Primary Goal: End AIDS, TB and Malaria.

Vision: A world free of the burden of AIDS, tuberculosis and malaria with better, equitable health for all.

Strategy Mission: A world free of the burden of AIDS, tuberculosis and malaria with better, equitable health for all.

 Over the last 20 years the Global Fund (GF) partnership has saved 44 million lives and reduced the annual death toll from HIV, tuberculosis (TB) and malaria (HTM) by 46% since its peak in countries where the GF invests. The GF partnership of implementer governments, civil society, technical partners, development partners, the private sector and people and communities affected by the three diseases, have proven that by acting together, we can overcome barriers, save lives and dramatically change the course of these three terrible pandemics.

 Global Fund invests in the fight against HIV, tuberculosis (TB) and malaria through a partnership-based funding model, raising funds in three-year cycles known as Replenishments. Funding is then allocated to eligible countries to support HIV, TB and malaria programs and to strengthen health systems.

The Global Fund requires governments, civil society, people affected by the diseases, technical partners, the private sector and other partners to come together to decide how to best use the funding to meet the needs of people and communities.

 Global Fund has developed an ambitious new Strategy to get progress back on track against HTM and contribute to the Sustainable Development Goals’(SDG)target of achieving universal health coverage (UHC).

 To enhance impact, GF is putting even greater focus on equity, sustainability, program quality and innovation, taking determined action to tackle human rights and gender-related barriers, and leveraging the fight against HTM to build more inclusive, resilient and sustainable systems for health (RSSH) better able to deliver health and wellbeing, and to prevent, identify and respond to pandemics

2023-2028 Global Fund Strategy Framework Overview

The new strategy outlines a shift in GF’s investment approach. It calls for action to rise above disease-specific silos toward building resilient and sustainable systems for health (RSSH) in a way that places people and communities, not diseases, at the centre of the health system to achieve universal health coverage (UHC).

 Problem Statement

 The impact of COVID-19 was devastating, exacerbated existing inequities, diverting critical resources, slowing access to critical HTM prevention and treatment activities, and putting vulnerable people further at risk. In 2020, for the first time in history, key programmatic results declined across all three diseases. With only eight years to go, COVID-19 knocked us further off-course from the Sustainable Development Goal (SDG) target of ending the three epidemics by 2030.

 To achieve the mission of ending HTM as public health threats, countries must focus even more on making catalytic, people-centred investments that spur faster progress. GF is putting particular emphasis on reducing new infections across the three diseases, addressing structural barriers and leveraging innovations in prevention tools and approaches.

 The Global fund application process has faced a myriad of challenges in the past. The process is most times convoluted and without visibility from the three programs on what challenges each has faced, and any mitigation measures being taken by each program.

The process is further complicated with the numerous stakeholders who must be engaged. Smooth coordination of multi-sectoral stakeholder engagements has proven difficult in the past cycles.

There has been a problem of lack of full absorption of the grants in previous cycles with the main issue being that items, activities are budgeted for but with no implementation. Strengthening of Community referral systems, procurement of diagnostic tests were in the previous grant but remain a challenge to date.

To end AIDS

GF is supporting countries and communities to close HIV prevention and treatment coverage gaps, with an emphasis on most affected populations. Substantially reducing HIV incidence requires an enhanced focus on accelerating access to and use of precision combination HIV prevention, tailored to individuals’ risks and local contexts.

 GF will support and incentivize action to eliminate HIV-related stigma, discrimination, and criminalization to reduce human rights and gender-related barriers to accessing HIV services, leveraging community-led monitoring (CLM) and advocacy. The interventions being supported are:

o   Accelerating access to and effective use of precision combination prevention, with behavioural, biomedical, and structural components tailored to the needs of populations at high risk of HIV infection, especially key and vulnerable populations (KVPs)

 o   Providing quality, people-centred diagnosis, treatment, and care, to improve wellbeing for people living with HIV, prevent premature mortality and eliminate HIV transmission

 o   Advocating for and promoting legislative, practice, program, and policy changes to reduce HIV related stigma, discrimination, criminalization, other barriers, and inequities and uphold the rights of PLHIV and KVPs.

To end TB

To accelerate progress towards the 2030 TB targets and recover ground lost due to COVID-19, GF is

supporting countries to deliver equitable, people-centred, cost-effective, TB interventions that address

vulnerabilities, barriers and gaps in access to and quality of services.

