The Global Fund brings new funding model to Latin America

The Global Fund to Fight AIDS, Tuberculosis and Malaria is touring countries in the global south to explain the features of their new funding model (NFM).

Guest post by Javier Hourcade Bellocq:

The Global Fund to Fight AIDS, Tuberculosis and Malaria is touring countries in the global south to explain the features of their new funding model (NFM).

At the start of April, the Global Fund was in Quito, Ecuador, meeting with ministers and deputy ministers of health-related areas from participating Latin American countries, as well as representatives of ministries of economy and finance. Following this, it was the Caribbean´s turn with a similar meeting in Kingston, Jamaica.

As countries start the complex processes of applying for funding, the Global Fund has also published a leaflet, an explanatory video and ten FAQs.

Understanding the model

The first step in the funding application process involves applicant countries reviewing and validating their national strategic plan for AIDS, tuberculosis and malaria. These plans must be budgeted and have passed such checking and validation mechanisms as the Joint Assessment of National Health Strategies.

Country Coordinating Mechanisms (CCM) need to self-assess the minimum eligibility criteria and submit a development plan to improve and meet such criteria. The Global Fund and the International HIV/AIDS Alliance have developed a self-evaluation tool and have trained a dozen consultants in the region who are now working with the mechanisms.

Once the national strategic plan review and validation is underway, a national dialogue process begins. This means a permanent consultation process that is more inclusive than the CCMs, where all sectors involved in the response, whether by disease, population or country, have the chance to contribute to the proposal development and review.

El Salvador, a country that tested the NFM in its interim phase, showed the feasibility of a comprehensive dialogue in which different consultations by population and by intervention type helped nurture the concept note. CCMs submit a concept note (in place of the former application) based on national strategic plans and investment cases.

In the new model, the country teams of the Global Fund Secretariat participate more directly in the processes, with regular visits and technical support.

Impact and sustainability

The new funding model is not only a new way to apply for funding but also a new approach to the co-responsibility of implementing countries.

This includes counterpart funding, which refers to all public and domestic resources allocated to the response to the three diseases, including those allocated to the health sector in general. It will require an improvement in the measurement of health spending and spending per disease. In order to improve these national accounts the Global Fund will invest up to a maximum of USD 50,000 per country.

Out of the resources allocated per country and per disease, which have been reported publicly, the Global Fund will retain 15 per cent under the “willingness-to-pay” policy. This amount will be available once the government has verifiably increased its absolute investment in the disease and committed to the strategic areas of ongoing programs. These commitments will be detailed in the concept note.

Greater focus for greater impact

As a result of diverse interests and needs, it became clear through  the country dialogues in El Salvador that the Global Fund will not always provide funding to meet expectations.

Active participation of the Global Fund Secretariat was key to moderate expectations and focus the concept note. The Global Fund demanded that 50 per cent of funds requested be concentrated on work with populations who are key to the epidemic, a suggestion that the country eventually accepted.

And this will be the trend for countries in Latin America, mostly medium-income economies with HIV epidemics concentrated in men who have sex with men, transgender people and sex workers.

Read the orgininal article in Spanish on Corresponsales Clave

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Image: Adminstrator of HIV related medicine checks stock, Ecuador
© Marcela Nievas for International HIV/AIDS Alliance