Total health ODA commitments, 2001-2006 US$ Billions
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New instruments in global health World Bank Multi-country AIDS
Program (2000) Global Alliance for Vaccines and Immunization (2000)
-International Finance Facility for Immunization Global Fund to
Fight AIDS, TB and Malaria (2002) US Presidents initiatives -AIDS
(2003), Malaria (2005), Neglected Tropical Diseases (2008) Unitaid
(2005) (PRODUCT) Red (2005) World Bank Malaria Booster Program
(2005) Debt2Health (2007) Advanced Market Commitments (2008)
Affordable Medicines Facility for Malaria (2009) National Strategy
Applications (2009)
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The Global Fund: an innovative instrument in health and
development A financial instrument, not an implementing entity
Supports programs that reflect country ownership Evidence-based
Performance-based
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A unique partnership
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The Global Fund and civil society OP/290607/5 Estimates Rounds
2-6 proposals About 40 per cent of Global Fund-supported
implementers are NGOs/CBOs Governance (Board and CCMs) Implementers
Dual track financing Community systems strengthening
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Global Fund portfolio $14 billion in approved financing $7
billion disbursed 600+ grants in 140 countries
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Global Fund portfolio: AIDS
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Global Fund portfolio: malaria Private/Other US$ 4.4 million
(1%) Multilateral US$ 62.7 million (13%) Bilateral US$ 106.7
million (22%) Global Fund US$ 308 million (64%) Global Fund
portfolio: TB Grants from other sources US$ 66 million (33%) Global
Fund US$ 133 million (67%)
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140 countries with Global Fund grants BG/261107/6
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Targeting the poorest countries: Global Fund approved amounts
by country per capita income, September 2008 $m
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Resources go where they are needed Regions 60% of approved
funds in Rounds 1-8 are for sub-Saharan Africa 65% of funding for
orphan support is for southern Africa Diseases AIDS: 35% of Global
Fund financing for ART is for southern Africa Malaria: $1.5 billion
approved for 19 African countries that account for 90% of malaria
burden in Africa TB: More than $1 billion approved for 22 high
burden countries that account for 80% of global TB incidence
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e.g. Global Fund support to harm reduction programmes Reaching
the vulnerable
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Number of people receiving ARV therapy in low- and
middle-income countries, 20022007
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Global Fund results: June 2008 GP/110608/9
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AIDS impact: Malawi Initial decline in workplace mortality at
Escom (national electricity company) after roll-out of
antiretroviral treatment Source: Global Fund
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Decline in adult mortality with introduction of ART:
Botswana
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Increase in TB financing and new sputum positive cases detected
and treated
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Incidence~64% 2004 2001 2002 20032005 2007 2006 Declining
malaria in health facilities after scale-up of bed nets and
anti-malaria treatment: Rwanda, 2001-2007 WHO national
database
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Addressing health systems challenges Human resources
Procurement systems for drugs and health commodities Infrastructure
Laboratory equipment Monitoring and evaluation systems
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Direct funding of health systems through Global Fund
grants
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Direct funding of health systems through disease interventions
(approximately $945 million for Round 8; more than $4 billion
overall) Health systems support across more than one disease $186
million approved in Round 7 $ 290 million approved in Round 8
(health workforce, information systems, supply chain management,
community service delivery) Expanding health system capacity
-Non-government actors (NGOs, FBOs, communities, private sector,
people living with the diseases) are recipients of 50% of Global
Fund funding -Dual track financing Majority of Round 8 proposals
included community systems strengthening The Global Fund and health
systems strengthening
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Human resources Increasing the number of health workers
Salaries for health workers & community health workers Salary
top-up Training (96% of grants have a training component) Saving
lives of health workers to return to work Reducing AIDS, TB and
malaria burden so that health workers can focus on other health
needs
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Mukoma Health Centre, Rwanda (Source: PEPFAR) Infrastructure:
Support for renovation of existing health centres *Photo courtesy
of FHI
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Laboratory strengthening 67% of TB grants included laboratory
strengthening Examples: Chad: Newly equipped laboratories
Philippines: Training in sputum microscopy (public and private)
Yemen, Sri Lanka: New laboratories established
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Sustainability: more than resources alone Increased and more
predictable resources (domestic, external, further innovation)
Build demand for resources Address health systems challenges
Promote evidence-based interventions effectively targeted to those
in need Promote human rights Strengthen social protection
Strengthen global and local partnerships Learn and apply lessons:
research and evaluation
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Resource needs for AIDS, TB and malaria (2009 to 2015) Sources:
UNAIDS, STB, RBM
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Resources: increasing both availability and demand $ US billion
Available resources Demand EstimatedN eed Available resources and
demand Estimated Need
Slide 31
Global Fund requested and approved 2-year funding (Rounds 2 8)
40%34%39%22%34%47% 53% Approval rate