Participants in the GFF pledging event © World Health Summit

The atmosphere was electric at this major pledging event which attracted a full house in the Rudolf Virchow Room, the Summit’s largest venue.

The audience was looking forward to seeing and hearing distinguished speakers from global organisations, NGOs and governments around the world and to finding out how much money would be pledged in order to foster women’s, children’s and adolescents’ health. The World Bank, Germany’s Federal Ministry for Economic Cooperation and Development (BMZ), the Netherlands’ Ministry of Foreign Affairs and the Government of Côte d’Ivoire co-hosted the high-level event as a first milestone of the Global Financing Facility’s (GFF) campaign ‘Deliver the Future: Catalyzing opportunities for women, children and adolescents’, which seeks to raise US$ 800 million to provide life-saving health services for up to 250 million women, children and young people.

How the GFF aligns available resources and catalyses additional funding 

Launched in 2015 at the initiative of the World Bank, the GFF is a country-led partnership aimed at closing the financing gap for women’s, children’s, and adolescents’ health. Starting from an analysis of in-country resources, countries develop evidence-based strategies for investment in health –  ‘investment cases’ – identifying priority and cost-effective interventions. The overarching goal is to strengthen health systems and expand access to care, especially for women, children and adolescents. Investment cases align all available resources, from domestic, public and private sectors, to funding from bilateral and multilateral development partners. This enhances financing for the country-led prioritised health plans, thus multiplying the impact of the initial grant provided by the GFF. As a result, the US$ 800 million target for the ‘Deliver the Future’ campaign could unlock as much as US$ 20.5 billion financing for health, including US$ 8 billion of concessional World Bank financing.

The campaign ‘Deliver the Future’ aims to improve 250 million lives

The GFF is currently active in 36 partner countries. With its support, more than 630 million women and adolescents have accessed modern contraceptives, averting over 187 million unintended pregnancies; over 130 million women have received safe delivery care and eight partner countries have increased coverage of services in the hardest to reach communities. More than 100 million women have been reached with four or more antenatal care visits and over 111 million babies have benefited from early initiation of breast-feeding.

However, in partner countries and worldwide, the COVID-19 pandemic has diverted scarce resources from maternal, child and adolescent health, and funding for health overall is lower than before the pandemic. As the UN has warned, currently more than 60 countries are off-track in meeting the global goals for maternal, newborn, and stillborn mortality reduction, and 4.5 billion people are not fully covered by essential health services. A fully funded GFF will provide second-round financing for 27 partner countries and support up to seven additional countries by 2025, providing an estimated 250 million women, children and adolescents access to life-saving health services.

GFF’s cause aligns well with Germany’s new Feminist Development Policy

After an opening video presenting the GFF’s vision, the session’s keynote address was delivered by Svenja Schulze, Germany’s Federal Minister for Economic Cooperation and Development. Women and girls, she explained, will continue to have insufficient access to health and other benefits, as long as the ‘three Rs’ of equality – rights, representation and resources – are not ensured. Rectifying this imbalance is at the core of Germany’s Feminist Development Policy, which the Minister launched in March 2023.

Women’s rights are human rights… Only girls who are healthy and able to make decisions about their own bodies can grow up to become educated and self-sufficient women who enjoy the same rights, resources and representation as men. The GFF is one of the most powerful tools to make this a reality.

Svenja Schulze, Minister for Economic Cooperation and Development, Germany

Warning of growing restrictions on women’s rights around the world – in addition to budget- and crisis-related constraints on health spending – the Minister concluded with a vibrant plea to financially support the GFF’s ground-breaking efforts, announcing a pledge of EUR 25 million for 2024 on the part of Germany. 

Partner countries share their experience with GFF and their commitments for the future

Côte d’Ivoire, co-sponsor of the ‘Deliver the Future’ campaign, shared a video message from its Health Minister, Pierre N’Gou Dimba. Since partnering with the GFF in 2017, maternal mortality has dropped by 40% and post-natal consultations have risen by 59% in Côte d’Ivoire. The Minister announced new targets for his country: a further 18% drop in maternal mortality by 2025 as well as rehabilitation or construction of nearly 1000 primary healthcare centres. Côte d’Ivoire has already created 10 regional health hubs to ensure accessible care for all.

As the event played out, representatives of other countries reported on how they, with the support of the GFF, are taking the lead in improving services for women, children and youth in their respective countries. Ethiopia has entered into an agreement with development partners to gradually shift financial responsibility for procurement of contraceptives to the government. Malawi has committed itself to increase government resources for reproductive, newborn, child and adolescent health and nutrition by 10% each year. And Liberia is laying emphasis on promoting sexual and reproductive health and rights (SRHR) on the community level and ensuring at least one health centre per district is fully equipped to provide these services. It is committed to increasing its budget for women’s, children’s and adolescents’ health by 5% each year and to reducing maternal mortality by 35% by 2030.

