Board Decisions

GF/B19/DP34


Approved by the Board on:
06 May 2009


Enhancing the Global Fund’s Response to HIV/AIDS

1. As a leading multi-lateral financier of HIV/AIDS programs globally, the Board recognizes its role as a responsible steward of the Global Fund's investments on behalf of people living with and at risk of HIV and the need to ensure high impact of programs supported by the grants that it approves while achieving maximum value for money.

2. The Board recognizes that improving prevention efforts is critically important to the fight against HIV/AIDS and that the Global Fund should support countries in implementing HIV prevention strategies that are targeted, evidence-based and consistent with local epidemiology. The Board welcomes the initiative by UNAIDS to form, in an expedited manner, a working group, which may include interested Board constituencies, on assessing evidence and developing practical actions on increasing country adoption of 'combination prevention' strategies to determine relevant actions and the appropriate role for the Global Fund which will be presented to the Board at its Twentieth Meeting for relevant action.

3. The Board also recognizes that the Global Fund has a responsibility to use its influence to leverage a reduction in stigma, discrimination, criminalization of people due to their sexual orientation or gender identity and HIV+ individuals, travel restrictions and sexual and gender violence.

4. The Board recognizes that, despite important progress made, there are significant gaps in scaling up coverage of effective HIV prevention, treatment, care and support. In addition, there is an urgent need to improve the quality of care for people living with HIV, reduce the costs of treatment in the long term, and to increase the number of people served through programs supported by the Global Fund. Therefore, the Board:

i. Recognizes the urgent need to increase resource mobilization efforts, given the need to increase overall HIV treatment and care coverage to achieve the goal of universal access. In addition, acknowledges that increased uptake of innovations in HIV treatment and care may result in initial cost increases, but encourages the technical, programmatic and financial evaluation of these investments.

ii. Requests the Secretariat to work with partners to project the long-term financial costs of existing commitments and future demand on the Global Fund as a major funder of prevention, treatment, and care, including the potential impact of strategies to improve outcomes and reduce treatment costs. This study should include but not be limited to possible protocol changes. Findings should be presented to the Portfolio and Implementation Committee in order to recommend relevant Board action prior to the Twenty-First Board Meeting.

iii. Recognizing the value of new technologies to improving quality and cost-efficiency of HIV/AIDS prevention, care and treatment, requests the ad-hoc Market Dynamics Committee, in collaboration with partners, to consider how the Global Fund, its partners, Principal Recipients, and Sub-recipients can accelerate access to and uptake of cost-effective new technologies and optimized HIV treatment regimens, to improve outcomes.

iv. Requests the Secretariat to urgently work with partners to adopt measures to identify gaps and to further improve the quality of Global Fund supported prevention, treatment, care and support including operational research to identify effective scaling up strategies to improve outcomes. These measures should be reviewed by the Portfolio and Implementation Committee during its review of the Round 10 proposal form and guidelines.

5. The Board recognizes that prevention of HIV in women and preventing HIV-positive mothers from dying and babies from being infected with HIV is crucial to achieving the goals of universal access and an HIV/AIDS-free generation. Scaling-up access to, and use of effective prevention of mother-to-child transmission (PMTCT) and paediatric HIV care, support, and treatment services - which are integrated with primary, maternal and child health and comprehensive sexual and reproductive health programs - is a critical component of the Global Fund's Gender Equality Strategy. Therefore, the Board requests the Secretariat to conduct a review of the portfolio to identify paediatric HIV high burden countries with low PMTCT and paediatric HIV care, support, and treatment coverage rates and prepare options for the Portfolio and Implementation Committee to use available mechanisms to accelerate transitions to more efficacious ARV regimens for effective PMTCT strategies, which should be reported to the Board at its Twentieth Board Meeting

6. The Board urges CCMs to consider while formulating future proposals that are targeted, evidence-based and consistent with local epidemiology to (i) re-intensify efforts to prevent HIV including among vulnerable populations; and (ii) to improve the health of HIV-infected pregnant women and children through effective PMTCT and paediatric HIV care and treatment programs to ensure improved responses to high paediatric loss-to-follow-up rates; and that strengthen a family centred care approach. The Board also urges CCMs and Principal Recipients, as needed, to consider reprogramming existing grants on the basis of the above.