A ‘TOP 20’ RANKING OF COUNTRIES WITH THE LARGEST GLOBAL FUND 2020-2022 ALLOCATIONS FOR THE THREE DISEASES

Author:

Djesika Amendah

Article Type:

Article Number: 4

Mozambique, India, and Nigeria received the largest allocations for HIV, TB and malaria

ABSTRACT Using the Global Fund’s data service, Aidspan takes a look at which countries received increases in their total allocations of 50% or more, as well as the top 20 countries with the largest allocations for each of the three diseases in this 2020-2022 cycle (Mozambique, India and Nigeria for HIV, TB and malaria, respectively).

The Global Fund has increased funding by an overall 23% to all countries in the coming 2020-2022 cycle compared to the 2017-2019 cycle. (See recent GFO article describing the new allocations.) The Global Fund allocates funds to eligible countries using a formula that accounts for two main variables: the burden of disease and the income per capita. The Global Fund’s formula therefore favors low-income countries with high burdens of each disease.

This article highlights countries with increases in their total allocations of 50% or more, as well as the top 20 countries with the largest allocations for each of the three diseases in this 2020-2022 cycle. The data comes from the Global Fund’s data service.

Twenty countries with increased total allocations of 50% and higher

We first focus on countries with an increased total allocation of 50% or more in the 2020-2022 funding cycle, compared to the 2017-2019 cycle, as this represents a substantial increase in available funds to fight those three diseases.

For this section,  the data from the following countries/grants were not locatable within the Global Fund’s data service: Bulgaria, Fiji, Iraq, Multicountry Americas (an HIV grant for activities in 11 countries in Latin America), Palestine, Russian Federation, Syrian Arab Republic, and Yemen.

Albania received the highest increase in its total allocation, of 490%. Seven countries’ allocations have doubled between the two funding cycles (increases of at least 100%) (See Table 1, beneath Figure 1 below). Interestingly, most of those countries have relatively small portfolios: six countries received less than $10 million, nine others received between $10- and $100 million. Only two of these 20 countries (Mali and South Africa) are defined by the Global Fund as ‘high impact” – with a “very large portfolio, mission-critical disease burden”.

Figure 1: Countries with allocations higher by at least 50% compared to 2017-2019

Source: The Global Fund

Top 20 largest HIV/AIDS allocations

For this section, Aidspan could not locate the data from Bulgaria, Gabon, Multi-country Americas (CRN+), Palestine, Russian Federation, Syrian Arab Republic and Yemen on the Global Fund’s data-service website.

The 20 top HIV/AIDS grants

We rank the top 20 countries in terms of their 2020-2022 HIV/AIDS allocations, excluding catalytic funds, if any.

Among the top 20 countries with the largest HIV/AIDS grants, 17 are African, two are Asian (India and Indonesia) and one is Caribbean (Haiti; see Table 1). Mozambique and South Africa have received the highest absolute allocations in this cycle, of $496.4 million and $491.2 million, respectively. The allocations are in line with their disease burdens, as South Africa has the largest HIV epidemic in the world, with prevalence at 20.4% in 2017. Mozambique is a neighbor to South Africa with an HIV prevalence among adults of 12.6% in 2017, according to UNAIDS. Interestingly, Tanzania and Rwanda, despite a reduction in their HIV allocations by 11% and 21% respectively, are still in the top 20 in terms of allocations. The allocations for India and Myanmar remained essentially the same over the two periods, at $155 million and $123 million respectively.

 

Twenty-four countries received allocations increased by at least 50% to fight HIV/AIDS

Eleven countries’ allocations have at least doubled (increases of at least 100%). Among these countries, Egypt received the highest allocation increase, of 740%, while Paraguay’s allocation increased by 52%. Countries with the highest percentage increases are not the ones with the largest HIV/AIDS grants. For instance, Egypt’s HIV/AIDS grant in this cycle is $4.2 million, while that of Paraguay is $6.7 million.

Top 20 Largest TB allocations

For the TB allocations’ analysis, we did not have adequate data from the following countries/grants: Bulgaria, Fiji, Iraq, Multicountry Americas (CRN+), Palestine, Syrian Arab Republic and Yemen.

We rank the top 20 countries in terms of their 2020-2022 TB allocations. Among the top 20 countries with the largest TB allocations, 18 are High-Impact Asia and Africa (See Table 2). India and Pakistan have the two largest TB allocations at $280 million and $171.9 million, respectively. India, with a population of 1.4 billion, is home to more than a quarter of the global TB burden, according to the Global Fund. The country also has the world’s highest incidence of TB, with 2.7 million cases annually. India has set a goal of ending TB in the country by 2025, five years ahead of the Sustainable Development Goal (SDG) target year. Pakistan, its neighbor, has an estimated 562 000people with TB.

 

Malaria allocation

We ranked the top 20 countries in terms of their 2020-2022 malaria allocations. The top 20 countries in terms of amount of malaria allocations are in Africa (Table 3). India is 21st (not shown in the table). Nigeria has received the largest malaria allocation at about $417.8 million, followed by Democratic Republic of Congo at $393.9 million.  Malaria is endemic in these two large countries, which have populations of 206 million and 89 million, respectively. These two countries accounted for 37% of all malaria cases globally in 2018 (See WHO’s Malaria report of 2019:).

 

As with HIV/AIDS and TB allocations, countries that received the highest increases in malaria allocations are not among the top 20 in terms of the total allocation in the 2020-2022 cycle. Sao-Tome and Principe, and Congo received the highest increases – of 198% (total allocation $11 million) and 156% (total allocation $34 million), respectively.

All countries that received allocation letters must submit their requests for funding to the Global Fund during the three windows for application during 2020. Increases in allocations are associated with an increase in the countries’ co-financing commitments – in other words, with an obligation for countries to increase their domestic funding for their respective health sectors and programs for the three diseases. (See separate article in this GFO on co-financing in the latest allocations.)