THE PROBLEM

The world currently finds itself at a major crossroads in its battle against Covid-19 and in its larger thinking and planning on how to prepare for and respond to future pandemics and other major health threats. Covid-19’s devastating impact on global and national economies, communities and individual lives, and on health systems and services has laid bare the huge deficits in our current systems and capabilities to deal with such disease outbreaks, and has presented to us with greater clarity and urgency than ever before the unprecedented challenges and opportunities we have to change course and take swift and decisive actions to invest in improved policies, programs and governance and financing mechanisms.

Recent reports from the IPPPR and the G20 High Level Independent Panel give us some hope that the world will not fall back to its previous state of “panic and neglect”, as it did after Ebola in 2013-14 and that we will make the big moves required to build a strong PPR system worldwide including in Low- and Middle-Income Countries (LMICs).

In this uncertain and dynamic context, some imminent questions arise for the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GF) – what role should it play in contributing to major new initiatives in PPR? What are the GF’s current and potential future strengths in assisting LMICs in creating and operating robust national PPR systems that could simultaneously reinforce the new and evolving overall global PPR architecture? How could the Fund work with others in such an endeavor? Can this be made compatible with the GF’s original and current mandate to lead in ending the three major HIV, TB, and Malaria (HTM) epidemics by 2030? Indeed, is it essential that the Fund engage in this endeavor if it is to deliver on its core mandate? And what sorts of changes and adaptations in organization, skills, and processes would be required for the GF to play a substantial and effective role in PPR?

To inform the discussion around these questions, the GF has decided to conduct a thematic review of PPR and provide details for possible strategic directions.

THE PHAROS SOLUTION

Employed by GF’s Secretariat, in response to requests from the Board and the Technical Evaluation Reference Group (TERG), a Pharos team consisting international and national experts in public health and global health security has conducted a “thematic review” (TR) of the GF’s place in the future PPR universe, especially in supporting LMICs while contributing to a stronger regional and global PPR system.

Through interviews with over 50 global leaders and more than 80 national leaders in six representative countries (Cambodia, Colombia, Haiti, Liberia Malawi, Nigeria) Pharos identified several inherent features of the Fund’s existing model can serve the organization well in taking on this additional responsibility related to PPR and laid out areas of substantial and growing capabilities that can be further developed and leveraged to make a major contribution to PPR. Pharos furthermore analyzed potential areas beyond the current GF domains, where the Fund could have a big impact on PPR.

Based on these insights a spectrum of actions for the Global Fund have been developed and a strategic direction was recommended. For the recommended direction, Pharos provided an overview of the implementation modalities and impact on core GF processes and functions including grantmaking, resource allocation and partnership management.

The Thematic Review was officially approved and published by the Global Fund in May 2022. The link to the published review is below.

Status: Completed, October 2021

Team Members Involved: Robert Hecht, Shan Soe-Lin, Alexa Straus, Aishwarya Bhattacharya, Claire Young, Catalina Gutiérrez

For more information, contact Robert Hecht at [email protected].