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Global Fund Strategy for increased domestic financing

Global Fund Strategy for increased domestic financing. Satellite Session: Where is the Money?? Challenges & opportunities in mobilizing Increased Domestic Financing Melbourne, 23 July 2014. Dr Christoph Benn Director, External Relations Division Global Fund.

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Global Fund Strategy for increased domestic financing

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  1. Global Fund Strategy for increased domestic financing Satellite Session: Where is the Money?? Challenges & opportunities in mobilizing Increased Domestic Financing Melbourne, 23 July 2014 Dr Christoph Benn Director, External Relations Division Global Fund

  2. Context of the 5th ReplenishmentIs the period of sustained rapid DAH growth over? DAH including resources channeled through GF from 1990-2012 in 2010 US$ Billion ? Financing Global Health 2012: The End of the Golden Age? Seattle, WA: IHME, 2013 Need significant progress in other areas of financing for health: domestic financing, private sector partnerships & innovative finance mechanisms Melbourne

  3. Context of the 5th Replenishment ODA projected to increase in 2014 & then stabilize Net official development assistance 2004-13 & projections for 2014-16 (in current US$ billions) ODA in 2013 rebounded & reached $ 134.8 B despite economic pressure on donors but likely to stabilize after 2014  critical to ensure appropriate share for health OECD: http://www.oecd.org/newsroom/aid-to-developing-countries-rebounds-in-2013-to-reach-an-all-time-high.htm Melbourne

  4. Setting global targets for health financing in line with UHC • Governments encouraged to: • spend at least 5% of GDP on health, • ensure government health expenditures (GHE) of minimum $86 per capita Røttingen JA et al, Shared responsibilities for health A new global framework for sustainable health financing, Chatam House WG 2 on Health Financing, May 2014 • No single roadmap to achieve targets, this is a country-by-country process • Primary role of external financing is to fill the gap in the short and medium term for some low- and middle-income countries. Melbourne

  5. Key challenges & opportunities Melbourne Value for Money: As the resource landscape is changing, focus is now more on improving health program efficiency and effectiveness which calls for both “more money for health and more health for money” Domestic Advocacy: a large part of any increase in public funding for health will need to come from governments, therefore need to develop a convincing business and advocacy case for increased / sustainable public commitment to programs Sustainability:Domestic public spending should continue as economic growth continues, however it will not be sufficient to address all the health needs. Therefore, still a need for external resources in the short to medium termas well as to explore PS partnerships & other innovative mechanisms.

  6. GF domestic financing strategy GF strategy for increased domestic financing for health 1. Implement NFM policies linked to domestic financing (Counterpart financing & willingness-to-pay) 2. Support domestic resource mobilization efforts (priority countries) with help of partners 3.Advocate for political leadership & for realization of Government commitments • Country needs assessment/ target-setting & support the buy-in process • Options of tools/mecha-nisms for innovative financing • Documentation & dissemination of Best practices • Advocacy plan with key messages by GF, Donors, partners, private sector and CSOs • Revive co-champion-ships and identify other champions • Leverage key national/ international events & platforms • Support countries on CF/WTP (guidance & tools, country dialogue) • Review country compliance with CF & monitor WTP commitments • Track at grant & portfolio levels 1. Implement NFM policies linked to domestic financing (CF & WTP) 6 Melbourne

  7. New funding model: Counterpart financing aims to mobilize domestic resources Core Global Fund principles: Sustainability, Additionality, Country Ownership • ‘Willingness-to-pay’ commitment to further incentivize • Additional co-investments by government in disease programs in accordance with ability to pay • Realization of planned government commitments • 15% of allocation is contingent upon meeting WTP commitments • Mandatory minimum requirements of counterpart financing • Minimum threshold contribution (LI-5%, Lower LMI-20%, Upper LMI-40%, UMI-60%) • Increasing government contribution to disease programs and health sector • Reliable disease and health expenditure data

  8. Africa has made commitments & countries are demonstrating progress Source: UNAIDS, Oxford Policy Management, Et al. Melbourne Abuja Declaration on HIV/AIDS, TB and Other Related Infectious Diseases, 2001: Heads of State commit to spend at least 15 % of budgets on Health Addis Ababa, African Union roadmap on shared responsibility and global solidarity for AIDS, TB and malaria response, 2012. AU endorsed Roadmap on Shared Responsibility and Global Solidarity for HIV, TB and Malaria and the Pharmaceutical Manufacturing Plan Tunis Declaration on value for money, sustainability and accountability in the health sector, 2012. Governments commit to enhance value for money, increase accountability, improve sustainability of health resources and fight corruption. Abuja AU Special Summit Declaration on HIV/AIDS, TB and malaria, 2013. Calls for countries to honor the 2001 Abuja Declaration and other health commitments.

  9. In sum, the Global Fund is working with countries and partners to: Melbourne Leverage GF resourcesto encourage increasedGovernmentcommitment to disease programs & related health systemsstrengthening Improvedata quality and accessibilityfor bothdomestic and international health funding Identify and addressrigidbudgeting practices, allocativeinefficienciesthat are obstacles to the reallocation of revenues towardshealth Nurturepolitical leadership--►ongoingwork on multi-dimensionaladvocacy and messaging to ensure health isgiven top priority at national and international levels

  10. Conclusions Melbourne Health expenditures should keep pace with economic growth There is no single blueprint for increasing domestic funding for health Lessons learned and best practices should THANK YOU

  11. Overview of CF & WTP in new funding model Melbourne

  12. Domestic resource mobilization support to 5 priority countries in 2014-16 Melbourne

  13. Innovative ways of raising domestic resources and potential gains But how to 1) sell these ideas and 2) ring-fence the funds? Johannesburg

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