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Total health ODA commitments, 2001-2006
US Billions
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New instruments in global health

• World Bank Multi-country AIDS Program (2000)
• Global Alliance for Vaccines and Immunization
  (2000)
• International Finance Facility for Immunization
• Global Fund to Fight AIDS, TB and Malaria (2002)
• US Presidents initiatives
• AIDS (2003), Malaria (2005), Neglected Tropical
  Diseases (2008)
• Unitaid (2005)
• (PRODUCT) Red (2005)
• World Bank Malaria Booster Program (2005)
• Debt2Health (2007)
• Advanced Market Commitments (2008)
• Affordable Medicines Facility for Malaria (2009)
• National Strategy Applications (2009)

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The Global Fund an innovative instrument in
health and development

• A financial instrument, not an implementing
  entity
• Supports programs that reflect country ownership
• Evidence-based
• Performance-based

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A unique partnership
Multilaterals Bilaterals
Countries
Civil Society Private Sector
Patients Affected Communities
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The Global Fund and civil society

• Governance (Board and CCMs)
• Implementers
• Dual track financing
• Community systems strengthening

Estimates Rounds 2-6 proposals
About 40 per cent of Global Fund-supported
implementers are NGOs/CBOs
OP/290607/5
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Global Fund portfolio

• 14 billion in approved financing
• 7 billion disbursed
• 600 grants in 140 countries

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Global Fund portfolio AIDS
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Global Fund portfolio malaria
Global Fund portfolio TB
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140 countries with Global Fund grants
BG/261107/6
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Targeting the poorest countries Global Fund
approved amounts by country per capita income,
September 2008
m
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Resources go where they are needed

• Regions
• 60 of approved funds in Rounds 1-8 are for
  sub-Saharan Africa
• 65 of funding for orphan support is for southern
  Africa
• Diseases
• AIDS 35 of Global Fund financing for ART is
  for southern Africa
• Malaria 1.5 billion approved for 19 African
  countries that account for 90 of malaria burden
  in Africa
• TB More than 1 billion approved for 22 high
  burden countries that account for 80 of global
  TB incidence

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Reaching the vulnerable
e.g. Global Fund support to harm reduction
programmes
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Number of people receiving ARV therapy in low-
and middle-income countries, 20022007
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Global Fund results June 2008
GP/110608/9
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AIDS impact Malawi
Initial decline in workplace mortality at Escom
(national electricity company) after roll-out of
antiretroviral treatment
Source Global Fund
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Decline in adult mortality with introduction of
ART Botswana
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Increase in TB financing and new sputum positive
cases detected and treated
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Declining malaria in health facilities after
scale-up of bed nets and anti-malaria treatment
Rwanda, 2001-2007
Incidence?64
2004
WHO national database
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Addressing health systems challenges

• Human resources
• Procurement systems for drugs and health
  commodities
• Infrastructure
• Laboratory equipment
• Monitoring and evaluation systems

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Direct funding of health systems through Global
Fund grants


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The Global Fund and health systems strengthening

• Direct funding of health systems through disease
  interventions (approximately 945 million for
  Round 8 more than 4 billion overall)
• Health systems support across more than one
  disease
• 186 million approved in Round 7
• 290 million approved in Round 8 (health
  workforce, information systems, supply chain
  management, community service delivery)
• Expanding health system capacity
• Non-government actors (NGOs, FBOs, communities,
  private sector, people living with the diseases)
  are recipients of 50 of Global Fund funding
• Dual track financing
• Majority of Round 8 proposals included community
  systems strengthening

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Human resources

• Increasing the number of health workers
• Salaries for health workers community health
  workers
• Salary top-up
• Training (96 of grants have a training
  component)
• Saving lives of health workers to return to work
• Reducing AIDS, TB and malaria burden so that
  health workers can focus on other health needs

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Infrastructure Support for renovation of
existing health centres
Mukoma Health Centre, Rwanda (Source PEPFAR)
Photo courtesy of FHI
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Laboratory strengthening

• 67 of TB grants included laboratory
  strengthening
• Examples
• Chad Newly equipped laboratories
• Philippines Training in sputum microscopy
  (public and private)
• Yemen, Sri Lanka New laboratories established

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Sustainability more than resources alone

• Increased and more predictable resources
  (domestic, external, further innovation)
• Build demand for resources
• Address health systems challenges
• Promote evidence-based interventions effectively
  targeted to those in need
• Promote human rights
• Strengthen social protection
• Strengthen global and local partnerships
• Learn and apply lessons research and evaluation

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Resource needs for AIDS, TB and malaria (2009 to
2015)
Sources UNAIDS, STB, RBM
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Resources increasing both availability and demand
EstimatedNeed
Estimated Need
Available resources and demand
Demand
US billion
Available resources
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Global Fund requested and approved 2-year funding
(Rounds 2 8)
53
Approval rate
40
34
39
22
34
47
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