Increasing domestic investment in health systems and HIV, TB, and malaria disease programs is essential to accelerating the end of the three diseases. To strengthen the sustainability of national programs and enhance impact, the Global Fund has co-financing requirements designed to help catalyze progressive increases in spending on health and gradual uptake of program costs, including those financed by the Global Fund.
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The Global Fund’s approach to co-financing includes both core co-financing requirements as well as a co-financing incentive.
To access a Global Fund allocation, countries should show progressive government expenditure on health and show progressive uptake of key program costs, including those supported by the Global Fund.
To further encourage domestic investment, at least 15% of a country’s allocation (but in some cases more) is a co-financing incentive made available if countries make and eventually realize additional domestic commitments over the grant implementation period. These commitments need to be in addition to expenditures over the previous implementation period.
The amount and focus of these additional co-financing investments are determined by a country’s income classification and country context. More details are available in our guidance note, our policy, and the Operational Policy Note on Co-Financing, which is a section of the Operational Policy Manual: