Total health ODA commitments, 2001-2006
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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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Total health ODA commitments, 2001-2006

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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)

  • 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

A financial instrument, not an implementing entity

Supports programs that reflect country ownership



A unique partnership







Civil Society

Private Sector

The Global 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

$14 billion in approved financing

$7 billion disbursed

600+ grants in 140 countries

Global Fund portfolio: AIDS

Global Fund portfolio: malaria

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


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


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

Reaching the vulnerable

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


AIDS impact: Malawi

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

Source: Global Fund

Decline in adult mortality with introduction of ART: Botswana

Increase in TB financing and new sputum positive cases 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

Human resources

Procurement systems for drugs and health commodities


Laboratory equipment

Monitoring and evaluation systems

Direct funding of health systems through Global Fund grants

The Global Fund and health systems strengthening

  • 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

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

Mukoma Health Centre, Rwanda (Source: PEPFAR)

*Photo courtesy of FHI

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

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

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


Resources: increasing both 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







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