It’s all about the MONEY

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Editorial Team

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Article Number: 1

ABSTRACT This issue of the GFO is primarily about money, very timely given that many countries are rushing to submit their funding applications in Window 1. We take a look at Domestic Financing for Health, both the Officer of the Inspector General’s Advisory and our own take on what the topic entails. We also look into co-financing and, in relation to the new funding cycle, how catalytic investments have fared. We discuss the contentious issue of Burkina Faso being placed under the Additional Safeguards Policy. Finally, we can announce that the World Bank’s Pandemic Preparedness Fund is at last open for business.

Dear subscribers

As the closing date for Window 1 funding applications draws nearer, it’s appropriate to consider the issue of financing. All of the six articles in the issue, therefore, are directly related to money.

We start by looking at the trade-offs that the failure to fully meet the Seventh Replenishment targets has meant for support to catalytic investments (Reduced Catalytic Investments for 2023-2025 ).

We then go on to comment on the Advisory Report on the Global Fund’s Role and Approach to Domestic Financing for Health (DFH). This Advisory was published in July and our article about it was written in early September. Why, you may ask, has it taken us nearly six months to publish our article? The answer is that our article was deemed to be somewhat controversial and has not been popular with the Secretariat. We are critical of the Advisory – justifiably, we believe. As you know, we always seek feedback from the Office of the Inspector General, the authors, before we finalize our OIG articles to ensure that they are accurate and fair. In the case of the DFH Advisory, we ended up sharing our draft article with numerous colleagues in many different departments of the Secretariat; and this has taken several meetings and much time, resulting in no less than 13 different drafts. Their opinions, to the extent possible, have been observed and reflected in the article and changes made if deemed appropriate. Yet nothing they said questioned the accuracy of what we wrote and it must be remembered that we, the external readers, can only go by what is in the Advisory itself: we are not privy to the context, any background or annexes containing information that was not included in the Advisory.

In Aidspan’s role as independent observers and watchdog of the Global Fund, our mandate is to give credit where credit is due and point out where there are concerns. Above all, we want to be fair – both to the Global Fund, to ourselves as a watchdog and to you as the Global Fund stakeholder and reader. This means we have to tell it how we see it. We apologize for ruffling some Secretariat feathers but make no apologies for saying that a better job could have been done and that the Advisory neither pays justice to the topic nor the significant efforts that went into preparing it.

Given the limitations of the Advisory, which we feel omits some important aspects of DFH (and was therefore probably wrongly-named), article 4 (Determining, analyzing and increasing Domestic Financing for Health) explains DFH in layman’s terms for those who know less about the issue and would like to know more.

Burkina Faso has just been placed under the Additional Safeguards Policy (ASP). This has created something of a furore given that there has been no suggestion of misappropriation of funds or other financial shenanigans that are the main reasons for a country being placed under ASP. Moreover, it is notoriously difficult for a country, once under ASP, to escape from it. What are the implications for the future of Burkina’s programs? It remains to be seen if this has created a precedent which means that a greater number of countries could be threatened with ASP. See article 5, Burkina Faso under additional Global Fund safeguards: Who’s next? 

Our sixth article on the uncertainty of co-financing  is especially topical given that countries are required to submit Commitment Letters together with their funding requests, outlining the amount of national (domestic) resources that a country will contribute towards its disease programs. However, a commitment is not the same as actual expenditure, as our article goes on to discuss. How realistic is it, in the especially difficult global financial context, that countries can be expected to honour commitments and even increase them from previous funding cycles?

Finally, the World Bank’s Pandemic Preparedness Fund  is open for Expressions of Interest from eligible countries and implementers. See article 7 for how to apply.

As ever, Aidspan and our editorial team, under the leadership of Ida Hakizinka, does its best to ensure the accuracy of data and statements in our published articles ― and hence our inclusion of hyperlinks ― but if you, the reader, identify an error or important omission, please notify us and provide us with your data source; and we shall be happy to publish a correction or amendment.

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Don’t forget: if you are aware of an interesting development relevant to disease programmes or health systems and that you feel is worthy of global discussion, do let me know together with the name of a person prepared to write about this. Suggestions and comments can be sent to us, Ida Hakizinka or Arlette Campbell White in English, French or Spanish at ida.hakizinka@aidspan.org or acampbell.white@aidspan.org.

The Aidspan Editorial Team