Three delegations from the Global Fund Board joined 11 international non-government organizations to encourage countries that are eligible to receive Global Fund support to develop concept notes that include the 'full expression of demand' for resources.
The Developed Country NGO, Developing Country NGO and Communities delegations all signed the letter dated 12 June, urging countries to consider their current allocation a floor, not a ceiling, in order to leverage available and potential future resources for innovative programming that will defeat the three diseases.
In the open letter, a copy of which was sent to Aidspan, full expression of demand was defined as "all health needs and critical enablers related to HIV/AIDS, tuberculosis and malaria prevention, treatment, care and support are addressed and fully costed, including the needs of the most vulnerable communities such as key populations, people living with HIV, women and children."
Or, put another way, according to Peter van Rooijen, a member of the Developed Country NGO delegation to the Board and the executive director of Dutch-based International Civil Society Support, "what it takes to defeat AIDS, TB and malaria" as defined by countries themselves.
For many countries, 'full' means the bottom line for a fully costed national strategic plan (NSP): the multi-year platform based on up-to-date demographic data that builds an investment case to respond to the burden of disease among both the general and key populations.
The challenge, according to van Rooijen, is ensuring that those NSP are of the best possible quality: fully developed, ambitious and "reflecting a comprehensive and inclusive approach... developed with engagement of civil society and key populations".
Civil society's interest in encouraging a full expression of demand may butt sharply against the practical realities with respect to limited resources -- a conundrum freely acknowledged by the consortium of groups. Yet equally, it has the potential to inspire countries to shoot for the moon, to be "encouraged to go for real investment cases and fully developed strategic proposals," according van Rooijen.
Such ambition could be rewarded by the new funding mechanism known as the register for unfunded quality demand (UQD). Innovative programs that may be beyond the scope of the NSP are, once assessed and recommended by the technical review panel, placed in a register for a period of up to three years awaiting funding from additional sources.
"The UQD provides us with a much better resource-mobilization tool than we ever had before. We can now show, in this country, this is the vetted response that would save this many lives, but we don't have the money," said van Rooijen. "But that requires full expression of demand and that countries understand and believe in the UQD so that they feel encouraged to invest in proposals."