“Innovative approaches to meet diverse country needs are essential to accelerate the end of the epidemic.” This is the catch phrase The Global Fund uses to describe the first objective in its new Strategy: Maximize impact against HIV, TB, and malaria.
The Board adopted a Strategy for 2017-2022 at its meeting in Abidjan on 26-27 April. (See separate article in this issue.)
There are five operational objectives under the first strategic objective, as follows:
- Scale-up evidence-based interventions with a focus on the highest burden countries with the lowest economic capacity, and on key and vulnerable populations disproportionately affected by the three diseases.
- Evolve the allocation model and processes for greater impact, including innovative approaches differentiated to country needs.
- Support grant implementation success based on impact, effectiveness, risk analysis, and value-for-money.
- Improve effectiveness in challenging operating environments through innovation, increased flexibility, and partnerships.
- Support sustainable responses for epidemic control and successful transitions.
This article briefly summarizes each operational objective.
Scale up evidence-based interventions
The Global Fund will focus on where there is the greatest need and, therefore, the greatest potential for impact. To do this, the Fund will invest most of its resources where the burden of disease is highest and where countries have the least economic capacity to support health programs.
At the same time, the Strategy says, the Fund will target key and vulnerable populations that are disproportionately affected by the three diseases. To this end, the Fund will invest in (among other things) data systems for these populations; strengthening community systems; and addressing human rights policy and barriers.
The investment in community systems is designed to allow communities to do increased advocacy, monitor grant implementation, and deliver services.
Importantly, the Strategy adds that by working with countries to do effective and early thinking around sustaining programs, “The Global Fund will strive to ensure that essential programs targeting key and vulnerable populations are maintained even after a country transitions from support.”
Evolve the allocation model
The Global Fund believes that the allocation methodology introduced for 2014-2016 has generally been successful in getting resources to where they are needed and in increasing the impact of the Fund’s grants. The Strategy calls for some refinements to simplify the methodology and allow for greater flexibility in applying it. (See GFO article in this issue on the allocation methodology adopted by the Board.)
Support grant implementation
The Strategy says that The Global Fund will adopt a differentiated approach both at country level and within the Secretariat designed to mitigate risk while at the same time increasing impact, effectiveness, and value-for-money.
The Strategy explains that at country level this may mean that the Fund “invests through sub-national grants in large federal states, adopts a pay-for-performance scheme in some contexts, or provides direct funding in support of a national strategy in others.” A differentiated policy on co-financing will ensure that the programmatic elements supported by the Global Fund change as a country moves closer to transition. And for countries approaching transition, the goal will be to get countries to invest more into often neglected programs such as prevention interventions for key and vulnerable populations. (See GFO article in this issue on the policy on sustainability, transition and co-financing adopted by the Board.)
Improve effectiveness in challenging operational environments
The Global Fund aims to ensure greater flexibility and a quicker response to meet the needs of people in challenging operating environments, including refugees and internally displaced people. In COEs affected by chronic instability, the plan is to use Global Fund investments to increase access to services, and also to strengthen community and health systems. (See GFO article [link] in this issue on the policy on COEs adopted by the Board.)
Support sustainable responses
The Strategy calls for The Global Fund to support countries to sustain disease programs and move towards universal health coverage. The Fund will work with countries to, among other things, increase domestic resource mobilization, strengthen health and community systems, and remove policy and legal barriers to services.
The Global Fund Strategy 2017-2022: Investing to End Epidemics, Board Document GF-B35/02, should be available shortly at www.theglobalfund.org/en/board/meetings/35.