Jamra primary scholl for children affected by HIV/AIDS, drugs or poverty, Senegal (c) Nell Freeman/Alliance Participants in the Photovioce project, Ecuador © Marcela Nievas for the Alliance
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Debating the future of global health


Aids Alliance

Last week (12 July) Action for Global Health hosted a civil society workshop to review the options for delivering global health aid against a backdrop of financial uncertainty and undelivered commitments.

The Alliance is a partner in Action for Global Health. The main aims of the workshop were to share hopes and concerns about delivering global health from different perspectives within the sector, and to identify common-ground to strengthen civil society’s policy and advocacy work on shaping the global health agenda. It also generated first discussions on whether or not the Global Fund to Fight AIDS, Tuberculosis and Malaria should expand its mandate.

The workshop was attended by civil society organisations from the UK and Brussels, conducting work on a wide range of health-related issues including sexual and reproductive health, child health, maternal health, HIV and AIDS, TB, malaria, health in conflict and fragile states, and nutrition, as well as civil society participants with expertise in the World Bank, WHO, Global Fund, and the International Health Partnership and Related Initiatives (IHP+).

Current financing mechanisms

Elaine Ireland, Alliance Global Health Advocacy Officer, presented the latest updates on the International Health Partnership and Related Initiatives (IHP+) and the Health Systems Strengthening Platform that is currently under development with the Global Fund, the GAVI Alliance, World Bank and WHO.

DFID outlined the new UK government’s priorities for health and development, which include demonstrating ‘value for money’,  a focus on maternal health, which a recent report highlighted cannot be achieved without tackling HIV, and a focus on malaria.

Future of the Global Fund

The future role of the Global Fund was debated. Should it remain focused on the three diseases, or expand into a ‘Global Fund for the Health MDGs’? This workshop was the first important step in establishing agreement among health-related NGOs on whether or not to expand the Global Fund’s mandate. Discussions that followed aimed to find some consensus among the NGOs present regarding what the future of global financing for health should look like.

Taking shape

Perhaps the most important area of agreement was that the patient must be at the centre of decision-making, so that all needs are met. Taking the example of a woman in any developing country, she needs to have access to:

  • Maternal health services to deliver a baby safely
  • Healthcare, nutrition and safe sanitation for her children 
  • Medicines for illnesses she or her family succumbs to 
  • Treatment for HIV, TB and malaria 
  • A well-performing health system that has received investment in infrastructure, health workers, and medical supplies.

There was also consensus that:

  • The allocation of aid must be based on pro-poor policies that ensure the most marginalised and vulnerable populations are reached. 
  • The horizontal vs. vertical health financing debate is distracting. There should be concerted support for a ‘diagonal’ approach to health financing that delivers a balance of investments in health systems strengthening and targeted health interventions that are based on country needs. 
  • Frameworks must make use of, and strengthen, existing monitoring and evaluation frameworks rather then introducing new ones, and need to include qualitative as well as quantitative results. 
  • Civil society can give importance and credibility to financing institutions such as the Global Fund. UK civil society would like the new government to review the role of civil society, particularly the crucial contributions they make to holding donors, including DFID, accountable for delivering results. 

By finding common-ground on these issues, Action for Global Health sees the workshop as the first step in finding agreement among UK health-related NGOs on whether to expand the Global Fund’s mandate.

Follow up meetings with civil society are expected to take place around the MDG Review Summit, the Global Fund Replenishment, and the November Board meeting of the Global Fund where discussions on expanding the mandate of the Global Fund will take place. For more information on the outcomes, or to get involved in future discussions, please contact eireland@aidsalliance.org

    Aid must reach the most marginalised and vulnerable populations