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In the midst of a new pandemic, getting the next Global Fund Strategy right matters now more than ever

A doctor at Nair hospital in Mumbai, India, checks the vitals of a patient suspected of Covid-19

The Board of the Global Fund to fight Aids, Tuberculosis and Malaria (GFATM) just endorsed the Framework for the Global Fund Strategy 2023-2028. In a joint EU statement, Germany and partners emphasise the need for several strategic shifts to be spelled out in the Strategy Narrative in the coming months.

‘The strategy we are preparing with this framework is so important because the countdown towards 2030 has begun. It will determine what can still be achieved in two more grant cycles before we hit this deadline’, says Alexander Freese, Senior Policy Officer for Health at the Federal Ministry for Economic Cooperation and Development (BMZ), as he explains the ongoing Global Fund strategy development process. Sustainable Development Goal 3 of the 2030 Agenda states as one of its targets that the AIDS-, tuberculosis- and malaria epidemics be eliminated by the end of this decade – an ambitious goal that, in times of COVID-19, seems even harder to realise than prior to this new pandemic.

An inclusive strategy development process – against the backdrop of a new pandemic

The development of the new strategy began in early 2020 with online consultations to which all interested organisations and individuals could contribute. In February and March 2021 this was followed by three regional partnership fora at which representatives of the whole range of GFATM partners – from civil society organisations and representatives of affected communities to implementing organisations – were consulted. On the basis of all these inputs and against the backdrop of an expanding COVID-19 pandemic the GFATM Strategy Committee developed the new Strategy Framework which the GFATM Board endorsed on July 22, 2021. The German Constituency has been actively contributing to the process through input papers by civil society and by BMZ on the topic of One Health. Next, the GFATM Strategy Committee will develop the full Strategy Narrative which will serve as basis for the investment cases for the Fund’s crucial next two funding cycles (2023-2028).

A focus on people and communities, not on specific diseases

While the elimination of AIDS, tuberculosis and malaria remains firmly at the centre of the Global Fund’s mission, the new Strategy Framework formulates three prerequisites to achieve it: 1 – Maximising people-centred integrated systems for health; 2 – Maximising engagement and leadership of most affected communities; and 3 – Maximising health equity, gender equality and human rights.

In response to many partners’ inputs to the consultations, the new Strategy puts the needs of people and communities at its centre. This people-centred orientation should be reflected at all levels: In the way patients are treated, services are organised, data are managed and medication is procured. Secondly, to effectively reduce the still far too high incidences of the three diseases, an even greater focus will be placed on reaching and working with the most affected communities in order to effectively tackle their specific vulnerabilities and access barriers.

Thirdly, the Fund’s role in combatting the three epidemics as well as its leadership role within the global response to COVID-19 is captured in the ‘horizontal’ objective ‘Contribute to pandemic preparedness and response’. As pointed out in the joint EU statement, this role should not be realised through a separate mechanism but rather by creating synergies with HIV, tuberculosis and malaria-related services, strengthening health and community systems and working with partners in a coordinated way. Lastly, the need for countries to gradually transition from GF- to domestic funding of their HIV-, tuberculosis- and malaria responses is reflected in another horizontal goal, namely ‘Mobilising increased resources’. 

Annex 1 – Global Fund Strategy Framework

BMZ takes a stance for more coordination amongst global health actors…

As proactive Board member and as one of the Global Fund’s largest contributors, Germany has always advocated against a vertical, disease-specific and for a more horizontal health systems strengthening orientation of the Global Fund. Amongst global health actors, it took a clear stance, in 2018, for greater more systematic coordination and collaboration between the different multilateral health initiatives when it requested, together with Ghana and Norway, that WHO develop and lead an SDG3 Global Action Plan for Healthy Lives and Wellbeing for All (GAP). In the same spirit, Germany proposes to explicitly include and operationalise the commitments the GFATM made to these GAP objectives in the new Strategy. It regards this strategic shift as crucial for enhanced efficiency and for a reduction in the reporting and coordination facing recipient countries.

… and promotes a One Health approach, coupled with greater awareness of interventions’ environmental impacts 

Given the zoonotic origin of the COVID-19 pandemic and the steadily worsening impacts of the climate crisis on human, animal and planetary health, Germany has used the strategy development process to make GFATM constituents’ aware of the relevance of a One Health approach to the Fund’s mission. A BMZ-commissioned study and input paper that Germany presented to the Board formulates specific suggestions as to how this could be included in the new Strategy and in countries’ grant applications. In addition, Germany proposes greater sensitivity regarding the environmental effects of programmes and services that the GFATM supports.

What next?

Over the next few months, a full Strategy Narrative will be elaborated and Germany will continue to actively engage in this process to ensure that the above mentioned important strategic shifts are addressed in the Strategy.. It is planned that the full and final Strategy will be endorsed by the GFATM Board in November 2021 and then serve as basis for the 7th replenishment campaign and the next Replenishment Conference scheduled for autumn 2022. 

‘2022 will be an important year for the Global Fund partnership’, says Alexander Freese. ‘The 7th replenishment of the Global Fund in 2022 will be a critical moment to resource the fight against the three diseases in face of the setback by COVID-19 and its impact of health systems and people. Getting the underlying Global Fund’s strategy right for the crucial period until 2030 is the Board’s main task for the next months.’ 

Clearly, the next few years will be critical for the fight against the three diseases as the COVID-19 pandemic continues to reverse hard fought gains made to reach SDG 3 globally. And yet, rising to enormous global challenges is what the Global Fund has always been about.

Anna von Roenne, August 2021

© The Global Fund / Atul Loke / Panos
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