Board controversy over the Global Fund’s continued engagement with the World Bank’s Pandemic Fund resulted in it being referred back to the Strategy Committee
Samuel MuniuArticle Type:
Article Number: 6
The Global Fund should be an Implementing Entity of the Pandemic Fund but should not expend resources advocating to countries about it
At the 49th Board meeting held on 10-11 May 2023 the Global Fund Board heard the Secretariat’s proposals on the parameters of its engagement with the World Bank’s Pandemic Fund. This was related to the Pandemic Fund’s first call for applications. Due to different Board members’ views and a failure to reach a consensus on the Decision Point, the matter was referred to the Strategy Committee for further delibarations.
During its 49th Board meeting held on 10-11 May 2023 in Hanoi, Vietnam, the Global Fund Board discussed the Secretariat’s request that the organization continue to engage with the World Bank’s Pandemic Fund to collaborate and coordinate efforts. The Secretariat made the proposal to the Board following the Pandemic Fund’s first call for funding applications which opened on 3 March 2023 and closes on 19 May 2023.
Following exhaustive discussions, the Board referred the matter to the Global Fund’s Strategy Committee for further deliberation at its July meeting.
Failure to coordinate the COVID-19 Response Mechanism (C19RM) and Pandemic Fund applications may result in the inefficient implementation of parallel projects in overlapping areas. It may also increase the a country’s workload due to siloed applications, awards, and implementation arrangements for pandemic preparedness and response investments. Furthermore, it may pose reputational damage on the part of the Global Fund if it were to be perceived as unwilling to collaborate with the Pandemic Fund.
About the Pandemic Fund and its engagement with the Global Fund
The Pandemic Fund, a collaborative partnership among donor and recipient countries, foundations, and civil society organizations, finances critical investments to reinforce pandemic prevention, preparedness, and response (PPPR) capacities in developing countries. It also brings additional resources to incentivize countries to invest more in PPPR, including enhancing partner coordination and supporting advocacy efforts. The organization was established in response to the devasting human, economic, and social impact of the COVID-19 pandemic to coordinate efforts to build stronger health systems and mobilize extra resources for PPPR.
Figure 1: About the Pandemic Fund
Source: Global Fund Board document GF/B49/02
On 3 February, the Governing Board of the Pandemic Fund approved $300 million for its first round of funding to finance developing countries to better prepare for and respond to future pandemics. A month later the organization invited eligible countries, regional bodies, and approved implementing entities to apply for funding. The Global Fund is among the 13 organizations that the Pandemic Fund has pre-accredited as implementing entities. The funding is focused on three priority areas: strengthening disease surveillance and early warning systems; laboratory systems; and the health workforce.
After the submission of proposals between 1 and 19 May, the Pandemic Fund’s Technical Advisory Panel will begin to review eligible applictions, a process that will take place till June 2023. Then, in July 2023, the Pandemic Fund Governing Board will announce the selected proposals for funding.
Figure 2: The Pandemic Fund’s first call for proposals
Source: Global Fund Board document GF/B49/02
Even before the establishment of the Pandemic Fund, many organizations, including the Global Fund, had been supporting countries to respond to the COVID-19 pandemic. The Global Fund Board established the C19RM in April 2020 to support countries to mitigate the impact of COVID-19 on HIV, TB, and malaria services, as well as strengthen health systems.
Figure 3: The Global Fund’s COVID-19 Response Mechanism (C19RM)
Source: Global Fund Board document GF/B49/02
Coincidentally, the Global Fund embarked on developing its new Strategy during the COVID-19 period. The Strategy, approved by the Board on 22 July 2021, captures the need to address future pandemics. It has an “evolving objective” to contribute to pandemic preparedness and response, leveraging the Global Fund’s partnerships to bolster efforts to prepare and respond to pandemics. Enhancing pandemic preparedness and response in its Strategy is a clear statement of the organization’s intention of working with like-minded organizations to fight future pandemics.
In November 2022, the Global Fund Board had already instructed the Secretariat to engage the Pandemic Fund to explore ways of working together (see our article about it here). Since then, the Global Fund Secretariat, alongside other organizations, has been collaborating with the Pandemic Fund to determine areas requiring coordination or combined efforts. In February 2023, the Global Fund submitted a non-binding expression of interest to the Pandemic Fund with proposals on how the two organizations could cooperate to strengthen countries’ pandemic preparedness efforts.
However, it remains unclear how the Pandemic Fund will translate the expression of interest into designing programs to be supported under the initial call of funding of $300 million. This uncertainty prompted the Secretariat to turn to the Board for endorsement on the parameters of its engagement with the Pandemic Fund related to the first call of applications.
