Health Governance and Finance | 08.11.2018
Report on Global Fund processes in Malawi, Tanzania and Zimbabwe released
HEARD has released a research report examining Global Fund processes in three African countries, Malawi, Tanzania and Zimbabwe, each of which receive the some of the largest Global Fund investments for their national HIV responses.
Commissioned by the Bill & Melinda Gates Foundation, the report was prepared by HEARD Senior Research Officer Russell Armstrong with contributions from researchers Arlette Campbell White (Tanzania), Patrick Chinyamuchiko (Zimbabwe), and Steven Chizimbi (Malawi). Given the importance of Global Fund investments in each country, it is important for the foundation and others to understand how the countries plan for, receive and implement these three-year grants which have major impacts on their ability to manage their HIV epidemics.
The research shows that Global Fund processes and programmes have been come increasingly complex, challenging each country’s ability to effectively manage them. They have also remained largely separate from other processes and structures within the health sector from managing development assistance for health. Most of Global Fund resources are allocated support anti-retroviral treatment (ART) programmes in each country in the absence of any meaningful contribution from domestic budget. New HIV infections continue to occur in each country, reaching as high as 65,000 in 2017 in Tanzania meaning that the need for ART will continue to increase in the absence of significant investments in primary prevention. This trend will begin to strain Global Fund processes and programmes unless either new HIV infections can be reduced or domestic spending increase.
The report concludes with a series of recommendations for address these challenges, which include strengthening the relevance and efficiency of Global Fund processes and programme structures, improving country capacities to prioritise and plan for the HIV-related needs, and findings new opportunities to increase the availability for resources for investing in HIV prevention.