Global Fund’s efforts in strengthening global pandemic preparedness through Pandemic Fund partnership
Author:
Samuel Muniu
Article Type:Article Number: 7
On 9-11 October 2023, the Global Fund's Strategy Committee deliberated on the Global Fund's partnership with the Pandemic Fund, with the aim of improving global pandemic preparedness. In this meeting, the Secretariat presented insights gained from the Global Fund's participation in the Pandemic Fund's First Call for Proposals. Additionally, a suggestion was made to consider a pilot program for the Global Fund’s collaboration with the Pandemic Fund during its Second Call for Proposals.
During the 23rd Strategy Committee meeting in Geneva, Switzerland, on 9-11 October 2023, the Global Fund Secretariat provided an update on its collaboration with the Pandemic Fund. This partnership is a significant step in improving global pandemic preparedness. As the world faces ongoing and potential future pandemics, their cooperation aims to build resilient pandemic preparedness and response (PPR) systems owned by countries and communities. The decisions made in the coming months and years will greatly impact the level of achievable integration and coordination, shaping efforts to enhance pandemic preparedness.
The global health systems’ vulnerabilities have been starkly exposed by the COVID-19 pandemic, emphasizing the critical need for a unified and comprehensive approach to PPR. The Global Fund, renowned for its efforts in combating HIV, Tuberculosis (TB), and Malaria (HTM), has recognized the urgency of adjusting and broadening its goals to encompass PPR. HTM are among the most significant infectious diseases that disproportionately impact low- and middle-income countries and, as we know, progress in tackling the three diseases was severely compromised by the COVID-19 pandemic. While programs to tackle the three diseases showed a robust recovery following COVID-19 disruptions, according to the Global Fund’s 2023 Results Report, the emergence of new pandemics has the potential to significantly impede further progress in addressing these diseases.
In response to the threat of pandemics, the Global Fund has adapted its objectives, aiming to utilize its partnership’s expertise and inclusive model to not only protect against HTM but also to establish capacities capable of addressing future pandemics. This article offers an overview of the recent developments in the Global Fund’s collaboration with the Pandemic Fund, underscoring its pivotal role in the establishment of robust PPR systems.
The Global Fund’s role in pandemic preparedness
The Global Fund’s dedication to pandemic preparedness is evident in its 2023-2028 Strategy. A significant milestone in this commitment was the initiation of the COVID-19 Response Mechanism (C19RM), whose budget exceeds $5 billion. This mechanism serves the dual purpose of mitigating the adverse effects of COVID-19 on HTM programs while bolstering national responses to the pandemic. Moreover, it seeks to shift its focus towards making enduring investments in national health systems and pandemic preparedness that also benefit the delivery of HTM programs.
C19RM’s investments are channeled into various critical areas, including surveillance systems, laboratory infrastructure, diagnostics, human resources for health, medical oxygen and therapeutics, as well as health product and waste management systems. Furthermore, for the seventh grant cycle (GC7), applicants are actively encouraged to allocate resources to Resilient and Sustainable Systems for Health-Pandemic Preparedness and Response (RSSH-PPR) to enhance the buoyancy and capabilities of health systems. Approximately one-third of the total funding across GC7 and C19RM is projected to be directed towards RSSH-PPR initiatives.
The Global Fund’s significance extends to its pivotal role within the Access to COVID-19 Tools (ACT)-Accelerator platform, a crucial initiative aimed at expediting access to COVID-19 diagnostics and therapeutics. Additionally, the Global Fund is a key partner in the Global Oxygen Alliance, which is focused on improving the accessibility of high-quality medical oxygen.
Global Fund engagement with the Pandemic Fund and lessons learned
The Pandemic Fund, launched in September 2022 and managed by the World Bank, is a major advancement in global pandemic readiness. It has raised $2 billion from 25 contributors and directs its funds through approved Implementing Entities (IEs). During the First Call for Proposals from March to May 2023, the Pandemic Fund aimed to enhance disease surveillance, laboratory capabilities, and the healthcare workforce. It received 179 applications from 133 countries, seeking over $2.5 billion. Following a rigorous evaluation, 19 proposals were granted, totaling $338 million for projects in 37 countries, with about 30% designated for sub-Saharan African projects.
The Global Fund actively collaborates with the Pandemic Fund to address potential overlaps with the C19RM portfolio. In doing so, the Global Fund has shared valuable lessons learned during the First Call for Proposals with the Pandemic Fund. These lessons are as follows:
- Effective coordination at both country and global levels when investments areas overlap.
- The strategic significance of the Pandemic Fund’s operational model, including timing, co-financing requirements, and application processes. Recommendations include establishing longer and rolling application windows, prioritizing high-quality unawarded proposals, revising co-financing requirements, and aligning proposal information formats with country standards.
- Inclusive involvement of country-based non-state actors to enhance inclusivity, program alignment, scope, and trust-building in Pandemic Fund proposals.
Considerations for the future
The Global Fund is fully aware of the importance of active engagement in pandemic preparedness and building a strong partnership with the Pandemic Fund. However, this needs to be balanced with the substantial workload associated with GC7 and C19RM Portfolio Optimization Wave 2, which focuses on enhancing RSSH-PPR capabilities.
The decisions taken by the Pandemic Fund in the future will be instrumental in improving coordination between the two organizations. The pilot program will be assessed in early 2024, considering the extent of operational changes within the Pandemic Fund and their alignment with the Global Fund’s PPR-RSSH investments.
The Global Fund is in the process of seeking approval as a “public mechanism” under the Policy on Restricted Financial Contributions (PRFC) to receive resources from the Pandemic Fund. Restricted financial contributions are funds provided by private donors or approved public mechanisms, and they come with specific usage limitations. The PRFC operates based on principles that emphasize recipient, implementer, and country-driven approaches. It seeks to mitigate risks related to quality, timing, priority, influence, transaction costs, and sustainability that may arise when dealing with contributions not developed in consultation with in-country partners. The Global Fund’s Audit and Finance Committee (AFC) will be responsible for ensuring that policy conditions are met. These conditions include avoiding excessive transaction costs and guaranteeing that contributions are used exclusively for approved priorities and Global Fund activities.
Stakeholders’ feedback
Stakeholders supported the idea of a pilot program to assess whether the Pandemic Fund should be recommended as a “public mechanism” under the PRFC. It’s considered essential to maintain this pilot engagement at a minimal level. Furthermore, future updates on this topic will be crucial for Board discussions, particularly based on lessons learned from discussions with the Pandemic Fund. Board members serving on both the Global Fund and Pandemic Fund Boards were urged to emphasize the impact of key operational decisions made by the Pandemic Fund on integration and coordination with Gavi and the Global Fund, in line with the shared lessons learned.
However, some stakeholders have concerns regarding the proposed pilot for Pandemic Fund engagement. Firstly, it closely resembles the previous collaboration proposal that was rejected by the Pandemic Fund. Secondly, the timeline seems incongruent, as the second call for proposals is set for the end of this year, but a Board decision on the pilot is not anticipated until spring 2024. Thirdly, there is a reiterated request for a comprehensive overview of the pros and cons of acting as an IE and the presentation of alternative methods to achieve complementarity. It is strongly encouraged that the Global Fund and Pandemic Fund secretariats maintain a close information exchange, particularly in anticipation of the Pandemic Fund’s second call for proposals and its upcoming strategic plan submission in December.