Areas for collaboration between the Global Fund and the Pandemic Fund
The Secretariat made several proposals to the Board on how the Global Fund should constructively engage the Pandemic Fund. These comprise the following:
- The Global Fund should seek to enhance coordination of the design, application, review, approval, and implementation of C19RM and Pandemic Fund grants at both global and country levels. The coordination at the country level is key to avoiding duplication of efforts as both funds are likely to provide support for very similar activities.
- The Global Fund should engage the Pandemic Fund to leverage C19RM funding request submission, review, award, and implementation processes to optimize synergies at the country level. Also, the Secretariat should engage the Pandemic Fund to take advantage of existing C19RM monitoring, evaluation, assurance, and oversight mechanisms.
- The Global Fund is to apply for funding from the Pandemic Fund to increase the scale of country health systems investments funded through C19RM. Specifically, the funding will be directed to support high-quality demand from countries that the Global Fund is unable to fund within the available C19RM resources. Countries may benefit from such an arrangement as they will be required to prepare one funding request that will be financed by both the Global Fund and the Pandemic Fund. On the other hand, the Pandemic Fund will leverage the existing C19RM implementation arrangements at the country level by optimizing technical assistance and harmonizing implementation efforts.
- The Global Fund will request flexibilities from the Pandemic Fund in coordinating its review and award to follow the already established C19RM processes. On its part, the Global Fund has set 12 May 2023 as the deadline for countries to submit C19RM funding requests. This is one week ahead of the Pandemic Fund submission deadline of 19 May 2023. This potentially allows the Global Fund to share an overview of all country applications with the Pandemic Fund by the 19 May deadline. Thereafter the Global Fund can share detailed information following C19RM funding requests’ review and award-making.
- The Global Fund recommends the use of the Pandemic Fund resources through the existing Global Fund systems, including implementation, monitoring and evaluation, financial reporting, and assurance mechanisms.
- The Global Fund does not request any overhead costs associated with the Pandemic Fund’s first call of proposals. Rather, such operational costs are to be financed under the current organization’s operational expenditure and C19RM resources.
- The Global Fund asserts that any joint funding with the Pandemic Fund must be of sufficient scale to justify the coordination efforts required to jointly approve and program these funds.
Stakeholders’ feedback and deliberations in the Board meeting sessions
Stakeholders expressed a very wide range of differing views both through written statements and Board discussions on the Global Fund’s engagement with the Pandemic Fund’s first call for proposals. It was clear to most that the Global Fund has a role to play regarding PPPR, considering the C19RM resources it is already making available to countries. Thus, there is a clear need for the Global Fund to continue to try to find alignment with the Pandemic Fund to avoid siloed approaches, maximize impact and reduce transaction costs. Moreover, the Global Fund should ensure that communities and civil society is at the centre of PPPR, regardless of the source of the funding.
It was pointed out that most members of the Global Fund Board are involved in the governance and decision-making structure at the Pandemic Fund. Thus, they should take advantage of this to emphasize that the Global Fund is identified as the the best mechanism to achieve impact on PPPR. Moreover, they should ensure flexibility from the Pandemic Fund so that its review and award processes can be coordinated with Global Fund processes. However, some people expressed concerns about the duplication of efforts and potential conflict of interest for those that are members of boards of both the Global Fund and the Pandemic Fund.
Due to the evolving nature of the PPPR discussions some constituencies expressed a need to better understand the PPPR landscape as well as the ongoing discussions on international health regulations before the Global Fund identifies the role it can play. Part of this could be achieved by getting more clarity on the nature of the PPPR accord as agreed by Member States. Nonetheless, when it comes to PPPR there is a need to be proactive as it is essential for global health security and the avoidance and/or mitigation of another pandemic of the scale of COVID-19. The Global Fund’s engagement with the Pandemic Fund should be driven by a need to lower transaction costs, improve health, and maximize impact. Through their engagements, the two organizantions can reduce the administrative burden arising from the development of funding requests and grant implementation.
There were those that felt that the Global Fund should focus on its core business of figting HIV, tuberculosis, malaria, and strengthening health systems. Also, they pointed out that organization has significant C19RM resources and thus should direct its energies in helping countries to implement C19RM grants. Already the organization has previously faced challenges with C19RM reprogramming and some constituencies were concerned about the C19RM absorption rate. The demand for the Global Fund to serve as an Implementing Entity of the Pandemic Fund should be country-driven. Thus, it should not expend resources advocating to countries that they become one of the Pandemic Fund’s Implementing Entities. Should a country name the Global Fund as the Implementing Entity during the first round of the Pandemic Fund, the Secretariat was requested to fully disclose the additional operational burden to the organization.
Following Board discussions, the matters was referred to the Strategy Committee for further deliberations in its meeting in July.
Board Document GF/B49/02, Engagement with the Pandemic Fund’s First Call for Proposals, should be available shortly at https://www.theglobalfund.org/en/board/meetings/49.