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Total health ODA commitments, 2001-2006

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

  2. 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)

  3. The Global Fund: an innovative instrument in health and development A financial instrument, not an implementing entity Supports programs that reflect country ownership Evidence-based Performance-based

  4. A unique partnership Multilaterals Bilaterals Countries Patients Affected Communities Civil Society Private Sector

  5. 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 OP/290607/5

  6. Global Fund portfolio $14 billion in approved financing $7 billion disbursed 600+ grants in 140 countries

  7. Global Fund portfolio: AIDS

  8. Global Fund portfolio: malaria Global Fund Global Fund US$ 308 million(64%) US$ 133 million(67%) Private/Other US$ 4.4 million(1%) Multilateral US$ 62.7 million(13%) Bilateral US$ 106.7 million(22%) Grants from other sources US$ 66 million(33%) Global Fund portfolio: TB

  9. 140 countries with Global Fund grants BG/261107/6

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

  11. 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

  12. Reaching the vulnerable e.g. Global Fund support to harm reduction programmes

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

  14. Global Fund results: June 2008 GP/110608/9

  15. AIDS impact: Malawi Initial decline in workplace mortality at Escom (national electricity company) after roll-out of antiretroviral treatment Source: Global Fund

  16. Decline in adult mortality with introduction of ART: Botswana

  17. Increase in TB financing and new sputum positive cases detected and treated

  18. 2007 2002 2006 2001 2003 2005 Declining malaria in health facilities after scale-up of bed nets and anti-malaria treatment: Rwanda, 2001-2007 Incidence↓~64% 2004 WHO national database

  19. Addressing health systems challenges Human resources Procurement systems for drugs and health commodities Infrastructure Laboratory equipment Monitoring and evaluation systems

  20. Direct funding of health systems through Global Fund grants

  21. 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

  22. 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

  23. Infrastructure: Support for renovation of existing health centres Mukoma Health Centre, Rwanda (Source: PEPFAR) *Photo courtesy of FHI

  24. 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

  25. 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

  26. Resource needs for AIDS, TB and malaria (2009 to 2015) Sources: UNAIDS, STB, RBM

  27. Resources: increasing both availability and demand EstimatedNeed Estimated Need Available resources and demand Demand $ US billion Available resources

  28. Global Fund requested and approved 2-year funding (Rounds 2 – 8) 53% Approval rate 40% 34% 39% 22% 34% 47%

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