Delegates Briefed on Trends, Changes at Global Fund

Delegates to the 51st Directing Council participated in the first of a series of information sessions on the Global Fund to Fight AIDS, Tuberculosis and Malaria, which will be held from now on during each annual meeting of the Directing Council.

Paula Hacopian, manager of board relationst for the fund; Lelio Marmora, of the fund’s Latin America and Caribbean Region; and three regional portfolio managers shared information on the fund’s policies, governance and operations and answered questions from Directing Council delegates about recent changes in the fund’s practices.

Since its inception in 2002, the Global Fund has approved 126 proposals from 33 countries in Latin America and the Caribbean, for a total of more than US$2 billion in financing. Just over 70 percent of the funds have been for HIV programs, with the remainder split between malaria and TB. Currently, approximately 7% of the fund’s global portfolio is in the Americas.

PAHO Director Dr. Mirta Roses noted that PAHO has collaborated with the Global Fund since its inception in 2002, providing support for country proposals in addition to technical cooperation that has promoted successful project execution in the countries.

In recent years, Global Fund financing in Latin America and the Caribbean has increasingly focused on strengthening health systems and joint programs that address maternal-child care and sexual and reproductive care within HIV, TB and malaria services.

Dr. Roses praised the fund’s movement toward “greater alignment with national planning cycles and the recognition of the linkages between national capacities of health systems and sustainable health outcomes.” She also welcomed the fund’s acceptance, since 2008, of “national strategy applications” (NSAs), which emphasize sound national disease strategies as the basis for applying for Global Fund financing.

“This is providing a good opportunity for synergies with the work we are doing to strengthen national health policies, strategies and plans, and for complementing the fund’s attention to national disease-specific strategies and plans with a country’s overall health policy and strategic frameworks,” she said.

Lelio Marmora noted that the Global Fund has increasingly focused on health system strengthening and integrated programs, and has tried to avoid creating “parallel systems” and “distortionary elements” such as higher salaries in fund-financed programs.

Luca Occhini, a portfolio manager for Latin America and the Caribbean, explained two recent changes in the fund’s eligibility and participation criteria. Countries that have had a proposal approved within the past 12 months are not eligible to present a new proposal, he explained. In addition, every country is now required to provide counterpart funding, ranging from 5% for the lowest-income countries to 60% for the highest-income eligible countries.

Marmora said that, to be successful, proposals need to be “in the framework of a national strategy” and have a “systemic vision, rather than a fragmented one.” He added that proposals that request significant funding for salaries, overhead or other recurring expenses will be examined more critically. “The fund cannot replace national investment. The idea is to provide additional resources to cover gaps.”

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