Statement in response to the Global Fund Board’s decisions on financing
Statement by Dr Lucica Ditiu, Executive Secretary of the Stop TB Partnership and Dr Mario Raviglione, Director of the WHO Stop TB Department in response to decisions on the Global Fund’s funding model made at its 27th Board Meeting.
18 September 2012 - Geneva - We would like to thank our partners and friends for the excellent support and commitment shown to the fight against tuberculosis (TB) during the Global Fund Board discussions last week.
More than a hundred individuals and organizations joined us to advocate against capping the proportion of Global Fund financing available to TB at 16%, and to call for a more appropriate approach that doesn’t pit disease against disease. This collective voice was clearly heard.
The Global Board’s decision to adopt a new approach toward funding represents a significant step forward and goes in the right direction - towards strategic grants that can achieve greater impact. We believe that the new funding model will allow a more predictable and reliable process, making grants more effective. It also improves the partnership model of the Global Fund, for better continuity and sustainability.
Different viewpoints were expressed at the Board meeting, and it was clear that all parties want a new funding model that is both fair and effective. Many Board members and constituencies expressed their concern about the upfront disease allocation as well as the small share that TB would get, and agreed that we must unconditionally support innovative approaches to tackle the different challenges we face in TB, including TB/HIV and drug-resistant TB.
Constituencies also agreed that we must take a new, proactive and stronger approach to supporting countries in their future funding requests, so that planning is more ambitious and the resources available are increased.
While we cannot be very happy with the decision to initially set funding levels for each disease according to historical allocations, it is important to note that this is a one-year temporary measure and that the level of allocation for TB is not set in stone. We understand too that this measure was proposed to allow the start of a discussion on a model that will make the Global Fund’s allocations more strategic. Discussions remain open on what ‘historical allocation’ means. If more recent rounds are considered, TB will receive a higher overall allocation. Moreover, within a year the Board has called for a transition to a measure that can be used to estimate disease burden and financial demand across all three diseases.
We also welcome the decision to allow countries to request funding for each of the diseases according to their needs. However, more than ever, a higher allocation for TB will depend on the strength of our plans and contributions in discussions at country level as well as our ability to generate demand through ambitious and high-quality proposals and strategies.
In more detail, here is our understanding of the new funding model that the Global Fund has adopted in principle.
- Under the new model, funding will be allocated to groups - or ‘bands’ - of countries that will be determined by their income level and disease burden. Countries having similar patterns in terms of burden and funding will be bundled together into these bands. Funding will be allocated to each of these bands.
- Within the country bands, a portion of funds will be provided to support the prioritized needs within national strategic plans or investment cases.
- Another portion of funds will be used to encourage ambitious, high-impact, and well performing programmes.
- The Board may also allocate around 10% of funding to programmes, activities and strategic investments that it judges have not been adequately supported by funding provided through the country bands.
- At the national level, countries will have the flexibility to decide how much funding to request for each disease based on their National Strategic Plans.
- The Global Fund’s Secretariat and the Strategy, Investment and Impact Committee (SIIC) will work towards developing the details of the funding model, including the country bands and the formula for allocating funds, for approval at the next Global Fund Board meeting in November 2012.
We will come back to you all with further information as soon as it becomes available. The new funding model was also discussed at the TB Committee - a group advising the Global Fund Secretariat of which we are members - that met on 17 September.
It is clear that, at the moment, no detail of the future funding model has been finalised. However, the challenge that we face is already clear: we need to make sure that, at country level, TB gets the right level of attention, become a priority and are supported by ambitious plans based on the scale of the epidemic, funding gaps, opportunities to scale up innovative activities and the need to strengthen systems and the role of communities and civil society.
This also means that we all, as international partners, need to embark on more intensive work with countries to support their TB efforts within the Global Fund framework. We need to work with them towards developing technically sound national strategic plans, which include a full expression of needs and compelling Global Fund investment cases. At the same time we need to ensure the right level of engagement and participation of all local partners, including the affected communities. Finally, it will be paramount to advocate with the right stakeholders, including Country Coordinating Mechanisms, so that TB gets the attention it deserves.
We need to support the Global Fund in advocating for and mobilizing the resources needed to address these three public health threats globally. We all want to see a Global Fund that thrives.
In a short space of time, we have turned-up the volume on TB and made our voices heard. We must now maintain this momentum and ensure that the funding gap for TB of more than US $2 billion a year is closed, not widened. We owe this to all people who suffer from this disease.