GFO: What made this Replenishment a unique 'moment' in the life of the Global Fund?
DS: The result of this Replenishment, $14 billion, is exceptional. At the beginning of the Global Fund, we would have never imagined this was possible. This result was achieved thanks to the unprecedented mobilization of all partners: on the one hand, the traditional donors (G7, EU, OECD-DAC members) with whom we have built a lasting and solid relationship; on the other hand, emerging donors (G20, implementing countries, particularly from Africa). A significant number of new donors emerged from all continents, especially the United Arab Emirates, Azerbaijan, and Armenia. Finally, we managed to reconnect with some public donors who had stopped contributing, such as Spain. The other great success comes from the private sector contribution that reached its target and mobilized over $1 billion – we will come back to that later in the discussion.
This Replenishment was characterized by a mobilization of the international community that went beyond political, sectoral and other divisions, to demonstrate its commitment and its desire to end the diseases and accelerate progress towards Sustainable Development Goal 3 by 2030.
The experience was unique in that we managed to ensure strong coherence between all the elements of the campaign, and the arguments made in the Investment Case. With France’s announcement in May 2018 that it would host the Replenishment, we had much more time to work on the Investment Case than during the previous Replenishment (there was just 6 months between the announcement of the date and the Pledging Conference in September 2016). It allowed us to refine our messages, and to support them with examples, to make things more human. This also helped to ensure very strong ownership of the case by the French partners (government and civil society organizations).
GFO: In your view, which arguments were the most powerful in motivating donors’ decision to contribute to the Global Fund the historic sum of $14 billion?
DS: The Investment Case, which was launched in January 2019, presented the main arguments for a $14-million replenishment for the Global Fund:
- the urgency of making the decisive choice to accelerate the movement to end the epidemics by 2030 and achieve health for all;
- the Global Fund partnership builds on a track record of strong impact, and contributes to strengthening health systems and global health security;
- the partnership is committed to innovate more, collaborate more effectively with other global health actors, to implement programs more effectively, and help countries mobilize more domestic resources for health;
- the Global Fund plays an important catalytic role for funding and progress towards SDG3, with significant impact on all Sustainable Development Goals.
The arguments went beyond the scope of the three diseases and put forward the 2030 health agenda, as well as the central issue of strengthening health systems, and this has certainly been crucial for success.
In addition to the Investment Case, we also launched a communication campaign to engage the public, including the 'open letter to 7-year olds' inviting everyone to express their commitment to keep our promise to end the epidemics by 2030.
GFO: How do you interpret the even more pronounced engagement of the private sector?
DS: The private sector has reached its goal and surpassed the billion-dollar mark for the first time. Long-time private sector donors have made additional commitments – such as the Bill & Melinda Gates Foundation (17%), Product (RED) (50%), Comic Relief (36%) and Takeda (100%). Significant commitments, such as that of Sri Dato Tahir ($ 30 million), have been renewed. Major new and existing donors such as the Children's Investment Fund Foundation (CIFF), Rockefeller, Rotary and Co-Impact provide a platform for future growth. In addition, 11 new private sector partners are committed to supporting innovation and improving implementation in critical program areas. To name just a few examples, partnerships with Google Cloud, Mastercard, Microsoft, Société Générale and the Thompson Reuters Foundation were launched at a pre-programme event on innovation in Lyon.
This increased engagement of the private sector shows how the Global Fund works as a promotor of public-private partnership (PPP) and that private sector actors recognize the value and effectiveness of the Global Fund. We had a convincing investment case, be it our results over the last 17 years and our impact, return on investment, branding, and so on. The Global Fund is a good investment, not only in financial resources but also in expertise, skills, technology and innovation.
It also shows that the Secretariat’s efforts to update the private sector engagement framework and strategy have been effective: we have recently improved our internal due diligence processes, and reviewed the terms of private sector contributions. We must continue to evolve and innovate in these areas in order to remain competitive.
It is interesting to note that there was a real dialogue also between private sector donors, who encouraged one another. They engaged several new partners to improve implementation with the proposal of innovative ideas. This is an important added value, which will directly benefit programs to improve impact.
