C19RM Extension, Reinvestments and Portfolio Optimization

06 December 2022

Over the last six months as the COVID-19 pandemic evolved, the Global Fund observed a shift in funding priorities in implementing countries, from emergency pandemic response to strengthening systems for health, pandemic preparedness, and recovery of HIV, TB and malaria programs.

From June to August 2022, the Global Fund initiated an exercise called "COVID-19 Response Mechanism (C19RM) portfolio optimization" to meet these needs. This process allows countries to reinvest and reprogram C19RM funds and align investments with revised priorities. In response, 49 countries submitted C19RM portfolio optimization requests.

The submissions underlined a substantial need to strengthen health and community systems, with 56% of the C19RM unfunded demand for systems-strengthening interventions – up from 12% in 2021 when the focus was on COVID-19 tools.

C19RM Extension

Funding needs are evolving from procurement of COVID-19 health products, such as diagnostics and PPE, to rebuilding and strengthening countries’ ability to fight new pandemics, delivering benefits for HIV, TB and malaria programs and developing resilient and sustainable health systems.

As systems-strengthening investments take longer to prepare, review and implement effectively, the Global Fund requested an extension from its Board so C19RM funds can be used beyond 2023.

This extension presents a unique opportunity for countries to reprioritize interventions that are aligned with the C19RM mandate, especially those related to resilient and sustainable systems for health (RSSH) and pandemic preparedness. This includes community health workers (CHW) that work across several disease programs, lab networks, end-to-end surveillance, and systems-building for oxygen and respiratory care.

The extension is fully aligned with the following objectives of the new 2023-2028 Global Fund Strategy: (i) maximizing people-centered, integrated systems for health to deliver impact, resilience, and sustainability, and (ii) contributing to pandemic preparedness and response. As such, countries are encouraged to align the prioritization of needs that would be funded under C19RM with funding requests for the upcoming funding cycle, in order to complement investments and mitigate risk of duplicating efforts across funding sources.

C19RM Portfolio Optimization

Unfunded demand C19RM requests have been reviewed and in the coming weeks applicants will be informed of next steps in the letters to CCMs outlining the parameters for the extension.

As C19RM funding can now be used beyond 2023, countries have a new opportunity to reassess C19RM funding needs and consider their priorities alongside the design of core funding requests for HIV, TB and malaria for the next cycle of Global Fund grants.

Next steps

Detailed guidance on how the extension beyond 2023 will work, and updates on accessing additional C19RM funding will be communicated to CCMs in due time.