Post-Replenishment: from Pledges to Results
Donors at the Global Fund's Sixth Replenishment Conference pledged $14 billion for the next three years – the largest amount ever raised for a multilateral health organization. By all standards, our fundraising outcome in Lyon was a very impressive achievement, and testimony to the strength of the Global Fund partnership and the hope it brings to communities around the world.
As Chair and Vice-Chair of the Global Fund’s Board, we are extremely grateful to our partners for their unprecedented show of solidarity. At the same time, we are quite mindful that we now need to translate the $14 billion in pledges into results, as we work toward accelerating the end of HIV, tuberculosis and malaria. We have set high expectations. We simply cannot squander this opportunity, as we rightly owe it to taxpayers around the world, and to the people affected by the diseases, particularly the poor and the marginalized, to achieve as much impact as possible.
In the coming months, our colleagues in the Secretariat in Geneva will be busy preparing for grant-making for the next three-year cycle. We would like to identify our priorities under our mandate for the Board of the Global Fund as we aim to increase impact.
The Global Fund has had incredible results, but we now need to double our efforts to reach the most vulnerable and marginalized with effective interventions. Everything we do, every process we put in place, must be aimed at our mission. Programmatic effectiveness and results are the final objective of the Global Fund. This means all our investments in health should have a relentless focus on value-for-money, outcomes and impact.
We recognize that the Global Fund’s $14 billion is only part of the funding required to save 16 million lives over the next period. As the Investment Case spells out, domestic funding for programs to fight HIV, TB and malaria over the period 2021-2023 is projected to grow to $46 billion, an increase of 48 percent over the current cycle. Greater leadership in health by implementing countries will be a flagship effort.
For sustainable health financing, there will be a need for greater mobilization of domestic fiscal resources, increased allocations for health, and the right interventions. The Global Fund has a role to play in supporting this agenda. The Global Fund has leveraged additional domestic resources though its co-financing policies and is engaging more and more with international financial institutions on co-financing and technical work, and with civil society on advocacy. Focused and effective Global Fund support for sustainable health financing is essential. We commit to work with implementing countries, international financial institutions and partners for more and better investments to end the three diseases.
While there is general recognition of the excellent work of the Global Fund, we believe there is also room for stronger focus on purpose and efficiency. In terms of Global Fund governance, this will require an elevation of Board discussions to a more strategic level, as well as a careful look at how the Global Fund manages itself and its portfolios, and more broadly how the Fund positions itself within the global health architecture and the wider Sustainable Development Goals agenda.
The overarching questions we must consistently ask ourselves should be: how is the global effort performing? How are the countries we are supporting doing? What is the Global Fund’s contribution to that effort? And finally, what is it that we can do better or differently to maximize impact, with implementing countries and partners?
The Board is positive about the steady progress underway to improve performance management and would like more discussions on KPIs and results at the Board level. In addition, the Board has prioritized strengthening the independent evaluation function. Independent evaluation is not an add-on, it is core to organizational learning, it is core to accountability and independent judgment of what the Global Fund does, and this can only but increase impact.
Finally, we pledge an active leadership in the Global Fund Board, and support deepening partnerships through advocacy and engagement. We will be present on the ground, visiting some of the challenging environments to engage stakeholders. And we will continuously engage with Board members and constituencies’ views on how we can collectively best advance the Global Fund’s work.
Our Replenishment Conference in Lyon was the beginning of our road. We’ve had a terrific start. With a successful Replenishment behind us, we now look forward to fulfilling our promise to accelerate the end of the epidemics.
Dr Donald Kaberuka is the Chair of the Global Fund Board; Lady Roslyn Morauta is the Vice-Chair. Their two-year term as Chairs began in May 2019.