The following are some key takeaways from the Global Fund’s 39th Board Meeting, held on May 9-10 in Skopje, Macedonia.
During the 39th Board meeting, the French delegation announced that France will host the Sixth Voluntary Replenishment Conference for the Global Fund in 2019. The Sixth Replenishment will bring together donor countries, implementing countries and the private sector to commit contributions for the 2020-2022 Global Fund grant cycle. France was a principal founder of the Global Fund and continues to be a major contributor. We hope this announcement will encourage other nations to make early and increased pledges.
2. Opening Remarks by Prime Minister of Macedonia Zoran Zaev and Executive Director Peter Sands
Prime Minister Zoran Zaev of Macedonia, a country that transitioned from Global Fund financing to independent domestic financing, spoke to the Board about the importance of allocating sufficient resources and engaging civil society in developing long-term sustainability of health programs.
Peter Sands, attending his first Board meeting since becoming Executive Director of the Global Fund in March 2018, said that building country ownership — underpinned by a serious focus on health financing — and addressing human rights and gender issues, are essential elements for both Macedonia’s and any country’s successful transition. As he looks towards the Sixth Replenishment, Sands continues to focus on thinking strategically about ending the epidemics. The next Replenishment strategy must: (1) analyze the reality of what it will take to end the epidemics both financially and programmatically; (2) highlight what we can and should expect from national governments and their domestic financing for health initiatives; and (3) provide estimates of giving from the donor community.
3. Sustainability: Global Fund Board Strengthens Country Ownership and Domestic Financing
One major area of discussion was domestic financing and country ownership as drivers for sustainability in effective responses.
- Domestic Finance: The Board highlighted the importance of strengthening sustainability and supporting successful transition to increased domestic financing to build long-term solutions.
- Country Coordinating Mechanisms: The Board confirmed the importance of Country Coordinating Mechanisms (CCMs), which are the national committees, including civil society and implementers, that submit funding applications to the Global Fund. The Board approved additional funding for 2018 and 2019 to strengthen CCMs, and also approved a Code of Conduct for CCM members.
- Eligibility: The Board approved a revised eligibility policy in order to be more easily understood by all stakeholders and reinforce support for countries with the highest disease burden and the lowest economic capacity, as well as key populations. It features significant updates to tuberculosis (TB) disease burden metrics, including moving from case notification to incidence, as this provides a more accurate reflection of the true burden of TB. It also includes provisions to address malaria resurgences in non-eligible low- and middle-income countries, as well as minor changes to malaria burden thresholds to increase robust funding for countries that need it most.
- Potential Engagement with Non-eligible Countries in Crisis: The Board approved an approach for how the Global Fund may engage in non-eligible countries facing emergencies that adversely impact progress against HIV, TB and malaria. To inform the Global Fund’s engagement, the evidence-based and “light touch” approach will assess the health impact of economic crises, natural disasters or conflicts in ineligible countries. This approach will be considered within the broader context of the Global Fund’s Eligibility policy and only applies to crises with severe health impact that has detrimental consequences for people living with the three diseases.
Continued progress on accountability was a central theme:
- Risk appetite: The Board approved a framework for risk appetite that will help the Global Fund balance specific risks and risk-reward trade-offs.
- 2018 Office of Inspector General (OIG) Report: The OIG presented to the Board the 2018 OIG Report, which confirmed the steady progress of the Fund in its mission. In 2017, the OIG produced more reports than in previous years with a record number of 28 issued. The average number of weeks to finish audits decreased from 26 weeks in 2016 to 25 weeks in 2017 and from 51 weeks to 38 weeks for investigations. The OIG reported that stronger in-country financial mechanisms are increasingly mitigating financial loss and large cases of fraud are less prevalent.
5. Resource Mobilization and Planning for the Sixth Replenishment
Christoph Benn, the External Relations Director at the Global Fund, presented the Framework for Resource Mobilization Action Plan for 2018-2019 and plans for the Sixth Replenishment.
- Pledges for the Fifth Replenishment (totaling $12.9 billion) are on track and being converted to contributions in a timely manner. Efforts to mobilize additional resources are ongoing.
- At the Malaria Summit in April 2018, the UK announced its malaria match fund for up to £100 million to the Fund, which was followed by the Gates Foundation pledging £50 million.
- The private sector pledged an additional $35.1 million following the Fifth Replenishment, with (RED) reaching the $500 million contribution milestone, thanks in part to (RED) iPhone sales and the new Amazon partnership. Additional initiatives planned for 2018 include bringing Amazon (RED) to Europe.
- The Fund has a new engagement strategy for non-traditional donors, including those from emerging economies. The Board decided to create non-voting Board seats for public donors who pledge $10 million or more (i.e., South Korea) as an additional means to expand the donor base leading up to the Sixth Replenishment.
6. The Global Fund and the Global Vaccine Alliance (GAVI)
Peter Sands and Dr. Seth Berkley, CEO of Gavi, discussed how the Fund and GAVI are effectively collaborating on issues that add value to both organizations. They spoke to how GAVI and the Fund are working together to achieve more operational and programmatic efficiencies and collaborating in: (1) sharing knowledge and lessons learned; (2) coordinating political advocacy at both the global and country levels; (3) aligning programmatic policies; and (4) making joint investments. They discussed how their new shared building will deliver cost efficiencies in the form of lower rent, service charges and operational expenditures.