GFO: What role has civil society played in this process? How has this facilitated political and financial mobilization?
DS: The Global Fund partnership is lucky to have a rich and vibrant ecosystem of civil society and communities that are active in global, regional and national advocacy as well as in the implementation of the Global Fund. disease and/or community health programs, and the National Health Financing Dialogue. During the Sixth Replenishment campaign that lasted nearly a year, the mobilization of civil society, community members and other advocacy partners was important, and crucial. Mobilization campaigns were carried out at all levels. The voices of civil society and communities, including young people representing communities living with or affected by the three diseases, were also very present at the conference in Lyon.
Some particular points in terms of the role of civil society in the financial and political mobilization around the Replenishment:
French civil society – showed great commitment to the enlarged working group for the organization of the Lyon Conference, including pre-program events and stands, and implemented mobilization activities in France and in implementing countries.
Friends of the Fund and other NGO advocacy partners active in donor countries – they implemented, in coordination with the Secretariat, engagement strategies tailored to each region; we conducted a policy analysis on the engagement of decision makers in budget processes; they also organized visibility events and public awareness and mobilization campaigns.
The GFAN network with GFAN-Hubs from Asia-Pacific and Africa - helped to amplify and disseminate key messages (the 'aligned not alike' approach) on the results, impact and importance of replenishment of the Global Fund. GFAN’s Asia-Pacific and African Hubs reached an unprecedented level of coordination and sophistication, with ‘days of action,’ ‘Love more, Give more,’ and ‘Heroes Give More’ campaigns.
Other NGOs and networks - It is also worth noting the extraordinary work done at the national level by national civil society organizations and networks, whose constant pace and pressure has been absolutely essential in order to increase or maintain contribution levels to the Global Fund relative to national health financing.
GFO: Given the commitment of African countries to become contributors, and recognizing that the mobilization of domestic resources remains a difficult issue in countries, what role of leverage can the Global Fund play?
DS: There has been an unprecedented commitment of African countries – 24 of them announced pledges for the period 2020-2022, more than half of which are Francophone African countries. This commitment of more than $76 million, twice as much as last Replenishment, demonstrates the willingness of African countries to participate in the global effort to end the epidemics. This comes in addition to their commitment to mobilize and invest more domestic resources.
The Investment Case projects a significant increase in domestic resources and we know that we will not be able to generate the promised impact without the $46 billion invested by countries in their own programs. That is why we will also work hard to strengthen our leverage role and help countries mobilize and make better use of domestic health resources.
There is no single approach and each solution is developed to better fit the unique context of each country. The activities are highly differentiated according to the different contexts of the countries but we can categorize them as follows:
- More effective application of the Global Fund's co-financing policy;
- Capacity building and advocacy to enable local actors, e.g. the Ministry of Health, Disease Control Programs, civil society, parliamentarians, etc. to better intervene in their own capacities and areas for more investment in health; more effective mobilization, allocation and use of domestic resources;
- Facilitating national multisectoral dialogues on health financing;
- Establishment and management of partnerships and innovative mechanisms for national financing of health (e.g. with the African Union, the World Bank, the French Development Agency, etc.).
GFO: What are the issues and the responsibility today for the Global Fund with this $14 billion?
DS: The result of the Replenishment is a massive vote of confidence in the Global Fund as a whole, from how we allocate resources and negotiate the grant, to how we manage our finances, relationships with partners, risks, IT, personnel, governance, etc. - in short, all our activities.
Now it's up to us to seize the opportunity we've created. We have more resources than ever. We must demonstrate that we can achieve even greater impact, save many more lives, catalyze even more domestic resources, and achieve radical change towards the end of the epidemics and the achievement of SDG3.
The result of the Replenishment represents an extraordinarily exciting opportunity, but also a huge responsibility. We owe it to those who made the pledges and the millions of taxpayers behind them to do it right. We owe it even more to those who live with HIV, TB and malaria, or who are vulnerable to HIV.