabilities in these areas. As part of the procurement and supply management work, BCG completed a diagnostic of the private sector's needs, which will serve as an input to decisions on the specific roles for the RBM Partnership in this area.
The change initiative outputs related to the overall strategy, structures and systems of the new RBM Partnership will not be a topic of ongoing discussion among the Board or other bodies of the Board; instead, it is the foundation for how the Partnership will operate going forward, and is being executed by the Secretariat and the Executive Committee Chair. In contrast, the work related to harmonization, advocacy, and procurement and supply management are the essential topics that the Partnership will continue as long as they are central to realizing malaria control goals and saving lives.