Blended financing combines grant funds with funding from multilateral banks and other financial institutions. It can strengthen alignment and coordination amongst development partners and help implementer countries to build stronger, more resilient health systems that are better equipped to fight HIV, tuberculosis (TB) and malaria, while supporting critical health interventions – such as expanding treatment, reforming health insurance schemes and reaching vulnerable populations.
Blended financing complements traditional Global Fund grant financing and is part of the Global Fund’s overall approach to raising additional resources for health and the three diseases. Blended financing allows the Global Fund to use different financial mechanisms to achieve its objectives, making it possible to leverage borrowing for the social sector and work more closely with other financing partners to strengthen health and community systems, and fight HIV, TB and malaria.
In addition to helping the Global Fund expand available resources, blended finance transactions also benefit our partner institutions. As partners consider their own investments in health systems, the Global Fund can offer unique expertise in fighting HIV, TB and malaria and strengthening health systems.
By the Numbers
- Fourteen blended financing investments in total.
- US$215 million in transactions invested through blended financing, alongside approximately US$3.5 billion in partner and country investments.
- Loan buy downs in India and Indonesia supported approximately US$700 million for the health sector through Global Fund investments of approximately US$60 million.
Blended Financing Case Studies
Improving Access to Malaria Case Management and Preventive Treatment for Malaria in Pregnancy
In the blended financing transaction in South Sudan, the Global Fund’s US$22.9 million contribution to a donor funding pool of approximately US$375 million is expanding access to a basic package of health and nutrition services, including malaria case management and intermittent preventive treatment for malaria in pregnancy (IPTp). This investment is enabling a more aligned response with partners in a challenging operating environment, and is expected to increase malaria programmatic coverage by leveraging the extension of primary services to more communities, strengthening health systems that are essential to underpin a sustainable response and realizing efficiencies such as coordinated planning, drug distribution and responses to flooding or other challenges.
Reaching Migrant Populations with Lifesaving HIV Services
Since 2013, the economic crisis in Venezuela has spurred the displacement of people into neighboring Colombia. As of September 2024, there were over 2.8 million Venezuelan migrants living in Colombia according to UNHCR estimates. While many have health coverage through temporary protection status, migrants face barriers that may limit full access to care.
The “Program for Improved Access to Effective Health Services for the Vulnerable and Enhanced Health System Resilience” brings together US$300 million from the World Bank and US$5 million from Global Fund, in partnership with the government of Colombia, to strengthen Colombia’s national health system to withstand these pressures – and includes a specific focus on reaching migrant populations with lifesaving HIV services.
The Global Fund's contribution helped secure a disbursement linked indicator related to migrants’ ability to access comprehensive HIV services, such as antiretroviral therapy. This contribution complements the Global Fund’s overall investment in Colombia in fighting HIV, which also prioritizes supporting key and vulnerable populations who face barriers to accessing health services.
Transforming the Fight Against TB With Additional Funding
Indonesia has the second highest TB burden in the world, accounting for more than 8% of global cases.
Funding for TB in the country is predominantly domestic and has significantly increased in recent years, but a large funding gap remains and critical health reforms are needed. To help address these challenges, the Global Fund, the World Bank and the government of Indonesia collaborated on a loan buy down to improve the coverage, quality and efficiency of the TB response in Indonesia.
Through an investment of US$21.1 million, the Global Fund helped support government buy-in to develop and approve a US$300 million World Bank project designed to incentivize critical health reforms and strengthen the national TB response.
As a complement to continued Global Fund grant financing, the initiative aims to support health system reforms on sub-national primary care financing, engagement with the private sector and digital health, which could not be achieved with grant funding alone.
Integrating HIV and TB Care Into the Primary Health Care System
The Lao People’s Democratic Republic (Lao PDR) has made significant improvements in health and nutrition services in recent years, but rates of maternal mortality and chronic undernutrition among children are some of the highest in the region. The country has a high TB disease burden and faces a concentrated HIV epidemic. National HIV and TB programs have made important progress over the last years with high treatment success rates, but continue to face challenges in identifying missing cases in hidden settings and hard to reach areas.
To help address these issues, in 2020 the Global Fund began supporting the government-run Health and Nutrition Services Access (HANSA) project through a US$36 million parallel co-financing arrangement, which included a US$23 million contribution from the World Bank, US$10 million from the Global Fund, and US$3 million from the government of Australia. Implemented by the LAO PDR Ministry of Health and civil society organizations, HANSA helped women and children, people living in hard-to-reach areas, and vulnerable and key populations access essential health and nutrition services, including HIV and TB programs. Through this unique partnership, HANSA strengthened primary health care, including further integration of HIV and TB services.
Based on the success of the first HANSA project, a second phase of the project, HANSA 2 – totaling US$62 million – was launched in 2024 to address longstanding problems in bringing health services to rural communities, particularly to women and children from ethnic groups, and those being missed by the programs. Lao PDR is investing the full US$17.5 million Global Fund allocation for 2024-2026 into HANSA 2, in a joint investment that includes the World Bank, Gavi, the Vaccine Alliance, and the government of Australia.
HANSA 2 will continue to support improving the quality of and access to health and nutrition services in underserved areas of Lao PDR, increasing TB prevention and treatment coverage, and increasing access to HIV services among key populations and people living with HIV and AIDS. The project will continue supporting the integration of TB and HIV services into the primary health care system and the building of climate-resilient health systems. Other global health partners will support the program with technical assistance.