The Global Fund works closely with countries to help them achieve long-term sustainability of health programs, so they can maintain progress and continue to expand services after Global Fund support ends. Ultimately, ending the epidemics will only be achieved with sustainable health systems that are fully funded by countries through their own resources.
The Global Fund partnership takes a holistic approach to sustainability, both at the programmatic and financial level. Working with partners, we engage with all countries, regardless of their income level and disease burden, to support well-planned and successful transitions. Experience shows that planning a transition from Global Fund support takes time and resources.
Key pillars of our work on sustainability, transition and co-financing:
- Support countries to develop robust national health strategies, health financing strategies and national disease strategic plans
- Encourage additional domestic investments; require minimum 15% co-financing for every country allocation
- Accelerate efforts to prepare for transition, particularly for upper-middle-income and lower-burden, middle-income countries
- Strengthen focus on key populations and structural barriers to health
- Work with partners to advocate for programmatic and financial changes
- Strengthen alignment between Global Fund grants and country systems
- Support countries to identify efficiencies and optimize disease responses
Stimulating Domestic Financing
Encouraging and stimulating domestic investments in health is an essential component of the Global Fund’s strategy. The US$14 billion raised for the Sixth Replenishment seeks to spur domestic investment of US$46 billion through co-financing requirements, and technical assistance on health financing. Our Sustainability, Transition and Co-Financing Policy aims to support countries as they move toward full domestic funding of their systems for health, including their HIV, TB and malaria programs. In our 2017-2022 strategy, the Global Fund commits to work with all implementing countries to increase domestic resource mobilization for health, with a particular emphasis on investing in programs that support key and vulnerable populations.
The Global Fund works with countries to plan for transition. One way to do this is by conducting transition readiness assessments with the government and partners. Such assessments look into several factors including the country’s epidemiological context, domestic funding and budget priorities, the policy and legal environment, and support for human rights, gender equality, and key and vulnerable populations. To strengthen planning and better manage transitions, the Global Fund provides transition funding for up to three years to disease programs that become ineligible for regular Global Fund grants.