The Global Fund: 20 years of impact in Africa

In the recently concluded Global Fund 46^th Board meeting, the revised 2023-2028 Global fund strategy has come to light. It comes at a time when COVID19 risks jeopardizing the hard -won health gains including of HIV, TB, and Malaria. The global health community is under pressure to attain the 2030 development goals, hence brings the long, awaited strategic plan to light. Implementation of this strategic plan is dependent on a well-rounded resource mobilization, for which Global Fund’s Seventh Replenishment related activities would be soon unveiled.

In preparing the ground for the seventh replenishment, the Global Fund 20^th anniversary campaign launched in June 2021, has been showcasing the outstanding impact of the Global Fund on communities journey in the fight against HIV, TB and Malaria. Building on this momentum, collection and reflection on Eastern and Western Africa (ESA), Western and Central Africa (WCA) constituencies achievements and policy, recommendations has been an exercise that has shed additional light on Global Fund’s impact in the continent.

Consequently, what has been some of our constituencies’ achievements with regards to areas that our constituencies have identified as a matter of priority such as?

Community Systems Strengthening (CSS)
Procurement and Supply Chain Management (PSM)
Integrating Gender, Human Rights and Equity to improve access to HIV/AIDS, TB, Malaria Services, and
Implementation of Global Fund grants in the context of a challenging operating environment (COE)

CSS in Kenya

Kenya’s Community Health Strategy recommends the integration of service provision at community level. The core CSS interventions through Global Fund grant have been as follows:

Community- based monitoring for accountability
advocacy for social accountability
Social mobilization, building community linkages,
collaboration and coordination as well as institutional capacity building
planning and leadership development in the community sector.

These CSS interventions have improved the lives of so many by, primarily providing capacity building of Community Health Volunteers (CHVs), to collect accurate and reliable data, on how to use critical household health monitoring and reporting tools developed by the Ministry of Health (MOH). CHVs receive adequate training medical kits being both the first point of contact with the community and vital actors in the implementation of HIV campaigns to reduce stigma and increase access to care.

Beneficiaries of CSS programs and interventions in Kenya stress upon the necessity for the government to ensure continuity of activities, including the provision of commodities despite covid-19 restrictions. A specific action point for both the government and development partners has been to support counties to take an active role in Domestic Resource Mobilization. Download here.

PSM in Ethiopia

Another East African country, Ethiopia, where the Global Fund grant is highly commoditized (more than 70% of the grant is allocated for procurement of pharmaceuticals and health products), the contribution of GF grant ranges from allocating resources for procurement of pharmaceuticals and health products to storage and distribution as well as investing on infrastructures and human resources. Global Fund grants have also been impactful in enhancing the Supply management system of medicines and health products. In terms of procurement of lifesaving medicines and health products, the country has been using the Global Fund’s Wambo.org platform, which has been vital to the availability of small volume but critical medicines such as ARVs and health commodities, hence bridging procurement gaps.

Identifying the way forward, the Country underlines the need to support local manufacturing and sourcing of pharmaceuticals and health products, which will in turn ensure the sustainability and continuous availability of essential medicines in the country. Download here.

Addressing Gender and Human Rights-relate barriers in Senegal

In Western and Central Africa, Senegal has invested in programs to break down gender and human rights-related barriers. This approach is part of Global Fund’s “Breaking Down Barriers” initiative, which involves 20 countries, including Senegal. It is through this framework that inequalities and barriers related to Human Rights, gender and age that hinder access to services were identified. These include discriminatory behavior, violence against key populations, and people living with HIV, laws and social norms that are unfavorable to adolescent Sexual and Reproductive Health (SRH), stigma and judgmental attitudes of service providers towards adolescents and, legal barriers related to the age at which testing can be carried out (16 years) are among the major barriers which were underlined.

Intensified advocacy through establishment of new alliances engaging among others parliamentarians and relevant ministries, as well as mitigating the sensitive nature of the issues raised, through solely focusing on public health concerns will be actions that would need to be stressed upon by all stakeholders involved in addressing gender and human rights related barriers. Download here.

Lire en français.

Addressing Gender and Human Rights-relate barriers in Cameroon

Cameroon has well defined strategies to address human Rights and gender related barriers in relation to TB and HIV. Activities supported through Global Fund grants include addressing social stigma and discrimination among key populations, training of health workers in regards to Human Rights issues pertaining to the two diseases, provision of TB/HIV related legal services, and advocacy towards parliamentarians, and other policy makers to review and reform laws, policies and regulations. Furthermore, addressing gender related barriers, poverty and socio economic inequalities hindering access to services have been given prominence.

Implementation of Global Fund grants in the in the COE context in Mali

In Mali, Global Fund grants are implemented in the context of a Challenging Operating Environment (COE), where the involvement of local organizations, authorities, and communities has been pivotal to the successful implementation of activities in hard to reach areas. As a country with high malaria prevalence, exemplary cross-border initiatives, which ought to be cited, are alignment of the seasonal malaria chemoprevention (CPS) implementation period with campaigns carried out in neighboring countries like Burkina Faso, Guinea, and Senegal. This is as well as the distribution of second- generation mosquito nets, hence taking into account the realities of geographical resistance, particularly in the border regions of Burkina Faso. Establishing partnership with humanitarian organizations to better monitor implementation in hard-to-reach areas has been considered a practice worth scaling up. In light of the Challenging Operating Environment, prior to their intervention, partners are called upon to deepen exchange with all active and local partners in the field to better understand the context.

The impactful activities in the aforementioned countries, are obviously a snapshot of programs implemented in ESA/WCA constituencies. It is of utmost importance that the upcoming Global Fund 7th replenishment considers the gains that have been made thus far, the gaps identified by the beneficiary countries, and inspired by the newly adopted Global Fund strategy, to make financial pledges and contributions matching their renewed commitment and determination to end HIV, TB and Malaria in the continent. Download here.

Lire en français.