19 February 2013

Africa: Global Fund News Flash - Issue 14

The Global Fund plans to launch its new funding model in the coming days. Over the course of 2013, a transition period, the new funding model will allow the Global Fund to invest more strategically, and achieve greater impact in the lives of those affected by AIDS, TB and malaria. It will engage implementers and partners more effectively. It will engage implementers and partners together to achieve impact against the three diseases. It will provide implementers with more flexibility around when they apply for funds, as well as more predictability on the level of funding available, while still encouraging countries to express full demand.

The Global Fund will invite selected countries to participate in the new funding model in 2013. A small number of "early applicants" may submit a concept note and create a new grant using the new funding model. The countries selected will be those in a position to achieve rapid impact, those at risk of service interruptions, and those that have received proportionally less than they merit, by the calculus of the new funding model. There will be diversity across regions and diseases and types of applicants, so that elements of the new funding model can be tested and refined. In addition, around 50-60 "interim applicants" will also be able to access funding in 2013, through re-programming and top-ups for existing grants. Other countries, "standard applicants," may participate in dialogue geared toward preparing applications for 2014.

Throughout this year, the Global Fund and its partners will be asking public and private donors to invest in fighting the three diseases for the period 2014 to 2016. The new funding model will help demonstrate that the Global Fund is investing strategically for maximum sustainable impact, in places where we can make the biggest difference.

The Global Fund in Mali

Mali has been in the news quite a lot in recent weeks. Particularly following the military intervention by France to drive out insurgents as they closed in on the capital, Bamako. For those who work on keeping people safe, and those who work to help fight disease, the challenges of operating in Mali are tremendous.

The Global Fund has consistently operated in Mali, even after a coup d'état in March 2012. The health needs in Mali are considerable. The team of professionals at the Global Fund who work on Mali believe that it is all the more critical to deliver treatment and essential services, and that the difficulties and drastic security conditions caused by civil war are worth bearing. Senior management at the Global Fund supports that approach.

Late last year, the Global Fund went ahead with a new funding agreement with the United Nations Development Program. To implement the grant, many special precautions had to be taken, including some reprogramming to adapt to changing conditions on the ground, a zero-cash policy and a staggered sequence of delivery of health products. The new grant, worth EUR 58 million, will increase the number of people receiving antiretroviral treatment in Mali.

The need for such precautions was underscored when mismanagement of funds was discovered in 2010. Instead of abandoning those in Mali who still need treatment, the Global Fund has instead found ways to persist, by working in close coordination with international organizations, multilaterals, USAID, PMI, and French civil society, by taking necessary precautions, and by intelligent grant management, which means constantly adjusting to a changing reality.

It is paying off. New funding agreements to expand treatment for malaria and tuberculosis, worth a combined EUR 52 million, are expected to be finalized and signed by the end of March. At some point, the fighting in the civil war will diminish. Perhaps the enormous challenges of working in Mali will recede somewhat, and doing development work and disease prevention and treatment will flourish. Regardless, the work remains.

The Malaria 'Funding Gap'

A recent gathering of the African Leaders Malaria Alliance, held in Addis Ababa, essentially rang an alarm bell about funding for malaria in the coming years. In a report, leaders in the alliance, known as ALMA, looked at overall funding needs for malaria and estimated the overall funding gap for malaria in 2013 at US$1 billion. If that is not addressed, ALMA warned, a significant resurgence of malaria could occur in many countries. That could really undercut the gains that have been made in recent years.

The gains are impressive. In eight countries in ALMA, malaria cases have fallen by more than 75% over the past decade. Over this same time period, malaria mortality rates have fallen by approximately one-quarter globally. One principal reason behind that success has been an effective and broad distribution of insecticide-treated nets in recent years. Many of those nets now need to be replaced.

"Children with no immunity who have been protected over the past three years are beginning to get exposed, and the number of malaria cases among young children is expected to increase significantly this year if replacement nets do not come," said the ALMA report.

The Global Fund has been the leading investor in malaria control worldwide, and ALMA called on world leaders to support the Global Fund's efforts this year to raise funding for the period 2014 to 2016. That will be a critical factor, ALMA said, in protecting gains that have been made against malaria.

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