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The Global Fund held its 41st Board Meeting on 15-16 May at the Global Health Campus in Geneva. This article summarizes the main decisions made by the Global Fund Board at this meeting, one withdrawn decision point, recent decisions taken through electronic voting prior to the meeting, and a few of the many other topics discussed during the two-day meeting and the ‘Pre-Day’ sessions.


The allocation methodology for 2020-2022 will be very similar to the methodologies used for the last two allocation periods. The methodology prioritizes funding for high-burden and low-income countries. In approving the methodology, the Board decided that up to $800 million of the funds available for country allocations will be used to top up components that require “paced reductions” and components that previously received less funding than the formula calls for.


The Global Fund Board has approved the catalytic funding priorities for the next allocation period. The total cost to fully implement all 26 priorities is $894 million. However, the actual budget won’t be known until after the Sixth Replenishment pledging conference in October 2019. The Board decision contains five potential funding scenarios. Nevertheless, the Secretariat can now begin planning for implementation of the catalytic funding priorities.


In the resource mobilization and replenishment update to the Global Fund Board's 41st meeting, Director of External Relations Francoise Vanni emphasized progress made in the campaign for the Sixth Replenishment since the last Board meeting in November 2018, the key priorities leading up to the Pledging Conference in October 2019, and risk mitigation regarding donor confidence. The Board also approved a Decision Point on an amendment to restricted financial contributions.


An Advisory Report from the Office of the Inspector General on grant implementation in Western and Central Africa shows progress in reducing mortality from HIV and malaria, poor performance in tackling TB, and better absorption of funds than other African regions. It also identifies the complex, systemic challenges that countries from this region face in implementing health programs, and makes recommendations on five areas affecting grant performance. The OIG is expected to publish this report shortly.


The latest annual Community, Rights and Gender Report summarizes the Global Fund’s wide-ranging efforts to advance CRG principles through grants, a strategic initiative, and key partnerships. The Board approved continuation of the CRG-Strategic Initiative, among others, for the 2020-2022 allocation period. Additional programming in this area includes catalytic and matching funds grants, Secretariat-level reforms, and support for community-based monitoring of grants and grant-supported programs.


The latest strategic performance report indicates that the Global Fund is generally performing well against its key performance indicator targets, but that performance in some areas is lagging. One such area is incidence – i.e. the number of new infections and cases. Other areas where performance needs to improve are human rights and key population programming; availability of health technologies; service delivery; and gender and age equality. One area where the Fund is performing well is absorptive capacity. The performance report discusses some common misconceptions about absorption. This article also mentions a pilot project to provide some country-level performance reporting.


The Global Fund Board will shortly have a new chair and vice-chair. On 2 May 2019, the Board appointed Donald Kaberuka as chair and Roslyn Morauta as vice-chair. Each will serve for a two-year term starting from the adjournment of the 41st Board Meeting on 16 May. They will replace the outgoing chair and vice-chair, Aida Kurtović and John Simon, respectively. For this selection, the Board followed a new process that it adopted in May 2018.


The United States’ House Appropriations Committee approved increased funding for the Global Fund, of $1.56 billion for 2020, which if enacted would maintain the U.S.’s share of Global Fund funding at 33%. This amount is exactly what the Global Fund, health advocates, civil society, and other supporters have been working towards, in order to achieve the Global Fund’s minimum target of $14 billion for the Sixth Replenishment.