Call to Action on the New Funding Model

The final letter, signed by 56 organizations worldwide, was sent to the Global Fund Board in May 2012.

Background

In November 2011, the Global Fund Board decided on a new and exciting Strategy for 2012-2016. If fully funded and well implemented, this strategy will fundamentally change the course of the epidemics.

The Board also agreed to introduce a “new funding model” – representing a change in the way countries would apply for Global Fund financing. The new funding model is not designed yet—but the Board agreed that it should be a more streamlined and flexible approach, and should include dialogue between countries and the Global Fund to improve the quality of proposals. The new funding model should also allow countries better preparation for implementation and multiple opportunities in a year to request funding.

Civil society has been lobbying for this new funding model to be designed in the right way—at the same time we have been demanding a pledging opportunity in 2012, in order to reverse the damage to scale up efforts countries are facing as a result of the decision to cancel Round 11.

There are troubling signs that the Global Fund is considering a modelthat includes pre-determined funding allocations for countries. We believe that this is a mistake and would severely undermine core principles that have distinguished the Global Fund as an innovative donor over the last decade. Country allocations would turn into “caps” that would quash informed demand and unmet need from countries, would undermine proposal quality, would fail to reward ambition and success, and would weaken urgently needed resource mobilization efforts.

Call on the Global Fund Board:

Soon, the Global Fund Board will begin the process of deciding how to shape this new funding model and how it will invest additional funds raised as a result of the new pledging opportunity. This letter calls on the Board to develop a new funding model that:

  • Rejects pre-set country funding allocations or ‘funding envelopes’ as they will work as a ceiling or cap and quash well-informed, full expressions of country demand.
  • Allows for high quality demand to be identified and aggregated in a queue if funding is temporarily insufficient.
  • Develops a more flexible resource mobilization strategy that can provide predictable and sufficient funding opportunities.
  • Applies characteristics of the new funding model also to investments for any additional pledging in 2012 or 2013.

Call to Action on Round 11 Cancellation

We need a fully funded Fund

The final letter sent to the Global Fund Board at the end of 2011 was signed by 215 organizations worldwide.

CALL TO ACTION

The cancellation by the Global Fund to Fight AIDS, TB and Malaria of all new programming until 2014 is unacceptable. This decision will cost lives and cripple international efforts to deliver on health-related goals, breaking promises made to some of the world’s most vulnerable people, and punishing the Global Fund’s success of the last ten years.

People living with HIV and their supporters, as well as communities affected by TB or malaria, are extremely concerned about the damage under-funding of the Global Fund is causing. We therefore demand that:

  • The Global Fund Board and Secretariat mobilise the resources necessary to scale-up the response to the three diseases through a new funding opportunity for 2012, estimated at US$2 billion.
  • Donors to the Global Fund – particularly governments –urgently deliver on the commitments they made to meet health goals  and to fund the Global Fund at its Replenishment Meeting in 2010.
  • The Global Fund hold an emergency donor conferenceand issue a new call for proposals before the International AIDS Conference in July 2012 to fully fund the scale-up of programmes that will fundamentally change the course of these three epidemics, and put the world on the path towards ending AIDS.

Donors and others now have 200 days, starting from 1 January to save the Global Fund.

We cannot wait until 2014 for the Global Fund to support further scale-up of programmes and life-saving treatment. We urgently call on the Global Fund to meet the timeline above and for donors and affected countries to ensure that interventions with the highest impact on the three epidemics are supported.

The clock is ticking. Millions of lives are at stake.

Civil Society position papers in response to the Global Fund resource needs paper

Global Fund advocates assessment of the Global Fund’s resource needs for 2014-2016: what will it take to defeat AIDS, TB and Malaria? 

Download the full position paper

Introduction

In preparation for the first meeting of the 4th Voluntary Replenishment 2014-2016 of the Global Fund to Fight AIDS, Tuberculosis and Malaria on April 9-10, 2013 in Brussels, civil society advocates have reviewed the Global Fund’s Needs Assessment paper.

