The Global Fund’s latest strategy: What’s new?

The board of the Global Fund to Fight AIDS, Tuberculosis and Malaria approved the multilateral organization’s new strategy for 2023-2028. Though the strategy mainly reemphasizes the work the Global Fund already does, some newer aspects have been added that will see the organization playing a role in pressing issues such as pandemic preparedness and climate change. “We're placing a much greater emphasis going forward on meeting the needs of people and communities, on integrating programs for greater impact and sustainability, on addressing health equity, and human rights and gender barriers to health,” Harley Feldbaum, Global Fund’s head of strategy and policy, told Devex. Part of that means more Global Fund resources going to community-based organizations. Feldbaum said community-based organizations play a key role in reaching vulnerable populations and have shown their ability to respond to new circumstances such as COVID-19, while adding that governments’ role remains critical. “We will never have the scale of action required if implementer governments don't continue to step up with their own financing, and own health programs,” he said. The new strategy also references pandemic preparedness and response as an “evolving objective.” The organization is also looking at what can be done to address the threats of climate change, both internally and through its grants. Integrating pandemic preparedness work There have been multiple calls for the Global Fund to play a role in future pandemics. Some experts argued that the organization is best placed to do so given its core mission focuses on addressing infectious diseases and because of its community reach. During the COVID-19 pandemic, the Global Fund said its COVID-19 Response Mechanism, or C19RM, has also become the largest grant mechanism responding to nonvaccine-related needs. As of Oct. 20, over $3 billion has been awarded via C19RM. “We need to support countries [to] build climate-resilient health systems because this threat is here now and it's going to impact our work.” --— Harley Feldbaum, head of strategy and policy, Global Fund to Fight AIDS, Tuberculosis and Malaria According to Feldbaum, the fund is also currently working with Merck, UNICEF, and generic manufacturers in getting molnupiravir, Merck’s candidate COVID-19 antiviral pill, to low- and middle-income countries, pending regulatory approval, which include World Health Organization recommendations. Now its board has decided for it to continue playing a role in pandemic preparedness and response. But it’s not clear yet what exactly that role is. “We couldn't describe every aspect of exactly how the Global Fund will respond because the world is in fact still deciding on what the outlines of better pandemic preparedness and response looks like,” Feldbaum said. However, he said the fund’s work with C19RM has shown it can build this response on the back of its existing programs. C19RM has been authorized by the board to operate within a limited time period, but Feldbaum expects it will continue as long as there is a need in the COVID-19 response. “I think that ‘evolving objective’ in our strategy indicates that the Global Fund is ready to play a similar response role in any future pandemic,” he said. A dedicated climate fund? Another new aspect in the strategy highlights the Global Fund’s recognition of the impact of climate change on its mission and health in general. A quantitative assessment by WHO estimated that climate change may cause an additional 60,000 malaria deaths between 2030 and 2050, and projected that about 5% or 21 million malaria cases globally would be attributable to climate change in 2030. Scientists warned that climate change will also lead to more extreme weather events, making the provision of health services more challenging. It could also displace more people, and affect their livelihoods, which in turn could affect their ability to access health care. “Our role, I think, is in a couple of different pieces. One, we need to support countries [to] build climate-resilient health systems because this threat is here now and it's going to impact our work,” Feldbaum said. “And there's a lot of work to do with countries, with technical experts, as to how best to do that. And there's probably not one-size-fits-all solutions that we're gonna need to support countries with.” The fund is also looking at its own procurement work and internally. Feldbaum said the organization has introduced waste management practices, such as reducing plastic packaging of mosquito nets when shipping them, which he said both reduced cost and waste. The Global Fund Secretariat in Geneva, is also taking some steps to limit their carbon footprint, whether it’s through recycling or looking at the fund’s travel costs, Feldbaum said. “I think as we explore the next set of grants, we will be looking at whether or not there are partnerships with other multilateral climate financiers that would make sense, but those are still in early stages,” he said. Climate financing however will likely be more integrated into the Global Fund’s existing programs rather than a dedicated funding stream. “I think financing usually works best when you try and integrate it with the rest of our mission,” Feldbaum said.