The Global Fund to Fight AIDS, Tuberculosis and Malaria’s Board passed its new strategy for the period 2017-2022 yesterday in Abidjan, Cote d’Ivoire during its 35th Board Meeting. The Africa constituencies of West and Central Africa and East and Southern Africa were very pleased to see the long process of developing the new Global Fund Strategy reach a successful conclusion. Through an extensive consultation process, the resounding message was for the Global Fund to “stay the course” and refine priorities rather than make major strategic shifts. It was gratifying to note that these refined priorities align very closely to what was identified at the May 2015 meeting of the Africa constituencies in Addis Ababa, Ethiopia as the most critical issues for Africa.
- Resilient and sustainable systems for health (RSSH)
Building resilient and sustainable systems for health (previously “health system strengthening”) is the top priority for the Africa constituencies. The Africa constituencies strongly believe that investments in RSSH will not only yield the maximum impact for disease-specific programming, but will also enable countries to better respond to predictable and emergency public health issues across the board. The constituencies hope this will not only help to achieve Global Fund goals, but lift the overall health status of Africans across the continent through improved national systems.
Specifically, it was good to see attention to human resources for health, including pre-service training for community health workers. This is a major victory since this has been an area most funders have resisted supporting. The constituencies hope their countries will take full advantage of this. They were also pleased to note support for countries to develop M&E plans and investments into data systems to feed into these plans–another huge step in the right direction. The constituencies hope to see alignments of goals and targets with other global agendas will be carried over to this area to ensure that non-Global Fund investments into data systems are coordinated.
- Women and girls
As Global Fund Executive Director Mark Dybul said, the battle will be won or lost based on how well we address the epidemic in women and girls in sub-Saharan Africa (SSA). In some places in Africa, the rate of HIV infection is two girls for every one boy; in others, infection rates are as high as 10 to one.
Structural and societal barriers contribute to this disadvantage and prevent access to life-saving interventions for the other diseases. The Global Fund’s focus on this issue in its 2017-2021 Strategic Plan is therefore critical to achieve its global goals. This includes, for example, interventions that support girls to improve health as well as education, an unprecedented move by the Global Fund. As the strategy explains:
“…[Th]e evidence is growing that keeping adolescent girls and young women in school reduces their vulnerability to HIV infection and other health risks, and ultimately enables girls to become healthy, educated and financially independent women who make well-informed choices about their lives. By working together with organizations such as the Global Partnership for Education, the World Bank, and bi-lateral partners, investments made by the Global Fund may be leveraged or vice versa to enable adolescent girls and young women to have access to both better health and better education.”
The Africa constituencies very much hope that sharpened focus on women and girls leads to swift improvements in capturing age and sex-disaggregated data at the country level.
- Challenging Operating Environments (COE)
Challenging environments may result from enduring political, social and/or environmental issues or from emergency situations. The constituencies include a number of countries classified as COE. Such environments compromise the ability of investments by the Global Fund to achieve the intended impact or, worse, derail progress. There is need to respond effectively to COE, whether chronic or acute, to ensure that ground is not lost in the disease response. The need for flexibility that emerged from the Addis meeting has been very well captured here.
The strategy development process was led by Strategy, Investment and Impact Committee chair David Stevenson and vice-chair Anita Asiimwe, the out-going board member representing the East and Southern Africa constituency.
The Africa constituencies congratulate the Global Fund Board for delivering an ambitious strategy that responds to the current realities in global health. It makes sense that the plan demonstrates strong alignment with the Sustainable Development Goals and other global agendas and partnerships, and the deliberate efforts taken to harmonize the strategic focus, goals and objectives with other global initiatives to tackle the three diseases (specifically with the End TB Strategy, the UNAIDS Fast Track and the Global Technical Strategy for Malaria).
This strategy allows the Global Fund to maintain its role as a transformative force and a global agent of change that will spearhead efforts to rethink health system investments. There is a real opportunity to demonstrate that investments can be made in the foundations of strong and resilient health systems on which successful disease-specific interventions can be built, while staying true to our core mandate of fighting the three diseases.
Now comes the hard part: implementing the strategy. But with strong support from donors and implementers around the world, there is little doubt that the next phase of Global Fund activities will take us further in global health than we could have imagined at the inauguration of the Global Fund back in 2002. Africa holds the greatest disease burden and so strongly appreciates the support from the Global Fund and its donors. Together with its country partners, the Global Fund has saved some 22 million lives. The Africa Constituencies believe we—all of us involved in the work of the Global Fund at all levels around the world–are at a critical juncture as we move into the next replenishment cycle to ensure that the Global Fund is able to invest strategically and ambitiously to support countries to meet their goals of eradicating the epidemics through strong and resilient health systems.
The African Population and Health Research Center provides technical support to the Africa constituencies to the Global Fund Board.