Office of the Inspector General

The Global Fund’s Role and Approach to Domestic Financing for Health

21 July 2022

OIG Advisory Report
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Domestic Financing for Health (DFH) is a critical building block for resilient and sustainable health systems, and key to ensuring the long-term sustainability of national responses, Global Fund investments, and health outcomes.  

This OIG advisory performed a series of country deep dives, which highlighted several priority DFH challenges, including weak governmental ownership and prioritization of health, excessive out of pocket expenses, low engagement within the public sector and with key private stakeholders, and weaknesses in public financial management and Health Financing data. At Secretariat level, the OIG reviewed activities and processes related to DFH. The current “levers” defined by the Secretariat are appropriate tools to drive impact, however they are at different stages of maturity and operationalization.   

Overall, the Global Fund's role within, and approach to, DFH is moving in the right direction. But there are opportunities to enhance the deployment of DFH levers, to ensure they both reflect the organization’s profile and address specific DFH challenges at country level. In addition, to effectively support countries to strengthen DFH, the Global Fund should leverage ‘cross-cutting’ enablers and opportunities, such as its overarching strategic approach, its operating model and the role of Civil Society Organizations as advocates and service providers.