Reduced Catalytic Investments for 2023-2025

Author:

Aidspan

Article Type:

Article Number: 2

The absence of reporting renders it difficult to assess the potential consequences

ABSTRACT The Seventh Replenishment did not meet the target total. In order to maintain or increase country allocations for the 2023-2025 period, the Global Fund has therefore looked to reduce other allocations, including those for catalytic investments. As a result, the proposed budget for planned catalytic investments in the 2023-2025 period has been reduced by 44% from the previous period. A difficulty in assessing the potential effects of this diminution is that there are no reports available that provide information on the actual amounts of catalytic investments and their performance. This article calls for open and easily accessible reporting on those investments.

Introduction

While the efforts of the Global Fund and its advocates succeeded in securing an increase in funding pledges for 2023-2025, the target was not achieved. The Global Fund’s top priority was to maintain – and, if possible, to increase – country grant allocations at the levels of the 2020-2023 cycle. This has meant reducing other funding. Hence the Global Fund Board is being asked to approve a reduction in catalytic investments for 2023-2025.

Catalytic investments are of three types:

1. Strategic initiatives
2. Catalytic multi-country funds
3. Catalytic matching funds

 

Strategic Initiatives

In November 2019, the Board approved 19 strategic initiative workstreams totalling $343 million for 2020-2022 to support the success of country allocations that could not be funded through country grants – see Table 1.

 

The proposal now under consideration is to reduce strategic initiatives to only eight workstreams, as yet unspecified, totalling $119 million. That will mean a 65% reduction in the amount invested in strategic investments; but, bearing in mind the impact of inflation, that will mean more like a 70% reduction in coverage.  This could well put a brake on progress towards developing resilient and sustainable systems for health (RSSH).

While $343 million was the approved total for strategic initiatives, the most recent financial report, as of 30 June 2022, presented to the 20th Audit and Finance Committee Meeting on 13-14 October 2022, shows a total of $323 million available for strategic initiatives and forecasts a utilisation of only $263 million by the end of 2022.  On the basis of the forecast total utilisation of $263 million for 2020-2022, the proposed total of $119 million for 2023-2025 is a reduction of 55%.

Catalytic Multi-Country Funds

Multi-country funds were introduced to make grants available to tackle priorities in a limited number of geographical regions. Multi-country grants are designed to accelerate the end of the HIV, TB and malaria epidemics and to strengthen health systems by tackling regional bottlenecks and cross-border issues. They have the potential to achieve impact in particular settings, especially where bottlenecks cannot be resolved by a single country application.

Applicants for funding are eligible if the majority (at least 51%) of the countries included in the funding request are eligible for funding in their own right. Applicants for multi-country funds must be either a regional coordinating mechanism or a regional entity with an independent legal personality that is not a United Nations agency or a multilateral or bilateral organisation.

There is a dire lack of data on actual multi-country funds. The most recent publicly available report on multi-country funds is the Office of the Inspector General Audit Report dated 14 February 2019; but that report includes only budget amounts: no actual grant disbursement totals are quoted.

Catalytic Matching Funds

Matching funds are designed to encourage innovative and ambitious, evidence, based approaches to increase impact in priority areas.  For the 2023-2025 allocation period, the priority areas are:

• HIV: Prevention for key populations
• HIV: Prevention for adolescent girls and young women (AGYW) and their sexual partners
• HIV: pre-exposure prophylaxis
• TB: Find and treat the missing people with drug-susceptible TB and drug-resistant TB
• RSSH: Innovation fund
• RSSH: Digital health impact accelerator
• RSSH: Integrated laboratory systems strengthening
• RSSH: Scaling-up programs to remove human rights and gender-based barriers
• RSSH: Effective community-based systems and responses.

 

We have information on the proposed budgets for 2023-2025 matching funds in four categories:

1. Adolescent girls and young women (AGYW)
2. Human rights
3. Key populations
4. Effective community systems and responses

 

Programs aimed at AGYW have become a priority, yet the proposal is to reduce the total of matching funds of $55.8 million approved for 2020-2022 to only $8 million for 2023-2025, a reduction of 86% – see Table 2.

Table 2. AGYW Matching Funds, GC5-GC7

Human rights matching funds look to fair better, with a reduction of only 23% – see Table 3.

Table 3.Human Rights Matching Funds, GC5-GC7

Most surprising is the proposed 68% reduction in matching funds for key populations – see Table 4.

Table 4. Key Populations Matching Funds, GC5-GC7

New matching funds for effective community systems and responses are proposed for 2023-2025 – see Table 5.

 

The proposed budgets set out in Tables 2-5 total $97.8 million.  The total proposed budget for matching funds is $266 million but information on other categories, totalling $168.2 million (and presumably including many RSSH priorities) is not yet available.

Summary

As Table 6 shows, the proposed total budget for catalytic investments for 2023-2025 represents a reduction of 44% from the budget for the previous period.

 

While this may be of concern to some people, especially regional organisations in need of increased multi-country funding, it is impossible to assess the potential effects of this diminution.  This is because, apart from the estimated total usage of funds for strategic investments (referred to above), there are no reports available in the public domain that provide information on the actual amounts of catalytic investments and their performance.  We therefore encourage the Secretariat to introduce regular reporting on spending on catalytic investments and their outcome and performance.