Finding and treating all people with drug-susceptible TB (DS-TB) and drug-resistant TB (DR-TB) requires a renewed focus on the scale-up of new tools and innovative approaches and more responsive services that are tailored to people’s needs and preferences and differentiated by context. Countries are being guided to accelerate progress in reducing new TB infections by intensifying support for TPT and strengthening the quality of TB care and management of comorbidities. The interventions being supported are:

o   Focus on finding and treating all people with Drug-Susceptible TB and Drug-Resistant TB through equitable, people-centred approaches.

o   Scale-up of TB prevention with emphasis on TB preventive treatment and airborne infection

o   prevention and control.

o   Improve the quality of TB services across the TB care cascade including management of co-morbidities

o   Adapt TB programming to respond to the evolving situation, including through rapid deployment of new tools and innovations

 o   Promote enabling environments, in collaboration with partners and affected communities, to reduce TB-related stigma, discrimination, human rights and gender-related barriers to Care: and advance approaches to address catastrophic cost due to TB.

 Prioritized interventions

o   Screening and diagnosis

o   Treatment and care

o   TB prevention

o   Drug-resistant TB

o   TB/HIV collaborative activities

o   Key and vulnerable populations

o   Collaboration with other providers and sectors

o   Community systems and responses

o   Equity, human rights and gender-related barriers

o   New products and innovations

o   Strategic information

o   Program essentials for Global Fund supported services

Global Fund catalytic investments

To end Malaria

To accelerate progress towards the 2030 malaria goals, GF is supporting countries to increase the

efficiency and effectiveness of people-centred, human rights-based and gender responsive integrated

malaria interventions tailored to sub-national levels, responsive to local contexts and to barriers to

access and quality of services. The interventions being supported are:

o   Ensuring optimal vector control coverage

o   Expanding equitable access to quality early diagnosis and treatment of malaria, through health facilities, at the community level and in the private sector, with accurate reporting

o   Implementing of malaria interventions, tailored to sub-national level, using granular data, and capacitating decision-making and action

o   Driving towards elimination and facilitate prevention of reestablishment of malaria

Prioritized interventions

o   Evidence-based decision making

o   Prevention

o   Case management

o   Elimination

o   Cross-cutting Areas

Resilient sustainable systems for health (RSSH)

Building RSSH- is essential for ending HIV, TB and malaria as epidemics. Common constraints in both community and formal health system prevent the delivery of essential health services and threaten progress in the fight against the three diseases. Investing in RSSH yields broad health outcomes and enables health care to be delivered in a sustainable, equitable and effective way while accelerating progress toward better health and wellbeing for all.

 RSSH Interventions Eligible for Global Fund Support

GF’s RSSH Module provides a summary of RSSH interventions eligible for support. Countries are being guided to prioritize modules and interventions based on the gaps and priorities identified during inclusive country dialogue. See below summary of interventions eligible for support:

 o   Health sector planning, leadership and governance

o   Health financing and financial management systems

o   Community systems and responses

o   Monitoring and evaluation systems

o   Human resources for health and quality of care

o   Health products management systems

o   Laboratory systems strengthening

o   Medical oxygen and respiratory care systems

o   Additional cross-cutting considerations: private sector engagement and digital health

 Achieving the primary goal is pegged on each player in Global Fund’s extraordinary partnership playing their distinct and complementary part. Success of the new Global Fund strategy is based on the principles of country ownership and partnership. Implementer governments are responsible for the critical role of delivering strong, equitable health systems and disease programs that respond to the needs of people and communities; and communities for guiding how their needs can best be met and for delivering programs that ensure no one is left behind.

 How CHAI comes in

We are working with the HTM programs to identify the major gaps in the previous funding cycle and establish key mitigation actions in the coming cycle. We will also identify the gaps that are executable with timely tracking of what is in the GF strategy for performance tracking

CHAI will be engaging with multi-sectoral stakeholders to identify and prioritize key interventions under HTM. Emphasizing on the need for integrated and highly impactful interventions.

We will be working with different stakeholders to bring clarity to the issues faced in the previous grant. To establish why implementation was difficult.

There are several requirements to establish what needs to be prioritized especially in community systems and responses. We are working with the national programs to identify the gaps in these areas and what interventions need to be put in place.

We have several materials and tools designed to make the application process as efficient as possible. We will be providing these and additional technical assistance to the HTM programs

CHAI is working with the national programs to identify and prioritize the key interventions that will promote resilient sustainable systems for health, especially under: health financing and financial management systems, monitoring and evaluation systems, human resources for health and quality of care, laboratory systems strengthening, medical oxygen and respiratory care systems, private sector engagement and digital health.