Officials at the Global Fund to Fight AIDS, Tuberculosis and Malaria have launched a "new round of arm-twisting" of its main donors -- the United States, Japan and European Union countries -- amid fears that the fund will "wither away" without new financing, the Financial Times reports. The need for increased contributions to the fund will be on the agenda of both the G7 finance ministers meeting in May and the G8 summit in June, before a scheduled meeting of the donor countries in July, according to Richard Feachem, executive director of the fund.
Resource allocation and health financing
global fund launches funding drive
Global Fund moves to assure Africans at ICASA
Neondo H: Africa Science News, 9 December 2011
At the 16th International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA), held in December 2011 in Ethiopia, the Global Fund announced that it has put transitional funding mechanisms in place to ensure continued treatment for people living with HIV and AIDS. The mechanisms will bridge funding gaps that may arise following delayed payments by those who had pledged contributions to the Fund. In November 2011 the Fund adopted exceptional measures to suspend Round 11 but denied that the Fund is in financial trouble, arguing that only one of its funders has announced a decrease in funding. It identified the main problem as delayed payments. According to United States president, Barack Obama, the Fund remains on track to support more than US$8 billion in grant renewals and new grant commitments between 2011 and the end of 2013. The Fund is undergoing reforms to allow it to transition to a more flexible, sustainable and predictable funding model that will ensure that resources go to high-impact interventions and to people who need the help most. The Board has also taken steps to better target Global Fund resources on countries with the greatest need and least ability to pay. The article indicates that this means that at least 55% of Fund resources will be directed to low-income countries.
Global Fund rejects Zimbabwe’s HIV and TB funding application
Afrique Avenir: 4 December 2010
The Global Fund to Fight HIV, Tuberculosis (TB) and Malaria has rejected Zimbabwe’s application for US$220 million to finance HIV and TB programmes for 2011, threatening to derail progress achieved so far towards efforts containing the two diseases. The Global Fund did not give reasons for the rejection. Zimbabwe had applied for US$170 million for HIV and US$50 million for TB. National Aids Council chief executive, Dr Tapiwa Magure, described the development as devastating, and doubted that Zimbabwe would be able to attain the Millennium Development Goal of universal access to treatment. Zimbabwe’s adult HIV prevalence has been on a downward trend, dropping from 18.1% in 2006 to 13.7% in 2009. Yet, according to the government, about 343,600 adults and 35,200 children under 15 years urgently need anti-retroviral (ARV) treatment out of a total of 1.2 million Zimbabweans living with HIV and AIDS. The government’s anti-retroviral programme only caters for about 200,000 infected people, while an estimated 3,000 people die of AIDS-related illnesses every week.
Global Fund replenishment meeting ends with massive funding shortfall, as millions of lives hang in the balance
Results UK: 6 October 2010
At the conclusion of the meeting to replenish the Global Fund to Fight AIDS, Tuberculosis and Malaria on 5 October 2010 in New York, donors fell far short of investing the US$20 billion needed to fully fund the fight against the three pandemics. Instead of the doubling of funding commitments needed to accelerate HIV, TB and malaria programme scale up, countries announced initial increases averaging approximately 25% or, in the case of some donors such as the United Kingdom, Ireland and Spain, did not pledge at all. This shortfall, unless corrected, will mean that the Global Fund will have to reject high-quality country proposals, and dramatically slow down the pace of scale up. The pledges and projections add up to $11.687 billion. Unless more commitments are made, the $8.3 billion funding shortfall will result in millions of deaths: at least 3.1 million people will die of AIDS and more than 2.9 million in need of TB treatment will not have access. On the positive side, one outcome of the meeting was the first ever multi-year commitment to the Fund from the United States, which intends to seek $4 billion for the Fund for 2011 through 2013, amounting to a 38% increase over the preceding three-year period.
Global Fund targets US$15 Billion to effectively fight AIDS, TB and Malaria
Global Fund: 8 April 2013
The Global Fund to Fight AIDS, Tuberculosis and Malaria announced a goal of raising US$15 billion so that it can effectively support countries in fighting these three infectious diseases in the 2014-2016 period. The Fund aims to help turn these three high-transmission epidemics into low-level endemics, essentially making them manageable health problems instead of global emergencies. It said that together with other funding, including an estimated US$37 billion from domestic sources in implementing countries and US$24 billion from other international sources, a US$15 billion contribution would allow the Fund to address close to 90% of the global resource needs to fight these three diseases, estimated at a total of US$87 billion. This aggregate level of funding would mean that 17 million patients with tuberculosis and with multidrug-resistant tuberculosis could receive treatment, saving almost 6 million lives over this three-year period.