Voices of youth make themselves heard

Youth advocates Christina Chilimba, Founder and Executive Director of All for Youth, Malawi, and Tjedu Moyo, Founder and Executive Director of the Lunia Centre for Youths, Zimbabwe, in separate interventions, brought home to participants the full meaning of ‘delivering the future’. Their challenging life experiences have led each one to reach out to help other youth and become partners in the GFF-supported health plan for their respective countries. Christina Chilimba related how, growing up, she felt that adults were not listening to her, she did not to know which policies affected youth, and she did not have access to the health services she needed.

My generation will drive our future economy. We are also the first generation whose lives will be shaped by climate change, and the group most impacted by reproductive rights…The GFF understands the fundamental importance of involving youth: this is why the GFF is a critical development partner.

Christina Chilimba, All for Youth, Malawi

Tjedu Moyo, from a remote village in Zimbabwe, recounted how, after her father’s death, she could have been exposed to early marriage and premature motherhood. The resilience and protection of her mother enabled her to escape this fate and become an activist for youth rights.

No one knows the wants and needs of today’s youth better than us. That is why for young people to fully access their sexual and reproductive health and rights, and be empowered to build a future that is fair and healthy, we must be involved in designing and delivering policies and programmes that meet our needs. Our partnership with the Global Financing Facility is doing just that.

Tjedu Moyo, Lunia Centre for Youths, Zimbabwe

Bright minds engage in a series of mini-panels and spotlight conversations

A first panel followed up on the question of women’s and adolescents’ rights, representation and resources – as raised in Minister Schulze’s keynote speech – especially against the backdrop of reduced financial resources and increased backlash against gender equality and bodily autonomy. Pascalle Grotenhuis, Vice Minister for International Cooperation in the Dutch Ministry of Foreign Affairs, declared ‘We have to step up to ensure better rights and opportunities for women and girls, particularly in the hardest-to-reach communities,’ and announced that the Netherlands, as co-host of the ‘Deliver the Future’ campaign, is tripling its contribution to the GFF to EUR 100 million.

In a spotlight conversation on ‘Innovation and collaboration to deliver rights and opportunities’, Dr Natalia Kanem, Executive Director of UNFPA, Inger Ashing, CEO of Save the Children, and Dr Wilhemina S. Jallah, Minister of Health, Liberia, debated on the way forward, particularly to promote community-level SRHR. The panellists underlined the importance of prioritising women’s and girls’ needs. Said Dr Kanem, ‘We see this session which is actually talking about delivering rights and opportunities as a clear signal that there are things that we can do to address the challenges, beginning with attitudes: girls are important!’  

A second spotlight conversation on ‘Transformative primary health care’ brought together the Ministers of Health of Ethiopia and of Malawi, respectively Dr Lia Tadesse and Hon. Khumbize Kandodo Chiponda, in an exchange with Dr Atul Gawande, Assistant Administrator, USAID. Summing up the discussion, Dr Gawande said, ‘We believe that primary healthcare and health workers are paramount in delivering better community health for millions of women, children and adolescents.’ 

A final panel on ‘Unlocking resources and accelerating impact’ asked – with so many countries facing fiscal constraints, debt distress, and growing needs – how we can sort out the health financing equation to ensure that money reaches even the hardest to reach communities. Catherine Russell, Executive Director of UNICEF, is optimistic: ‘Our collective dedication to prioritising children, girls and adolescents’ well-being is the cornerstone of lasting impact.’ 

A promising start – yet additional contributions are needed

The event was punctuated by in-person and video commitments and recommitments of funding for the GFF. Children’s Investment Fund Foundation (CIFF) and the United States have joined the GFF as new investors, while existing donors including the Netherlands, the UK, the Bill & Melinda Gates Foundation, and Germany have committed new funding to the partnership. These pledges add to Japan’s new contribution for 2023 and existing commitments from other donors through 2025. Norway will announce its new commitment once its parliamentary budget has been finalised.

The culminating moment of the event was the announcement of the total pledge amount by Dr Juan Pablo Uribe, GFF Director and Global Director for Health, Nutrition & Population at the World Bank. Altogether, participants had pledged US$ 445 million over the period of one and a half hours – more than half the total amount required to fully fund the GFF through 2025. The replenishment campaign will continue to run in the coming months. Thanking the partners and co-hosts for their commitments, Dr Uribe reminded the world that more funds will be needed for the GFF to be able to meet its goals: ‘This is a good start – but we need to go faster and further. We look forward to welcoming additional contributions to the GFF in the months ahead.’

October 2023