Global Fund Board Hails Recovery in Fight Against HIV, TB and Malaria After COVID-19 Setbacks, Commits to Strengthen Investments in Climate-Resilient Health Systems

17 November 2023

GENEVA – The Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria held its 50th meeting this week in Geneva, Switzerland. Two months after the release of the Global Fund’s Results Report, Board members praised the unprecedented progress achieved in the fight against the three diseases in 2022 and the significant investments made to strengthen health systems around the world, including through the reprogramming of funds from the Global Fund’s COVID-19 pandemic response. However, they expressed concern that the growing challenges of climate change, conflict, and the erosion of human rights undermine the partnership’s ability to end the three diseases by 2030.

“In the face of colliding crises, the Global Fund partnership must lean into the resilience and agility that has underpinned our success so far,” said Lady Roslyn Morauta, Chair of the Global Fund Board. “We must also leverage our flexibility to further support countries affected by humanitarian crises. To get back on track towards the global goals, the Global Fund will continue to foster the meaningful engagement of civil society and communities to strengthen our inclusive, country-led, partnership governance model.”

“The world is in turmoil,” acknowledged Global Fund Executive Director Peter Sands in his update to the Board. “But we continue to deliver extraordinary impact. The dramatic changes in life expectancy across much of Africa, and the sharp declines in infection rates and mortality across the three diseases, plus the significant advances in health system capacities in many low- and middle-income countries, owe much to the work of the Global Fund partnership. In a world where the concept of our common humanity seems diminished, the Global Fund remains a powerful expression of global solidarity.”

Sands highlighted the unprecedented scale and breadth of the Global Fund’s investments in health systems, including in primary health care, community systems and community-led monitoring, and emphasized the massive investments made to enhance access to medical oxygen. “Our investments in oxygen are a powerful demonstration of how the Global Fund can help transform health system infrastructure and capacity,” he said. “Access to medical oxygen will deliver a step change in many countries, reinforcing their ability to save lives.”

A few days ahead of COP28 – which will address the impact of climate change on health for the first time – Board members noted that climate disasters disproportionately affect low- and middle-income countries with high disease burdens, weak health systems, and fragile political or conflict contexts, putting communities – who have contributed the least to global carbon emissions – at risk. They committed to supporting actions across the partnership to adapt programs to the impact of climate change, build climate-resilient health systems, and respond to climate-related disasters. The Board noted addressing climate change is a critical part of the Global Fund Strategy, and currently more than 70% of Global Fund resources support the 50 most climate-vulnerable countries, and 87% of both the global malaria burden and Global Fund allocations for malaria are in these climate-vulnerable countries.

“Climate change is a profound threat to the achievements of the Global Fund’s mission and to the vulnerable countries, communities and people at the center of our Strategy,” said Bience Gawanas, Vice-Chair of the Global Fund Board. “Addressing climate change is not an expansion of the Global Fund’s mission, but instead a response to an unprecedented shift in the context of human and animal life on Earth that will affect most aspects of the Global Fund’s work.”

Board members reiterated their concern that climate change, in addition to drug- or insecticide-resistance, poses an urgent threat to malaria control and elimination efforts. Following up on their decision last May [ download in English ] to increase risk appetite for malaria interventions to adapt to the situation, Board members approved adjustments to the Risk Appetite Statement for malaria that provide more flexibility for potential revisions in line with the risk landscape, the progress made against the disease and future funding.

Noting the major successes recently achieved in improving access to and affordability of lifesaving HIV, tuberculosis and malaria products, the Board hailed the strategic role played by the Global Fund, technical partners, the private sector and civil society in market-shaping. They committed to supporting the successful execution of the Global Fund’s NextGen Market Shaping approach to further accelerate the introduction of more efficacious health products at scale, contribute to improved value for money, and support delivery of the Strategy and universal health coverage. Board members also encouraged the Global Fund and other global health partners to collaborate even more closely to further support the scale-up of local and regional manufacturing, particularly in Africa. They approved the updated quality assurance policies for pharmaceutical products and medical devices, paving the way for Global Fund resources to be used to procure essential health products manufactured closer to where they are used while maintaining high-quality assurance standards.

As countries get ready to implement their new grants in January 2024, Board members discussed a number of topics related to the Global Fund’s sustainability, transition and co-financing policy, especially domestic financing. Taking stock of fiscal and financial constraints in many countries, the Board expressed support to further explore innovative financing by approving the Global Fund’s updated approach to blended finance. This will allow the Global Fund to consider additional blended finance partners, beyond the World Bank, to strengthen the financing of health systems and national responses to the three diseases in line with the Global Fund’s Strategy objective, with the stated ambition of unlocking up to US$300 million in additional investments. The Board reiterated that this approach requires strong oversight, and they called for regular monitoring, evaluation and reporting throughout the development, review, approval and implementation of blended finance transactions. In addition, Board constituencies responded positively to the Global Fund’s proposed approach to strengthening co-financing for the three diseases, with a focus on country ownership and data quality, while bringing a realistic approach to macro-fiscal challenges.

The Board also approved the 2024 operating expenses budget to accelerate the delivery of the Global Fund’s core programs in line with the three-year envelope agreed for this grant cycle.

The meeting closed with welcome news from Luxembourg, who announced a new contribution of €750,000, bringing Luxembourg’s total pledge for the 2023-2025 period to €15.45 million, a 70% increase over their previous contribution.

Over the three-day meeting, the Board expressed recognition and praise for the hard work, professionalism, commitment and achievements of in-country partners, as well as staff working at the Global Fund Secretariat.


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