The Needs Assessment paper determines there is a total funding need of US $87 billion for AIDS, TB and Malaria for 2014-2016 and proposes a Global Fund share of US $15 billion. It describes current trends and scenarios that indicate that a successful Global Fund replenishment of US $15 billion, together with other sources of anticipated funding, would meet 87% of the total resource need (US $76 billion of the total US $87 billion), leaving a US $11 billion gap.

The Needs Assessment rightly describes that we are at a ‘crossroads’—facing the choice between risking the gains made against the three diseases or accelerating progress to save millions more lives and billions of dollars of additional costs over the long-term. The paper asserts that by accelerating efforts with a successful Global Fund replenishment of US $15 billion, even with a US $11 billion gap, the world will be well positioned to push towards complete control of AIDS, TB and Malaria.

Reaching the tipping point

The new Global Fund replenishment period (2014-2016) not only offers a historic opportunity to set the trajectory to defeat AIDS, TB and Malaria in the next decade, it is also one of the last opportunities to scale up resources to achieve the Millennium Development Goals on AIDS, TB and Malaria.

By taking advantage of scientific advances, lessons learnt from the past and current investments of the Global Fund and investing strategically, a concerted global effort to boost funding would deliver a decisive step towards ending the burden of AIDS, TB and Malaria. Global Fund advocates strongly believe that the 2013 replenishment and subsequent resource mobilization efforts should be driven by an ambitious commitment to seize the current momentum to halt disease progression and mortality, end new transmission, and get to a ‘tipping point’ in the fight against these three diseases. The promise of ending AIDS, TB and Malaria related deaths and avoiding new infections requires sufficient funding, more effective targeting of prevention, diagnosis and treatment interventions alongside health systems strengthening and increased sustainable domestic resource mobilization. .

Global Fund advocates support the request of US $15 billion from the international donor community as being a critical investment and the absolute minimum that donors must deliver. We also call for additional resource mobilization efforts to close the remaining gap of US $11 billion.

Why a US $15 billion target is a minimum

While Global Fund advocates fully support the US $15 billion funding request for the Global Fund, there are a number of assumptions and caveats included in the methodology of assessing this need that reveal why this target should be considered an absolute minimum, including:

  • Reaching the tipping point requires additional investments in the short-term that will deliver gains in the longer term through, for example, savings incurred from avoiding future treatment costs. Inadequate investments mean that we risk not reaching the critical level of resources needed to dramatically bring down the level of new infections and deaths—allowing the intensifying spread of deadly and drug-resistant strains of MDR-TB, for example. Therefore, in addition to supporting the Global Fund replenishment, implementing and donor countries must continue to search for ways to close the projected remaining funding gap of US $11 billion, while also ensuring that domestic funding and non-Global Fund external financing levels are sufficient.
  • Even if necessary scale-up were possible with 87% of the total funding need, the US $87 billion figure is premised on a highly ‘aggressive’ growth path for domestic funding (growing from current levels of US $23 billion to US$ 37 billion), as well as maintenance of other levels of external financing at US $24 billion.
  • While advocates support expanded domestic investment, the assumed level of domestic funding described in the Needs Assessment paper is extremely ambitious and suggests that domestic funding will outpace recent trends for investment as well as projected growth in general government expenditure. Overall financial resources per capita for health at the country level are a function of a country’s GDP per capita, so predicting total health expenditures to grow alongside or slightly faster than GDP is more realistic and closer to the “low” rather than the “medium” scenario for domestic funding described in the Needs Assessment paper. Advocates strongly support the call on implementing countries to increase domestic investments for health and increased total health expenditure per capita, and to develop more effective and accountable expenditure tracking systems. But projected shifts in domestic expenditure for health by poor countries should be grounded in reasonable assumptions.
  • Additionally, the assumptions in the Needs Assessment that increased funding from other funding streams for synergistic efforts in broader development areas (in the case of HIV), and the level of non-Global Fund funding for AIDS, TB and Malaria will continue at US $24 billion over the 3 year period is very optimistic, considering the fact that some donors are freezing or even cutting their development aid budgets.
  • Finally, the methodology assumes that efficiencies and drastically decreased treatment costs will cover the full additional costs associated with country implementation of the new WHO treatment guidelines for HIV as well as enable the scale up of new diagnostic and treatment tools for tuberculosis. This is most likely too optimistic—along with the assumption of a 65% reduction in treatment costs

