10 May 2018
SKOPJE – The Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria, at its 39th Board meeting, highlighted the importance of strengthening sustainability and supporting successful transition to domestic financing to build long-term solutions and achieve greater health security.
The Global Fund is committed to being a good partner in working toward sustainability, acting as a catalyst to additional investment, filling short-term gaps, and addressing bottlenecks to successful transition to more domestic funding. While shifting financing often includes challenges, including how to effectively fund civil society, transition increases country ownership and is necessary to end epidemics.
Prime Minister Zoran Zaev spoke to the Board about the importance of allocating sufficient resources and engaging civil society in developing long-term sustainability of health programs. He expressed strong confidence that a collective approach can lead to success.
Peter Sands, attending his first Board meeting since becoming Executive Director of the Global Fund in March 2018, pointed to strong leadership in Macedonia by the government and by civil society to make transition work effectively. He said that building resilient and sustainable system for health, underpinned by a sensible approach to health financing, while addressing human rights and gender issues, are essential elements for successful transition.
The Board reaffirmed the central role of Country Coordinating Mechanisms (CCMs), the national bodies formed in each country to submit funding applications to the Global Fund and monitor grant implementation. The Board approved an evolution approach and additional funding for 2018 and 2019 to strengthen CCMs to better carry out their function, and also approved a Code of Conduct for CCM members. The Board stressed the critically important role of CCMs in strengthening engagement of civil society, key populations and communities.
The Board also approved a framework for risk appetite that can guide the Global Fund to take appropriate levels of risks to achieve its strategic objectives. The Framework will help balance specific risks and drive consistent risk-reward trade-offs and decision-making.
The Board discussed the decision announced by the Global Fund in February 2018 to not go ahead with new grants to the Democratic People’s Republic of Korea (DPRK), due to serious concerns arising from the unique operating environment that prevent the Global Fund from being able to provide the Board with the required level of assurance and risk management at this time.
The Board expressed continued concern for people affected by TB and malaria in DPRK, and appreciated that a responsible phasing out of current grants should help ensure provision of mosquito nets and medicines for 2018, and availability of sufficient TB drugs, plus a buffer stock, to allow patients enrolled on treatment during the current grant period to complete their treatment.
The Board remains committed to supporting the health of the people of the DPRK, and notes that DPRK remains eligible for Global Fund financing. The Global Fund hopes to re-engage with DPRK when the operating environment allows the access and oversight required.
Separately, the Board approved an approach to ineligible upper-middle income countries in crisis where economic and epidemiological metrics are collapsing and where spill overs threaten regional progress against HIV, TB and malaria. The approach is also applicable to previously malaria-free low and middle income countries experiencing major malaria resurgence.
The Board also approved a revised eligibility policy that embraces a more refined approach to determining eligibility for Global Fund grants. The Board stressed support for countries with the highest disease burden and the lowest economic capacity, and acknowledged the need to continue to support key populations that are disproportionately affected by the diseases.
The Board approved membership for its three standing committees. Some Board members raised concerns about the selection process, and the Board unanimously agreed to make improvements to the process of selecting Board Committee leadership.
The Board endorsed statutory financial statements and approved the Global Fund’s 2017 Annual Financial Report.
The Board welcomed a report from the Ethics Officer, who outlined progress on the Global Fund’s Ethics and Integrity program, including initiatives on due diligence and activities to reinforce our expectations for ethical conduct.
The Global Fund recognizes the dangers of sexual harassment and sexual violence, a key driver of HIV that also creates barriers to services for people affected by TB and malaria. The Global Fund supports programs that improve gender equality, and is also committed to taking action by strengthening its own policies and requiring appropriate conduct by all partners.
In addition, the Global Fund recognizes the courage of survivors of sexual harassment all over the world who are now publicly sharing their experiences, inspiring greater prevention and accountability.
Just prior to the Board meeting, Ministers of Health from South-Eastern Europe met with global development partners and civil society to discuss progress made and what remains to be done to meet the goal of ending the AIDS and tuberculosis epidemics in the region as part of the 2030 Agenda for Sustainable Development.
The ministers recognized increasing ownership of the national responses to the diseases, as external financial support including from the Global Fund is transitioning to support countries with the highest global burdens of disease and least economic capacity. The ministers expressed commitment to allocating domestic funding for and ensuring access to HIV and tuberculosis treatment for all, guided by governance structures that involve civil society and affected communities along with health professionals and technical partners.