February 24, 2023
The Global Fund & Pandemic Preparedness: A Track Record of Success
By Chris Collins, President and CEO, Friends of the Global Fight Against AIDS, Tuberculosis and Malaria
A new blog from the Center for Global Development includes many factual errors about the Global Fund and its role in pandemic preparedness.
Victoria Fan and Eleni Smitham’s blog ignores the Global Fund’s track record of success responding to COVID-19 as well as core elements of the Global Fund model that make it well suited to be at the center of pandemic preparedness funding. The Global Fund directs its support through both governments and NGOs, as appropriate. During COVID-19, the Global Fund demonstrated its agility and ability to act fast, becoming the largest provider of non-vaccine grant support to low- and middle-income country governments in the world. With the support of its donors, the Global Fund has so far awarded nearly US$5 billion to help countries respond to the pandemic, mitigate its impact on lifesaving HIV, TB and malaria services and make urgent improvements to health systems.
Strengthening pandemic preparedness is fundamentally about building stronger health systems, particularly public health capacities. Investing in preparedness is thus a logical extension of the investments the Global Fund already makes to support countries in building more resilient and sustainable health systems.
There is widespread evidence of the Global Fund’s system impacts.
- The Global Fund is the largest provider of health system strengthening grants, enabling countries to seek funding specifically for this priority. No other organization matches the scale of its investment in laboratory systems, health management information systems and numerous other facets of health systems.
- An analysis in the Lancet from 2022 found that over one third of Global Fund investments support health security.
- More recently, an analysis in BMJ Global Health found significant alignment between needed preparedness investments and the Global Fund, identifying several “areas of opportunity” for the organization to build out from its core mandate to support preparedness priorities such as surveillance, laboratory systems, AMR and healthcare workforce.
Finally, in regard to financial sustainability, the authors ignore the Global Fund’s co-financing approach; the Global Fund requires partner governments to demonstrate increased domestic health investment. In addition, the Global Fund has helped support a variety of country-driven efforts for sustainable financing, such as Rwanda’s community-based health insurance plan. Looking forward, the Global Fund and others can do more to support civil society in holding their governments to account for increased investment in health.
The authors point to multilateral development banks that, they claim, have a record of “supporting horizontal as well as diagonal approaches that deliver a set of highly cost-effective interventions.” However, regarding the best organizations suitable to lead on preparedness, the authors’ colleagues have already criticized other channels in the previous CGD piece, “New data show the World Bank’s COVID-19 response is too small and too slow.”
Beyond these points, Fan and Smitham fail to consider core aspects of the Global Fund model that make it a very strong candidate for preparedness investment. This includes a track record of success in fighting pandemics, relationships with governments and community organizations around the world, broadly representative governance, and an emphasis on human rights-based approaches. Research showing the critical importance of trust in fighting pandemics is one reason why the Global Fund’s inclusion of civil society in decision making, program design and implementation make it well suited to channel preparedness funding.
The Global Fund has the infrastructure, relationships, track record and value set to make it an ideal candidate for pandemic preparedness investment.
The COVID-19 pandemic made clear the consequences of the world’s chronic underinvestment in health. The recognition that we need to do better should be a catalyst for all global health institutions to prioritize systems investments, and to make it easier for country partners to integrate funding streams. Pitting one model against the other isn’t the point – what is needed is a more integrated approach to global health investment across institutions.