GENEVA – The Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria held its fiftieth assembly this week in Geneva, Switzerland. Two months after the discharge of the Global Fund’s [Results Report[(https://www.theglobalfund.org/en/results/), Board members praised the unprecedented progress achieved in the fight against the three diseases in 2022 and the significant investments made to strengthen health systems around the world, including through the reprogramming of funds from the Global Fund’s COVID-19 pandemic response. However, they expressed concern that the growing challenges of climate change, conflict, and the erosion of human rights undermine the partnership’s ability to end the three diseases by 2030.

“In the face of colliding crises, the Global Fund partnership must lean into the resilience and agility that has underpinned our success so far,” said Lady Roslyn Morauta, Chair of the Global Fund Board. “We must also leverage our flexibility to further support countries affected by humanitarian crises. To get back on track towards the global goals, the Global Fund will continue to foster the meaningful engagement of civil society and communities to strengthen our inclusive, country-led, partnership governance model.”

“The world is in turmoil,” acknowledged Global Fund Executive Director Peter Sands in his update to the Board. “But we continue to deliver extraordinary impact. The dramatic changes in life expectancy across much of Africa, and the sharp declines in infection rates and mortality across the three diseases, plus the significant advances in health system capacities in many low- and middle-income countries, owe much to the work of the Global Fund partnership. In a world where the concept of our common humanity seems diminished, the Global Fund remains a powerful expression of global solidarity.”

Sands highlighted the unprecedented scale and breadth of the Global Fund’s investments in health systems, including in primary health care, community systems and community-led monitoring, and emphasized the massive investments made to enhance access to medical oxygen. “Our investments in oxygen are a powerful demonstration of how the Global Fund can help transform health system infrastructure and capacity,” he said. “Access to medical oxygen will deliver a step change in many countries, reinforcing their ability to save lives.”

A few days ahead of COP28 – which will address the impact of climate change on health for the first time – Board members noted that climate disasters disproportionately affect low- and middle-income countries with high disease burdens, weak health systems, and fragile political or conflict contexts, putting communities – who have contributed the least to global carbon emissions – at risk. They committed to supporting actions across the partnership to adapt programs to the impact of climate change, build climate-resilient health systems, and respond to climate-related disasters. The Board noted addressing climate change is a critical part of the Global Fund Strategy, and currently more than 70% of Global Fund resources support the 50 most climate-vulnerable countries, and 87% of both the global malaria burden and Global Fund allocations for malaria are in these climate-vulnerable countries.

“Climate change is a profound threat to the achievements of the Global Fund’s mission and to the vulnerable countries, communities and people at the center of our Strategy,” said Bience Gawanas, Vice-Chair of the Global Fund Board. “Addressing climate change is not an expansion of the Global Fund’s mission, but instead a response to an unprecedented shift in the context of human and animal life on Earth that will affect most aspects of the Global Fund’s work.”

Board members reiterated their concern that climate change, in addition to drug- or insecticide-resistance, poses an urgent threat to malaria control and elimination efforts. Following up on their decision last May [ download in English ] to extend danger urge for food for malaria interventions to adapt to the scenario, Board members authorised changes to the Risk Appetite Statement for malaria that present extra flexibility for potential revisions consistent with the danger panorama, the progress made towards the illness and future funding.

Noting the key successes just lately achieved in bettering entry to and affordability of lifesaving HIV, tuberculosis and malaria merchandise, the Board hailed the strategic function performed by the Global Fund, technical companions, the non-public sector and civil society in market-shaping. They dedicated to supporting the profitable execution of the Global Fund’s NextGen Market Shaping strategy to additional speed up the introduction of extra efficacious well being merchandise at scale, contribute to improved worth for cash, and assist supply of the Strategy and common well being protection. Board members additionally inspired the Global Fund and different world well being companions to collaborate much more carefully to additional assist the scale-up of native and regional manufacturing, significantly in Africa. They authorised the up to date high quality assurance insurance policies for pharmaceutical merchandise and medical units, paving the way in which for Global Fund sources for use to obtain important well being merchandise manufactured nearer to the place they’re used whereas sustaining high-quality assurance requirements.

As international locations get able to implement their new grants in January 2024, Board members mentioned various matters associated to the Global Fund’s sustainability, transition and co-financing coverage, particularly home financing. Taking inventory of fiscal and monetary constraints in lots of international locations, the Board expressed assist to additional discover modern financing by approving the Global Fund’s up to date strategy to blended finance. This will permit the Global Fund to contemplate further blended finance companions, past the World Bank, to strengthen the financing of well being techniques and nationwide responses to the three illnesses consistent with the Global Fund’s Strategy goal, with the acknowledged ambition of unlocking as much as US$300 million in further investments. The Board reiterated that this strategy requires sturdy oversight, and so they known as for normal monitoring, analysis and reporting all through the event, evaluate, approval and implementation of blended finance transactions. In addition, Board constituencies responded positively to the Global Fund’s proposed strategy to strengthening co-financing for the three illnesses, with a give attention to nation possession and information high quality, whereas bringing a sensible strategy to macro-fiscal challenges.

The Board additionally authorised the 2024 working bills funds to speed up the supply of the Global Fund’s core applications consistent with the three-year envelope agreed for this grant cycle.

The assembly closed with welcome information from Luxembourg, who introduced a brand new contribution of €750,000, bringing Luxembourg’s whole pledge for the 2023-2025 interval to €15.45 million, a 70% improve over their earlier contribution.

Over the three-day assembly, the Board expressed recognition and reward for the onerous work, professionalism, dedication and achievements of in-country companions, in addition to employees working on the Global Fund Secretariat.