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Total health ODA commitments, 2001-2006. US$ Billions. 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)

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New instruments in global health
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 President’s 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)

The global fund an innovative instrument in health and development
The Global Fund: an innovative instrument in health and development

A financial instrument, not an implementing entity

Supports programs that reflect country ownership



A unique partnership
A unique partnership development







Civil Society

Private Sector

The global fund and civil society
The developmentGlobal Fund and civil society

  • Governance (Board and CCMs)

  • Implementers

  • Dual track financing

  • Community systems strengthening

Estimates Rounds 2-6 proposals

About 40 per cent of Global Fund-supported implementers are NGOs/CBOs


Global fund portfolio
Global Fund portfolio development

$14 billion in approved financing

$7 billion disbursed

600+ grants in 140 countries

Global fund portfolio malaria
Global Fund portfolio: malaria development

Global Fund

Global Fund

US$ 308 million(64%)

US$ 133 million(67%)


US$ 4.4 million(1%)


US$ 62.7 million(13%)


US$ 106.7 million(22%)

Grants from

other sources

US$ 66 million(33%)

Global Fund portfolio: TB

140 countries with global fund grants
140 countries with Global Fund grants development


Targeting the poorest countries: developmentGlobal Fund approved amounts by country per capita income, September 2008


Resources go where they are needed
Resources go where they are needed development

  • 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

Reaching the vulnerable development

e.g. Global Fund support to harm reduction programmes

Number of people receiving ARV therapy in low- and middle-income countries, 2002—2007

Global fund results june 2008
Global Fund results: June 2008 middle-income countries, 2002—2007


AIDS impact: Malawi middle-income countries, 2002—2007

Initial decline in workplace mortality at Escom (national electricity company) after roll-out of antiretroviral treatment

Source: Global Fund

2007 detected and treated






Declining malaria in health facilities after scale-up

of bed nets and anti-malaria treatment:

Rwanda, 2001-2007



WHO national database

Addressing health systems challenges
Addressing health systems challenges detected and treated

Human resources

Procurement systems for drugs and health commodities


Laboratory equipment

Monitoring and evaluation systems

The Global Fund and health systems strengthening detected and treated

  • 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

Human resources
Human resources detected and treated

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

Infrastructure support for renovation of existing health centres
Infrastructure: Support for renovation of existing health centres

Mukoma Health Centre, Rwanda (Source: PEPFAR)

*Photo courtesy of FHI

Laboratory strengthening
Laboratory strengthening centres

  • 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

Sustainability more than resources alone
Sustainability: more than resources alone centres

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

Resource needs for aids tb and malaria 2009 to 2015
Resource needs for AIDS, TB and malaria centres(2009 to 2015)


Resources increasing both availability and demand
Resources: increasing centresboth availability and demand


Estimated Need

Available resources and demand


$ US billion

Available resources

Global Fund requested and approved 2-year funding (Rounds 2 – 8)


Approval rate