Global Fund welcomes G8 recommitment
Angola Press, 26 June 2007
The Global Fund to Fight AIDS, Tuberculosis and Malaria has welcomed the latest "endorsement by the G8 leaders of US$6 billion to US$8 billion per year for the Global Fund, a three-fold increase from the current level," as "a strong agreement that makes it possible to defeat" the pandemics.
Global funding for HIV/AIDS in resource poor settings
This fact sheet analyses current trends in the global funding of HIV/AIDS. It argues that funding to address the epidemic (provided by major donor governments, multilateral organisations, affected countries, and the private sector) has only recently increased to significant levels, but it is still less than estimated need. Actual spending is typically less than budgeted funding, and in 2003 both were well below the estimated need of $6.3 billion. Some key findings included the fact that budgeted funding for HIV/AIDS in 2003 totalled $4.2 billion while actual spending in 2003 totalled about $3.6 billion. In addition, donor governments provide 61% of budgeted funding to address HIV/AIDS in resource poor settings utilising bilateral and multilateral channels.
Global funding trends for malaria research in sub-Saharan Africa: a systematic analysis
Head M: Lancet Global Health 5, doi: http://dx.doi.org/10.1016/ S2214-109X(17)30245-0, 2017
Total domestic and international funding for malaria is inadequate to achieve WHO global targets by 2030. The authors describe the trends of investments in malaria-related research in sub-Saharan Africa and compare investment with the national disease burden to identify areas of funding strength and potentially neglected populations, including that for malaria control. Research funding data related to malaria for 1997–2013 were sourced from existing datasets, from 13 major public and philanthropic global health funders, and from funding databases. Investments (reported in US$) were considered by geographical area and compared with data on parasite prevalence and populations at risk in sub Saharan Africa. 45 sub-Saharan African countries were ranked by amount of research funding received. The authors found 333 research awards totalling US$814.4 million. Public health research covered $308.1 million (37.8%) and clinical trials covered $275.2 million (33.8%). Tanzania ($107.8 million [13.2%]), Uganda ($97.9 million [12.0%]), and Kenya ($92.9 million [11.4%]) received the highest sum of research investment and the most research awards. Malawi, Tanzania, and Uganda remained highly ranked after adjusting for national gross domestic product. Countries with a reasonably high malaria burden that received little research investment or funding for malaria control included Central African Republic (ranked 40th) and Sierra Leone (ranked 35th). Congo (Brazzaville) and Guinea had reasonably high malaria mortality, yet received little investment. Some countries receive reasonably large investments in malaria-related research (Tanzania, Kenya, Uganda), whereas others receive little or no investments (Sierra Leone, Central African Republic). Research investments are typically highest in countries where funding for malaria control is also high. The authors suggest that investment strategies should consider more equitable research and operational investments across countries to include currently neglected and susceptible populations.
Global funds: Allocation strategies and aid effectiveness
Isenman P, Wathne C and Baudienville G: Overseas Development Institute, 14 July 2010
This report starts with a brief overview of the Paris/Accra approach to aid effectiveness and a definition of global funds and partnerships and their role in the overall aid architecture. It summarises strategies for allocating funds across countries, including challenge funds and results-based aid, as well as specific model examples used by selected global funds and partnerships. It found that global funds, like external funders in general, seek to maximise the impact of their assistance and use a variety of allocation mechanisms to ration their funds. Overall, country sub-sectoral support can vary in modality (including sectoral budget support) and may make use of indicative country allocations based on need and performance. The difference between the approaches of global funds and of Paris/Accra ‘horizontal’ aid is not whether they seek to achieve results. Instead, the differences lie in how the fund allocation strategies are designed and implemented to achieve these results. A key issue for all approaches to linking finance to results is the relative emphasis between short- and medium- to longer-term results and between results per se and intermediate steps that bring them about. In this context, this report also emphasises three issues related to achieving medium- to long-term results: predictability, sustainability and capacity.
Global health actors no longer in favour of user fees: a documentary study
Robert E and Ridde V: Globalization and Health 9(29), 26 July 2013
This study identified and analysed the stance of global health actors (GHAs) in the debate on user fees. The authors reviewed public documents published by and officially attributed to GHAs from 2005 to 2011. They identified 56 GHAs, and analysed 140 documents. Among them, 55% were in favour of the abolition of user fees or in favour of free care at the point of delivery. None of the GHAs stated that they were in favour of user fees, although 30% did not take a stand. The World Bank declared support for both user fees and free care at point of service. GHAs generally circumscribe their stance to specific populations (pregnant women, children under 5 years, etc.) or to specific health services (primary, basic, essential). Three types of arguments are used by GHAs to justify their stance: economic, ethical and pragmatic. While the principle of “user pays” certainly seems to have fallen out of favour, the authors suggest that the next step is yet to be taken, ie for GHAs to provide technical and financial support to those countries that have chosen to implement user fee exemption policies.