The Global Fund to Fight AIDS, Tuberculosis and Malaria will continue a contentious malaria program that was created to expand people’s access to artemisinin-based combination therapies — but with modifications.
This was among the big decisions the organization’s board made at its 28th meeting, which also included the selection of a new executive director. The Affordable Medicines Facility for malaria program will be integrated into the fund’s core grant funding process. This means countries will decide how much of their malaria grant money will cover co-payments for malaria medicines, as there will no longer be separate funding for those.
The decision will “likely translate into AMF-m activities simply being terminated in most countries,” with “no new money ringfenced for the AMF-m once its runs through its current funding,” Nature senior reporter Declan Butler warned in a blog post. Many AMFm advocates have expressed the same fears, even prior to the meeting.
The decision was based on an independent evaluation of the program’s pilot phase, which showed various levels of success among its eight pilot areas.
Oxfam, meanwhile, welcomed the board’s decision. The health funding agency, according to the anti-poverty organization that has been advocating for AMFm’s termination, has “made the right decision by allowing countries to decide how best to tackle malaria.” Oxfam, however, expressed hope the Global Fund will invest more in community health workers.
AMFm is set to end by Dec. 31, but the board has decided to extend the Global Fund’s mandate to host the program for another year for transition purposes. Further modifications to the program, such as the inclusion of rapid diagnostic tests, may be introduced following assessment by the fund’s technical partners.
The board has also decided on the composition and structure of Country Bands, which form part of the new funding model and will help shape the organization’s resource allocations.
The Global Fund will set up four Country Bands, including one targeting most at-risk populations. The country’s gross national income and disease burden will determine band classifications.
Support for countries with the highest disease burden, but with the least ability to pay is among the set principles that will guide Country Band funding allocations. Others include the provision of a simple methodology, use of widely accepted and available data, and flexibility.
“The output of the allocation formula is a guiding number, to be adjusted by pre-determined qualitative criteria,” according to the board’s decision points.
The Global Fund will also have a separate budget for high-impact, well-performing programs in the form of incentive funding. Details regarding its awarding process and methodology will be available in 2013.
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