Global Alliance for Progress Program: Duration and phases

The Global Alliance for Progress (GAP) Program of the World Federation of Hemophilia (WFH) is an intensive development program designed to establish a full-scale national care program integrated within the healthcare system of a country. GAP methodology has been adapted to take into consideration specific objectives of a new three-tiered approach. GAP Programs are implemented for a period of three to five years, depending on the specific tier, the goals of the programs, the level of success attained, and available WFH program funding.

The GAP Program is carried out in five phases:


During the assessment phase, the WFH looks at its Country Programs and considers their potential for the establishment of a national care program (NCP), integrated within the healthcare system, that covers the six areas of hemophilia care development: government involvement, care delivery system, medical expertise/laboratory diagnosis, availability of treatment products, capacity of the patient organization, and data collection and outcomes research.

Tier 1 FULL-GAP PROGRAM: The WFH may consider a country for the GAP Program following one year of Country Program implementation.
Tier 2 POST-GAP PROGRAM: The WFH may consider a first-decade GAP country, for the current GAP Program, if the country would benefit from additional support in advancing a national care program and/or in meeting its first-decade GAP objectives.
Tier 3 MID-LEVEL PROGRAM: The WFH may consider a country for the GAP Program if a country needs help in moving forward into the next level of care for people with bleeding disorders. 


During the selection phase, the WFH determines whether a country meets all of the GAP selection criteria by using a scoring sheet that takes into account, for each specific tier, demographic/economic indicators, the current hemophilia care system, the local leadership, and the overall potential for success. For each tier, countries must receive a high score to be eligible for GAP selection.

Preparation (pre-GAP)

Countries that are selected to become GAP targets undergo a one-year preparation phase. During this time, the WFH conducts a detailed needs assessment, based on its comprehensive development model, to determine the country’s GAP targets and objectives, to prioritize and define action plans, and to obtain general program agreement from all key players. By the end of this phase, GAP countries under each tier must have a development plan.


During this phase, GAP countries implement all of the activities outlined in their GAP development plans. WFH teams, comprised of programs staff and volunteer advisors, conduct annual or bi-annual monitoring visits to provide regular coaching and to facilitate the implementation of the program. For countries under Tier 1, one of the key features of the program is to obtain, from governments, signed commitments or memorandums of understanding (MOUs) to increase resources for bleeding disorders care. However, this is not always possible for every GAP country under Tier 1.


When GAP countries complete their implementation phase and accomplish their set goals and outcomes, the WFH gradually reduces its level of activity and begins to phase out.

Updated March 2013

The 11th WFH Global Forum is supported by funding from: