Resilient and Sustainable Systems for Health

The Challenge

Even before the COVID-19 pandemic, formal and community health systems in many low- and middle-income countries were strained, facing shortages of skilled health care workers; costly and incomplete supply chains; inadequate data; poor integration of government, private sector and community health systems; siloed implementation of national disease control programs; and many other challenges. To end HIV, tuberculosis (TB) and malaria as epidemics and fight emerging threats like COVID-19, we need to strengthen the formal and community health systems and responses that make up resilient and sustainable systems for health (RSSH).

RSSH is not just about government health systems, but also about services provided by communities, the private sector and other providers, which together should ensure that individuals’ health needs are met wherever they seek care. These systems are essential for ending HIV, TB and malaria as public health threats, producing better health outcomes for all and delivering health services in a sustainable, equitable and effective way. RSSH is also the basis for preventing, preparing for and responding to future pandemics.

The whole world benefits when we build the strength and resilience of formal and community health systems everywhere. This year, with the Global Fund’s Seventh Replenishment conference, the world has an opportunity to invest more in stronger systems for health and build a healthier, more equitable world for everyone, everywhere.

The Response

The Global Fund is the largest multilateral provider of grants for strengthening systems for health. Over the 2021-2023 funding cycle, we are investing US$4.9 billion, or US$1.5 billion a year, in formal and community health systems through our core grants and our COVID-19 response – about one-third of our total investments.

Our investments in RSSH take different approaches. We invest in the treatment and prevention of HIV, TB, malaria and COVID-19 and support countries to respond to those diseases, while also improving overall health systems by boosting the quality of care, data tracking, accountability and governance, and service delivery. By reducing the burden of HIV, TB, malaria and COVID-19, we free up health systems’ capacity for other health priorities.

Community systems for health are designed, led and organized by communities themselves to address local needs and reach the most marginalized and vulnerable people. They play a crucial role in increasing access to equitable and high-quality services.

The Global Fund’s new Strategy recognizes the essential role that RSSH plays in ending HIV, TB and malaria and in helping countries prevent, prepare for and respond to new pandemics like COVID-19 and for future health threats. In order to support countries and communities to strengthen their health and community systems, our new Strategy focuses on seven sub-objectives:

• Deliver integrated, people-centered services to address an individual’s multiple health needs at different points in their lives, improving overall health with a more cost-effective and efficient approach.
• Strengthen community systems and community-led programming and help integrate them into national health and social systems.
• Strengthen creation and use of health data at all levels so countries and communities can make decisions based on latest evidence.
• Strengthen supply chains to ensure medicines, laboratory services and health products are available when and where they’re needed.
• Expand our NextGen market shaping focus on providing equitable access to quality health products through innovation and partnership, and by promoting sustainable sourcing and supply chains at global, national and community levels.
• As part of Global Fund efforts to strengthen country oversight of the overall health system, better engage and harness the private sector to improve the scale, quality and affordability of services wherever patients seek them.
• Deepen partnerships between governments and non-public sector actors so programming and services are sustainable and can reach more people.