Independent Review of the Sustainability and Transition Component of the Global Fund’s Value for Money Special Initiative


In 2016, the Global Fund announced its “Sustainability, Transition and Co-financing Policy,” which requires that countries with rising levels of income and/or decreasing burdens of disease develop plans to achieve the sustainability of their national HIV, TB, and malaria responses and prepare for eventual transition towards full national financing. Based upon its transition criteria, twenty-four countries are projected to transition away from Global Fund financing for at least one component by 2025.

Over the past several years, the Global Fund has launched new policies and initiatives designed to better support successful transitions, including the Value for Money Initiative. Successful transitions will require new tools to collect data on domestic and international spending on health, map financing gaps, and develop transition plans. Innovative financing will play an important role in mobilizing new resources for transitioning countries, and the Global Fund has the opportunity to grow the evidence base for innovative financing approaches.

Through its Value for Money Special Initiative, the Global Fund financed eight projects to inform global thinking, Global Fund practice, and country actions related to domestic expenditures, national transitions, and innovative financing in the health sector. After the completion of these projects, the Global Fund aimed to understand the extent to which the work contributed to the three Value for Money objectives: 1) monitor and enhance domestic spending; 2) assist in developing financial sustainability plans; and 3) promote innovative financing.


Pharos assessed the eight projects financed by the Global Fund for quality of execution, outputs, and impact, as well as their contribution to overall Value for Money goals through desk reviews and key informant interviews. Each activity was assessed based upon the extent to which it assisted transitioning countries in better measuring spending for TB, HIV, and malaria, mapping gaps in financing, assisting countries in mobilizing domestic financing, and identifying new or underused approaches in domestic resource mobilization.


Pharos found that the Special Initiative has helped institutionalize and strengthen the level and quality of sustainability and transition support as a focus area in the Global Fund across multiple teams. Through the Special Initiative, the Fund has become a leader in transition analysis and policy. Moving forward the Fund should continue the activities in its Special Initiative and ensure that transition planning remains a priority in Global Fund programming and funding.

Status: Completed, May 2017

Team Members Involved: Rachel Wilkinson and Robert Hecht

For more information, contact Diana Gonzalez at

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