Latin America and Caribbean constituency expresses concerns following Global Fund’s 41st Board meeting
Edner BoucicautArticle Type:
Article Number: 3
Issues include allocation methodology, and key populations during countries’ transitions
ABSTRACT The 41st Board Meeting of the Global Fund to Fight AIDS, Tuberculosis and Malaria held in May 2019 was an opportunity for the organization to pledge its commitment and support to the LAC region, where $2.2 billion has already been invested to date to fight the three diseases. Investments include technical assistance to build resilient health system infrastructures in 36 countries in the continent, while maintaining an emphasis on co-financing commitments to cover key transition risks that include uptake of services for key populations. A member of the Latin America and Caribbean delegation to the Board offers his perspective.
The decisions of the Global Fund at its 41st Board meeting contributed to a commitment to reviewing the key performance indicators and expected results before the upcoming Replenishment pledging conference, to be held in Lyon, France in October 2019, and accelerating efforts towards ending AIDS, TB and Malaria.
The Latin America and Caribbean (LAC) constituency had an active and strong voice in emphasizing the impact of increased social, economic and political instabilities on the implementation of the Sustainability, Transition and Co-financing (STC) policy in the region, urging the Global Fund to better redefine the criteria and expectations for a successful transition. The purpose of this is to have accurate information as the context in which to monitor and evaluate transition processes, progress towards reaching goals, and protect achievements, according to Dr Mirta Roses Periago, LAC Board Member, during the Implementers group pre-meeting ahead of the Board.
The LAC Delegation also raised concerns in relation to the allocation methodology for the 2020-2022 cycle put forward by the Strategy Committee and the Secretariat: the LAC delegation believes that this methodology should ensure that the Fund’s investments deliver on the objectives of our strategy and to reach out to additional partners, share common global health goals that are aligned with the Global Fund’s vision to strengthen information systems, contribute to Resilient and Sustainable Systems for Health (RSSH), and develop innovative interventions and new tools.
Among other key issues addressed by the Board at its May 2019 meeting, ahead of the Sixth Replenishment conference, the Board reviewed the Private Sector Engagement Framework, Catalytic investments for the 2020-2022 allocation period, and Resource Mobilization and Innovative Financing.
The LAC delegation highlighted issues of critical importance to the Global Fund’s key performance indicators, such as the role of Civil Society Organizations (CSOs) in achieving the Global Fund’s mission of saving lives and ending epidemics. CSOs’ role needs to be fully recognized, declared Dereck Springer, the Director of the Pan Caribbean Partnership Against HIV/AIDS (PANCAP), and the LAC Communication Focal Point. The advocacy role of CSOs has been critically important in increasing domestic funding as well as securing successful replenishments for the Global Fund itself, he said.
On the other hand, the LAC team expressed concerns with regard to the slow progress on key populations and human rights in transition countries (Key Performance Indicator/KPI 9) and the need to review the persistent barriers highlighted in the Strategic Performance Reporting Document, which was made available during the Board meeting only to members and delegates.
LAC emphasized during its own constituency meeting that political instability in some countries in the region, as well as transitions in process, place civil society organizations and key populations at risk. Delegates from the constituency believe that there is uncertainty about effective mechanisms to ensure that civil society and key populations are guaranteed funding to deliver key population-friendly services in the decision-making bodies such as the local CCM, following transition.
The LAC constituency praised the Global Fund’s September 2018 decision (GF/B39/EDP11), to pledge $5 million from the Emergency Fund to address the humanitarian crisis in Venezuela and to support the procurement of critical health products, such as antiretroviral treatment for HIV. However, key populations’ and migrants’ programming, among other issues, are yet to be addressed, due to lack of political will, LAC delegates asserted, during the implementers’ group meeting the day before the Board meeting.
Pending the outcome of the Sixth Replenishment, the LAC constituency recognizes that many components could experience large reductions. Qualitative adjustments would be required to ensure that reductions are not immediate or too steep. These adjustments, the LAC constituency suggests, should include regional contextual factors to capture the potential risk of resurgence of malaria, for example, as experienced with other disease elimination efforts in the region, as well as sustainability and transition considerations.
While the LAC delegation welcomed the appointment of Dr. Donald Kaberuka as Chair of the Board and Lady Roslyn Morauta as Vice-Chair, LAC appreciates the effort undertaken by the Ethics and Governance Committee (EGC) to strengthen GF’s Governance culture under its delegated authority and the openness of the process to discuss and seek feedback from Board constituencies, according to LAC’s public statement made during the opening session of the Board.
The LAC delegates acknowledged with satisfaction the improvements in the Board leadership nomination committee documents to guarantee transparency and due diligence, especially in the following areas: a) preserve institutional memory for effective continuity; b) balance representativeness to ensure that all constituencies serve on at least Strategy Committee or Audit, Finance Committee for any given term; c) ensure representation on each committee of at least one civil society constituency; and d) enhance competency-based processes.
The LAC constituency believes that governance at Board level has been successfully improved and will be an important contribution to the Global Fund’s performance. But there’s still a lot of work to be done, particularly in gender and human rights, said Dr. Periago, who is completing her term as the LAC Board member this coming fall.
To make sure the Global Fund can continue with its critical work, the Board is asking G20 world leaders to join hands and help save 16 million lives over the next 3 years by meeting the Sixth Replenishment’s goal of at least $14 billion. Such an investment would be seen as a global commitment to get us on track to ending the three epidemics. It is against this background that the LAC constituency is urging the world’s leading economies to ‘Step Up the Fight’ by fully funding the Global Fund.
Edner Boucicaut is a Civil Society Organization member of the Latin America and Caribbean delegation to the Global Fund Board.