WE MUST FOCUS ON THE POSITIVE ASPECTS OF THE SEVENTH REPLENISHMENT – WHILE RECOGNIZING THAT WE HAVE TO WORK HARDER WITH LESS

Author:

Christian Djoko

Article Type:

Article Number: 8

Interview with Éric Fleutelot, Technical Director of the Pandemics Division of Expertise France's Health Department

A month after the seventh Global Fund replenishment in New York has come to a close, we hear from a leading institutional actor about the level of pledges and challenges for the upcoming three-year cycle.

1. If you had to introduce yourself in a few words, what would you say?

Pandemics, infectious diseases, community health and human rights. To be more precise, I manage the Pandemics Division of Expertise France’s Health Department, where I am the Technical Director. I joined Expertise France in April 2019, after nearly five years in Southeast Asia as a Regional Global Health Advisor for the French Ministry of Foreign Affairs. I am naturally drawn to community health, particularly in relation to HIV. But I have also worked on and have a great interest in other pandemics, and the field of health research and diplomacy.

2. What is your overall take on the recent Seventh Replenishment conference in New York?

There were several positive aspects, of course, because with the current international context it was not a given that pledges of that level would be mobilized. There is still interest from large and smaller donors and there is a shared commitment not to stop halfway. It is clear that many political leaders have reiterated the importance of continuing and scaling up the response to the HIV, tuberculosis and malaria pandemics. However, it is also clear that we are still a long way off the $18 billion target, and Italy and the United Kingdom have only announced that they plan to make future pledges but have not yet committed on the amount.

3. The Global Fund requested a minimum of $18 billion for the next three-year funding cycle (2024-2026). Pledges made to date by the various donors amount to $14.25 billion. Doesn’t that mean we have failed, despite the record level of pledges?

Pledges currently amount to $14.25 billion, if we include 100% of the US pledge. However, this is conditional on the US contribution representing no more than one third of the total amount. Therefore, pledges may in fact be below $14.25 billion. This is obviously a cause for concern.

4. In your opinion, what are the main challenges facing the Global Fund in the next three-year cycle?

There are many challenges, but they are motivating. These challenges have the potential to move all members of the Global Fund partnership towards achieving the 2030 goals. These challenges involve all stakeholders, starting with countries themselves. Some examples, in no particular order of priority, include the operational implementation of the new Strategy, in particular its strengthened objective around integrated and people-centered health systems. Clearly, scaling up in many countries today will require more work around the different pillars of health systems. Thematic areas relating to human rights, gender and equity in access to health services are also a major challenge, particularly for the most marginalized populations and those in the most fragile contexts. The security context is also a delicate issue. In some countries, health services are no longer expanding, they are shrinking. How can we ensure access to primary health services in these regions? This is not just the responsibility of the Global Fund, but it will need to be part of the answer. Finally, we mustn’t forget the impact of COVID-19, which has shown just how fragile the gains to date have been.

5. Through its considerable contribution to the Seventh Global Fund Replenishment, France has reaffirmed its commitment to making a significant contribution to the eradication of HIV, malaria and TB as pandemics by 2030. In addition to the financial commitments announced, when President Macron presented France’s pledge, he also set out an approach and a framework for action. In this way, he wants L’Initiative, alongside the Global Fund, to play a more important role in the response to the three diseases. What does this mean in practice for you and for beneficiaries of your various interventions?

France is a faithful and loyal partner to the Global Fund and to the dynamic it undeniably brings to pandemic responses. There is no doubt about that.

L’Initiative therefore intends to support and strengthen the Global Fund’s ecosystem to ensure greater performance and coherence. We are there to support countries in the same way as the Global Fund. We are working towards strategic convergence to scale up massive investments to respond to pandemics so that health systems are more accessible, welcoming, affordable and of better quality. Global Fund and L’Initiative partners are one and the same. We work with national authorities, civil society organizations and other technical and financial partners. We have a focus on the most fragile states, in line with the list of priority countries for French official development assistance.

To ensure we are better prepared, we are currently updating L’Initiative’s strategy, which was adopted in 2020. Increasing L’Initiative resources will allow for more ambitious operationalization, particularly around systems for health and for the most vulnerable communities.

6. Is there anything you would like to discuss that wasn’t covered in the interview?

Aidspan’s role as an independent observer of the Global Fund remains crucial. There is a need to continue and expand the production and dissemination of information to better understand the Global Fund, country contexts, challenges and successes. So, I want to convey a message of encouragement both to the Aidspan team and to its readers and users.