The Global Fund: a financial partnership model for global public goods
By Friends of the Global Fund Europe’s Executive Committee:
Charles Goerens, former Minister of Cooperation in Luxembourg, Member of the European Parliament; Stefano Vella, Adjunct Professor, Global Health, Università Cattolica del Sacro Cuore, Rome; Laurent Vigier, former Senior Advisor to the President of the French Republic on multilateral/G8 matters; Louis-Charles Viossat, former French Ambassador in charge of AIDS and other contagious diseases; Heidemarie Wieczorek-Zeul, former Minister of Economic Cooperation and Development in Germany
The Sustainable Development Goals (SDGs), which supplanted the Millennium Development Goals (MDGs) in 2015, reflect the interdependence of global challenges and the need for a multilateral approach, grounded in equity, solidarity and inclusiveness, to collective pursuit of the common good. They embody “a shared blueprint for peace and prosperity for people and the planet, now and into the future”[1]. However, the 2030 target is fast approaching, amid an ever-growing array of climate, political, economic, humanitarian and health crises. The repercussions of climate upheaval on national economies, incomes and the health of populations are visible every day, alongside the spectre of a new pandemic and the resulting devastation, both financial and in terms of access to education, healthcare and human and social rights. These crises exacerbate inequalities between rich and poor countries, and between the wealthiest and the most vulnerable populations within countries. The SDGs are interdependent by nature, and international solidarity efforts must not lose sight of this fact.
The Paris Summit for a New Global Financing Pact will open this week, bringing together numerous Heads of State and Government in search of additional financial resources to advance the SDGs. The example of the Global Fund demonstrates that a well-designed multilateral financial partnership capable of adapting to changes and different contexts makes it possible to effectively employ the funds mobilised, achieve a substantive impact on a global public good, realise savings and returns on investment, and sustain resource mobilisation.
Twenty years ago, the scourge of AIDS was killing more than 2 million people a year. At the instigation of the United Nations, G8 leaders helped to create one of the great success stories of multilateralism: the Global Fund to Fight AIDS, Tuberculosis and Malaria.
The roots of the Global Fund’s success lie in its founding principles: partnership, impact, transparency and country ownership. Its partnership approach remains unique to this day: not only are countries’ roles in governance determined independently of the size of their financial contributions, but donor governments, implementing countries, civil society, communities directly affected by HIV/AIDS, tuberculosis and malaria, the private sector, and technical partners all sit around the same table.
Inspired by the motto of AIDS activists who chanted “Nothing About Us Without Us”[2], the Global Fund has enabled people suffering from widespread discrimination, marginalisation and persecution by their governments to wield political and financial power regarding the issues that concern them. The Country Coordinating Mechanisms (CCMs)[3] in which stakeholders develop and manage the programmes financed by the Global Fund are comprised of representatives of both governments and the private sector, as well as civil society organisations and communities affected by the epidemics.
The Global Fund’s impact goes beyond fighting pandemics: indeed, such initiatives serve as vital contributions to health systems as a whole, helping to strengthen them and enhance their ability to prevent, adapt and respond to crises. The organisation is also the leading multilateral funder of health system grants. Thanks to its unique partnership model, the Global Fund has a steadily effect on the six pillars of health systems, i.e. human resources, governance, financing, procurement, health information, and the quality and quantity of services. Moreover, its strategy[4] incorporates a people-centred approach based on human rights, the fight against gender inequality, and education for key and vulnerable populations[5].
Its flexibility, agility and ability to adapt to emergency situations give the Global Fund full legitimacy to intervene in crisis situations, whether political, humanitarian or health-based.
A few weeks after the emergence of Covid-19, the Global Fund authorised implementing countries to reallocate part of their budget envelopes to the fight against the virus and created an emergency mechanism to mitigate the impact of Covid-19 on country programmes. This mechanism has raised USD5 billion to date[6].
When Russia invaded Ukraine in February 2022, the Global Fund was able to respond quickly to the needs of Ukrainian civil society thanks to its Challenging Operating Environment policy[7], adopted in 2016. This policy, combined with the Global Fund’s unique experience in partnering with community-based networks, enables the organisation to maintain services in areas where the government, multilateral organisations and international NGOs are unable to operate.
Against a global backdrop of increased fragmentation and geopolitical rivalries, coupled with a narrowing space for civil society and a retreat from human rights, financial contributions to global solidarity must not be seen through a diplomatic lens; instead, let us recognise the effectiveness of pooling funds and strategies to safeguard global public goods.
The Global Fund, the “war chest”[8] that has saved 50 million lives and counting, is proof that multilateral and multi-stakeholder partnership approaches work and can make a difference for future generations. Its successes must be replicated for other global public goods.
Read Friends Europe’s contribution ahead of the Paris Summit for a New Global Financing Pact
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[1] UN Sustainable Development Goals: https://sdgs.un.org/goals
[2] This slogan, still widely used today by AIDS activists, is a legacy of the International AIDS Conference held in Denver in 1983.
[3] https://www.theglobalfund.org/en/country-coordinating-mechanism/
[4] In 2022, the Global Fund adopted a new strategy placing greater emphasis on a people-centred approach and the need to step up the fight for human rights and against gender inequality, and called “Fighting Pandemics and Building a Healthier and More Equitable World – Global Fund strategy 2023-2025”: https://www.theglobalfund.org/media/11612/strategy_globalfund2023-2028_narrative_en.pdf
[5] Key populations are the groups of people most at risk of HIV infection: Men who have sex with men, people who inject drugs, people in prison or detention, sex workers, transgender people and displaced or migrant people. For malaria, vulnerable people are defined as children under the age of 5 and pregnant women.
[6] The Covid-19 Response Mechanism (C19RM) was created in the first quarter of 2020 to mitigate the impact of Covid-19 on the fight against AIDS, tuberculosis and malaria, while combating Covid-19. To date, the C19RM has disbursed USD5 billion for these initiatives.
[7] The Global Fund Challenging Operating Environments Policy, 2016: https://www.theglobalfund.org/media/4220/bm35_03-challengingoperatingenvironments_policy_en.pdf
[8]UN News: “Global AIDS Fund should be up and running by year’s end, Annan says”, 27 June 2001: https://news.un.org/en/story/2001/06/4102