Previous studies by the UNDP, working with Arup, have demonstrated the feasibility of developing a measure of carbon footprint for the delivery of Global Fund health programmes. This method allows a grant programme to be assessed during the development of budget planning – a useful tool to inform the effect of a chosen grant strategy on overall carbon footprint. The challenge then becomes one of demonstrating how the actual delivery of a programme performs in carbon terms, and in providing this information during the grant operational phase – to inform the decision making of those individuals actually delivering grant activities. This study examines whether the techniques used previously for assessing grants can be effectively and practicably used during the operational phase, and if not then what alternative strategies are available to the UNDP-GF and its partners for achieving this