Any change to the performance framework (PF) has to be reflected in a Grant Agreement amendment agreed by the Global Fund and UNDP by signing an implementation letter (IL). Changes to the PF (i.e. scope and scale of the Global Fund-supported programme) during grant implementation are considered as reprogramming. The Global Fund process for approving reprogramming depends upon materiality of the change. Please contact the Global Fund/Health Implementation Support Team to receive further guidance on reprogramming. Changes to the PF during grant implementation can be considered if new information became available during grant implementation and required revision of initially agreed interventions and/or targets. Some examples include: 

• 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;
• findings and recommendations from programme reviews, evaluations or impact assessments;
• re-focusing of the grant on vulnerable and at-risk populations and high transmission geographies to ensure high impact, human rights and gender equality; and/or
• reallocating funding or reassessing interventions to reflect identified capacity gaps and risks.