Opinion: Making the case for the Global Financing Facility

A health extension worker examines a child diagnosed with severe acute malnutrition. Photo by: Mulugeta Ayene / UNICEF Ethiopia / CC BY-NC-ND

Last week, Bill and Melinda Gates released Goalkeepers, a new report that highlights the tremendous progress the world is making and outlines pathways to a more just and prosperous future. The report draws on compelling evidence to demonstrate that investments in the fight against poverty and disease are having a major impact. But it also underscores that progress isn’t inevitable, especially at a time when leaders in Washington and around the world question the value of foreign aid.

So what must we do to keep the world moving in the right direction? First, we need to remind world leaders that investing in the health of women, children, and adolescents offers a sure path to a better future for all, and one of the smartest ways to stimulate inclusive economic growth. In the past generation, maternal and child deaths have fallen by about 50 percent, and better health outcomes for mothers and children in low-income countries have helped lift more than 1 billion people out of extreme poverty.

We also need to recognize that strengthening the delivery of integrated health care to mothers, newborns, and infants is essential if world leaders are serious about eliminating preventable child deaths by 2030 and narrowing the huge gap between maternal death rates in low- and high-income countries.

If we can help low-income countries deliver the quality health care that women and children need, we can set in motion a chain reaction of positive outcomes for women and their families capable of transforming societies:

• When women have access to family planning, they are more likely to space their pregnancies.
• When women space their pregnancies, they are more likely to give birth to healthy newborns.
• When newborns are born healthy, they are more likely to grow up smart and strong.
• Then a generation of healthy young people, brimming with ambition, will initiate a virtuous cycle of prosperity that will continue for generations to come.

To achieve these outcomes, however, we need new ways of doing business that empower low-income countries to design and build the health systems they need to reach women, children, and young people everywhere in support of Every Woman, Every Child.

We’ve known for decades that foreign assistance is just one part of the formula for development. Low-income countries also need better strategies to maximize all available resources for health, including domestic financing and leveraging the private sector. But the complexity of the current model for financing health is holding us back from making progress.

That’s why the Bill & Melinda Gates Foundation is committing $200 million to kick off the replenishment of the trust fund supporting the Global Financing Facility, which was established at the Financing for Development Conference in Addis Ababa in 2015. The GFF advances the goals and objectives of the updated U.N. Global Strategy for Women, Adolescents and Children by strategically aligning a range of partners and available financing for health to achieve better results.  

Countries work with the GFF to develop evidence-based “investment cases” that reflect the country’s priorities and needs for improving the health of women, children, and adolescents. These investment cases help countries align donor, domestic, and private sector financing and secure favorable loans at low interest or no interest because they have produced solid, lower-risk business plans to strengthen their health systems. The GFF trust fund established at the World Bank links grant funding to International Development Assistance or International Bank for Reconstruction and Development projects. This substantially increases the scale of available funding for reproductive, maternal, newborn, child health, and adolescents at country level.

Country-led. Evidence-based. Customer-focused. Integrated. Results-oriented. This is still a relatively new approach, but the GFF has the potential to generate more sustainable financing for health over the long term by mobilizing support from donor governments, private sector partners, and a country’s own domestic resources.

It’s an idea worth investing in.

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About the author

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    Chris Elias

    Chris Elias, MD, MPH, is president of the Global Development Program of the Bill & Melinda Gates Foundation. He leads the foundation’s efforts to accelerate the delivery of proven health care products and solutions to those who need them most — especially women and children. Chris recently served as the president and CEO of PATH, an international nonprofit organization dedicated to improving the health of people around the world by developing innovative health technologies, strengthening health care systems, and encouraging healthy behaviors.