Let me think of three examples, because then you will also see that the method of results-based funding will change, depending on the situation.
You're right that the Global Fund has always said we are a results-based funding organization. That applies across the whole portfolio, but then the capacity of the countries varies.
One of the very clear top star performers has been Rwanda, for many years. You can see this from the results. It is quite outstanding. There you have a coverage now of AIDS treatment, malaria treatment, and mosquito nets of 90% across the whole country—fantastic results.
But not only that. They have the systems, with accountability whereby you can have trust that they use resources well. This allowed us to change our whole funding model and to take results-based funding to the extreme. Rwanda now gets paid for results. That's rather new. You can't do it everywhere, but with Rwanda basically you have a contract; you say that these are the results you're going to achieve and we will pay you for verified results. That cuts out a lot of bureaucracy in between.
Rwanda can do this, and they are a pilot for us. We are now exploring that model with other countries, such as Ethiopia, that are also very high performers and where we can probably apply the same method.
Another country that has done very well and is now graduating is Thailand, for example. We've supported them for many years with good results and it has relatively good health systems now. They indicated that this is the last replenishment period for which they are expecting funding from the Global Fund, that from now on they can take care of it—their systems are strong enough—and they don't expect funding from the Global Fund. This, I think, is another very good example. Obviously, we're happy to see it when countries can graduate out.
Then you would have countries at the other end of the spectrum. One extreme, I would say, is South Sudan, a new country with extremely weak systems, where you could not practice what we do in Rwanda, in the sense that we really have to make sure we follow all the disbursements to the level. We cannot even disburse to the government. We usually use UN agencies, or international NGOs, sometimes the Red Cross. They are our partners on the ground. It's still results-based funding, if you like; I mean, we agree on certain targets and we hold them accountable for them. But there is much more hand holding. We cannot just say we will pay you for the end results. We have to follow every step on the way.
That would be the spectrum: the extremely high performers, such as Rwanda, Thailand, Ethiopia; then in the middle you would have the Zambias and Tanzanias and Kenyas; then you have the really very fragile states with very weak systems—Chad, Central African Republic, South Sudan. We have the challenge of adapting our system so that we still achieve results, but with different levels of oversight and accountability mechanisms.