We therefore call on donors to ensure at least a level of investment of US $15 billion for the fall 2013 replenishment pledging meeting and ask them to commit to a subsequent collective resource mobilization effort during the replenishment period to provide additional support, including from new donors and innovative financing mechanisms, to the Global Fund and via other funding streams, to address the remaining funding gap so that we can fully realize the opportunity we have to defeat these diseases.

Global Fund Advocates Network

Brussels

April 7, 2013

 

 

Investment Framework Community Mobilization 2012

Please find below the links to the Background Documents for the Investment Framework Community Mobilization Consultations in Dar-Es-Salaam, Tanzania (21-23 February 2012) and Bangkok, Thailand (3-5 September 2012):

1. Investment Framework – Lancet Paper

2. Investment Framework – Lancet Paper Web appendix

3. Investment Framework Summary UNAIDS Issues Brief (Summary of Lancet Paper)

4. Community Mobilization and the IF (Jane Parry; Trends, gaps and opportunities in mobilizing the community response to HIV)

5. Community Mobilization and IF Programmatic Areas (Tiffany Lilly; Rapid Literature Review)

6. Discussion paper investment framework (The Alliance)

7. ITPC Community Treatment 2.0 Report

8. IF Q&A (UNAIDS)

9. GFATM: Investing for Impact/The Global Fund Strategy 2012-2016

10. GFATM: The Global Fund Strategy 2012-2016 -  strategy framework

11. GFATM: Community Systems Strengthening Framework

12. GFATM: Information Note on CSS (“R11 information note”, shorter version of CSS Framework)

13. GFATM: Information Note on the Transitional Funding Mechanism

14. Article AVAC

15. UNAIDS presentation day 1: Investment Framework Tanzania CS (ppt)

15. UNAIDS presentation day 1: Investment Framework Tanzania CS (pdf)

Investing in Communities to achieve Results (World Bank evaluation of the community response to HIV and AIDS carried out in partnership with DFID and the UK Consortium on AIDS and International Development)

16. WB Evaluation of CS involvement – summary

17. Aids Consortium Resources

18. Presentation Michael Bartos Wednesday 22 February 2012

19. Outcomes of the Investment Framework Meeting in February 2012

20. UNAIDS Presentation Webinar 28 August

21. Alliance-APCASO Presentation Webinar 28 August

22. Understanding and acting on critial Enablers and development Synergies for Strategic investments by UNAIDS and UNDP

23. Report Investment Approaches Civil Society Consultation Bangkok November 2012

Position paper

 

“How global and regional networks can support civil society and communities at country level; finding out what a Network Capacity Building Fund should support”, October 2011.

In the context of discussions on the need for and development of a dedicated funding mechanism for HIV/AIDS civil society and community networks – the Networks Capacity Building Fund - a group of global and regional networks reviewed the core elements of civil society and community contributions to HIV at the global, regional but especially the country level against the background of recent major shifts aimed re-shaping and transforming the overall policy framework for the HIV response globally through the UN Political Declaration on HIV and AIDS, the strategic Investment Framework concept, the UNAIDS Strategy 2011-15 and from the implications of the major scientific announcements at and associated with the Rome Pathogenesis Conference. The meeting analysed and reflected on the added value that global and regional networks can bring at different levels in re-shaping the HIV response overall but especially through supporting civil society and communities at country level.

Please click here to read the Position paper

The Global Fund Delegations Retreat Brighton 2008 and 2011

 

Please find here the Meeting Report of The Global Fund Delegation retreat held from 11th to 13th of July 2011 in Brighton, United Kingdom.

Please find here the Final Report of the Global Fund Delegation meeting from the 8th to 10th of February in 2008 in Brighton, United Kingdom

Joint Retreat of the Civil Society Delegations to the Board of the Global Fund to fight AIDS, Tuberculosis and Malaria