October 5, 2022
An international group of 50 civil society organizations sent a letter to the board members of the World Bank’s Financial Intermediary Fund for Pandemic Prevention, Preparedness and Response urging them to make the investment in strengthening country-level capacity and health systems the central focus of the new FIF. In addition, they called on FIF board members to allocate the great majority of investment to the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Dear FIF board members,
Thank you for responding to calls from civil society globally that representatives of implementing countries and civil society be included in governance of the pandemic Financial Intermediary Fund (FIF). We hope you will continue to move toward more equitable, inclusive governance in all elements of the FIF, including in the Technical Advisory Panel and in the design of key funding modalities.
At your upcoming board meeting, as you begin to discuss the FIF’s strategic approach, allocations to core areas, and calls for proposals, we urge you to make investment in strengthening country-level capacity and health systems the central focus.
Health systems that can identify and respond to new disease threats are the foundation of genuine pandemic preparedness. We saw in COVID-19 that health care workers, community systems, laboratories, and surveillance capacity that had been focused on other areas of health responded rapidly and with agility to tackle the new pandemic. Preparedness is not about purchasing tools and having them sit on the shelf. We know that investments in resilient and sustainable systems for health will help people access needed health services today and make these systems better prepared for tomorrow.
COVID-19 showed us the critical importance of establishing community trust in health systems. There is no better way to build community trust than deliver on health needs today, including through investments in community systems and community engagement.
As you discuss allocations to the three identified major areas of investment – regional and global capacity; strengthen country level capacity; and technical assistance and analytics – we urge you devote the great majority of funding to strengthened country level capacity.
Many of the institutions approved as implementing entities are not well suited to this stream of work, and some do not to meet the FIF’s own identified key principles of flexibility, inclusivity, transparency and accountability. To ensure FIF funding has the highest possible impact on country level capacity, the Board should design its call for proposals with the following minimum criteria:
- Priority for institutions with proven models for inclusive country-led planning, transparency, and community trust.
- Allowing for multi-country proposals from institutions with existing, equitable governance and allocation methodologies for country-level investment.
- Designing funding modalities in close and ongoing partnership with implementing entities that meet the criteria above, to ensure alignment with their operating systems.
- Multiyear funding, enabling longer term planning with predictable financing.
The Global Fund is the largest supporter of health systems in the world. Its model has won the support of implementing countries, donors and civil society for its focus on results, engagement of multiple stakeholders, alignment with country plans, and transparency. It has established and effective technical review, M&E and accountability systems in place. During COVID-19, the Global Fund was among the most successful of global responders, channeling billions of dollars to help countries respond to the new pandemic while protecting gains in AIDS, tuberculosis and malaria. COVID-19 was a test case in organization effectiveness in a new pandemic, and the Global Fund demonstrated its unique capacity to respond.
We therefore also urge you to allocate the great majority of country level capacity funding to the Global Fund. Gavi, the Vaccine Alliance, also deserves support in this area of funding. Fully leveraging the Global Fund’s advantages will require framing requests for proposals that allow for multi-country support. Doing so will mean investing in a proven effective organization that has established relationships with ministries of health, providers and civil society globally, and which places a premium on country-owned responses and human rights-based programming.
That is the kind of pandemic preparedness the world needs to advance health equity and make us all safer.
Thank you for your consideration.
Advocacy Network Africa, Kenya
Afrihealth Optonet Association (AHOA), Nigeria
AIDS-Fondet (The Danish AIDS Foundation)
AVAC, United States
Amoru AIDS Support Community Initiative (ASCI), Uganda
Centre for Supporting Community Development Initiatives (SCDI), Vietnam
Dareecha Health Society, Pakistan
Dream Alive, Eswatini
Eastern Africa National Network of AIDS and Health Service Organization (EANNASO)
Favours Low-cost Healthcare Foundation (FALCOH)
Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, United States
The Girls Advocacy Network, Ghana
Global Fund Advocates Network (GFAN)
Global Fund Advocates Network, Asia Pacific. (GFAN AP)
Good Health Community Programmes, Kenya
Harm Reduction International
Hope for Future Generations, Ghana
India Working Group (IWG), India
International Treatment Preparedness Coalition Global (ITPC)
International Treatment Preparedness Coalition – West Africa
Institute for Social Development Studies (ISDS), Vietnam
Kenya AIDS NGO Consortium (KANCO), Kenya
KNCV Tuberculosis Foundation, Netherlands
Korean Advocates for Global Health (KAGH), South Korea
LAC Platform HIV2025
LHL International Tuberculosis Foundation (Norway)
Most At Risk Populations’ Society, Uganda
National Association of PLWHIV, Nepal
Network of Zambian People Living with HIV/AIDS
Network of networks of HIV positives in Ethiopia (NEP+)
Reformed Drug and Substance Abuse Initiative (REDSAI), Nigeria
Rwanda Network of PLHIV (RRP+)
Southern African Miners Association (SAMA)
Swaziland Migrant Mineworkers Association (SWAMMIWA)
Transgender Welfare Equity and Empowerment Trust, India
UCOP+ (Union Congolaise des Organisations des PvVIH)
Vision makers CBO, Kenya
WACI Health, Kenya
Wote Youth Development Projects CBO, Kenya
Youth Engage, Zimbabwe