The Global Fund to Fight AIDS, TB and Malaria recently established a COVID-19 Response Mechanism (C19RM) to boost the resources implementing countries need to fight this new disease. The Global Fund’s Board took this decision on April 9. On April 22, the Secretariat published updated guidance to explain the application process for C19RM funding, its related coverage, and requirements. On the same day, the Secretariat also published a Health Product Supply Update for countries, and a document called ‘Monitoring Approach and Information Collection’.
The C19RM, endowed with $500 million, is open only to countries that cannot free up to 10% from their respective current grants in savings and re-programming to fight the COVID-19 pandemic. The application process follows some of the tenets of the Global Fund: inclusion of all stakeholders, and a requirement that the Country Coordinating Mechanism (CCM) submits the requests.
What are the Secretariat requirements to access the COVID-19 Response Mechanism?
Countries applying for funding from the C19RM must:
- Have active Global Fund grants;
- Submit applications through CCMs;
- Request no more than 10% of the country’s allocation for the period 2020-2022, if it is not possible to get 5% savings plus 5% reprogramming from the grants currently being implemented (from the 2017-2019 Allocations 2017-2019)
If countries’ 2020-2022 allocations are higher than their 2017-2019 ones, and those countries need more than 5%+5% of 2017-2019 grants for interventions to fight COVID-19, these countries can request the difference between the amount representing 10% of the 2020-2022 allocation and the amount representing 10% of the 2017-2019 allocation.
What kinds of interventions can the COVID-19 Response Mechanism fund?
- Direct COVID-19 responses in countries following the World Health Organization (WHO) guidance and country strategic plans for the pandemic response, when they exist. Elements of this response are:
- COVID-19 response planning, preparation, and surveillance (technical assistance, in-country planning missions, meetings, and monitoring and evaluation) ;
- Protection of front-line health workers including those working for Global Fund programs (personal protective equipment [PPE], hospital infection control products, set up of isolation and quarantine wards);
- Diagnosis of infection (laboratory equipment, consumables, staff, and specimen transportation);
- Treatment (COVID-19 related treatment and care, equipment, hospital beds, systems for home-based care).
- Risk-mitigation activities related to HIV, TB, and malaria programming, such as additional support to protect health and community workers against COVID-19, including PPE, when those workers conduct mass campaigns such as the distribution of Long Lasting Insecticide Nets (LLIN)
- Critical gaps in health and community systems, such as strengthening laboratory networks, supply chains, and community engagement.
What are the essential considerations in COVID-19 funding requests?
- The diseases HIV, TB, and malaria remain global pandemics whose programs need to stay on track, and Global Fund support is intended primarily to enable countries to adjust their HIV, TB, and malaria programs to the COVID-19 pandemic context. The Global Fund will support mitigation/adaptation plans for its programs. For example, countries should still organize mass campaigns to distribute LLINs while adhering to WHO technical guidance to protect the people who will distribute the bednets, and the people who will receive them.
- The Global Fund will pay for personnel protective equipment (PPE) for health workers and community workers. The Secretariat will help countries source the PPE, through partners.
- Countries can decide to purchase new diagnostic equipment through Global Fund mechanisms. But these countries should be aware of the global shortages that sometimes make the purchase impossible even if funds are available.
- Countries can use existing diagnostic equipment, such as GeneXpert machines (which the PCR diagnostic mechanism that tests for COVID-19 require), that they have already purchased with Global Fund support. In cases such as this, states should submit plans/requests to mitigate the impact of testing for COVID-19 on earlier plans for TB testing and HIV viral load testing.
- Community engagement is vital to adjust HIV, TB, and malaria programs and to respond to the COVID-19 pandemic.
What are the crucial elements of the application instructions for C19RM?
- Deadline for application: 31 May 2020; deadline for expenditure: 30 June 2021.
- Applications will be considered on a rolling basis. The Global Fund expects to communicate decisions within 10 days of receiving applications.
Countries should divide their requests into two components: Priority 1 should not exceed 3.25% of the 2020-2022 allocation, and Priority 2 will cover the remainder of the 10% allowable total for C19RM (10% minus the 3.25% and other funds accessed through the savings and re-programming, if any):
- Priority 1 should include immediate interventions necessary to maintain current HIV, TB, and malaria programs that are not funded through grant flexibilities. Priority 1 should also include the purchase of diagnostic tools if needed.
- Priority 2 will cover all COVID-19 remaining interventions and they will be funded as more resources become available
- Countries should list other applications for funding from international donors that they (implementing countries) are making for their COVID-19 responses.
- Country Team members are available to answer specific questions countries may have.
- Global Fund Board: Additional Support for Country Responses to COVID-19 (GF/B42/EDP11), Geneva 9 April 2020.
- Global Fund Secretariat: COVID-19 Response Mechanism Update for Implementing Countries, Geneva, 7 April 2020.
- Global Fund Secretariat: Funding Request Instructions Global Fund COVID-19 Response Mechanism, Geneva, 20 April 2020.