THE PROBLEM

Countries in Latin America and the Caribbean have been heavily impacted by Covid-19, more than any other LMIC region. Case rates and mortality from Covid-19 in the region are among the highest in the world. The economic and fiscal downturn caused by Covid-19 and related lockdowns has been devastating. Health systems have been undermined by budget cuts, diversion of funds to the direct Covid-response (testing, purchase of PPE, hospitalization of sick patients), and illness and deaths among health personnel. There is considerable concern, supported by emerging and still incomplete data, that Covid-19 has negatively affected LAC countries’ HIV, TB, and Malaria programs, eroding earlier gains and threatening the achievement of national plans and goals.

As the LAC countries begin to recover from Covid, it will be crucial to rapidly reinfuse resources in their health sector, including mitigating the impact of Covid-19 on other priority infectious diseases including HIV, TB, and malaria and resuming lost momentum in program strengthening. Plans to move to a more sustainable and self-sufficient national response to HIV/TB/malaria will have been slowed or reversed by Covid-19 over the past 12 months – those sustainability action plans need to be restarted and accelerated.

The Global Fund has just received additional resources through a special contribution from the US and Germany, which needs to be rapidly deployed as part of the Covid-19 Response Mechanism for 2021 (C19-RM). The country allocations for LAC have been announced, providing a good basis for dialogue and planning. There is an opportunity to allocate these funds to the highest potential Covid-19 mitigation actions and to fill priority gaps in existing and likely near term domestic and external financing for the three diseases and in agreed sustainability plans.

Pharos Global Health was requested to assist the LAC countries and the Global Fund in conducting a rapid assessment of Covid-19’s impact and in helping national stakeholders to identify and justify the top priorities for the use of the expected extra grant resources that will be available starting in mid-2021. The Pharos team was asked to work in 19 countries in the region: Bolivia, Colombia, Costa Rica, Ecuador, El Salvador, Guatemala, Guyana, Honduras, Jamaica, Nicaragua, Paraguay, Peru, and Suriname plus the regional coalition of the Organisation of Eastern Caribbean States.

THE PHAROS SOLUTION

Drawing on recent LFA Covid-19 interruption analyses, National Strategic Preparedness and Response Plans for COVID-19, transition readiness assessments, transition/sustainability work plans, focused country evaluations, investment cases, the Pharos team used a combination of document review, one on one interviews, and focus group discussions/consultations to document the impact of Covid-19 on the disease responses; recalibrate plans and budgets for 2021-23; and highlight the priorities for the expected supplementary grant funding.

A series of standard templates were prepared at the outset of the assignment, with input from all the Pharos team members/experts and advice from the Global Fund, to (a) collect key information, (b) conduct interviews, and (c) draft country reports using a standard structure and format. The Pharos team need to assist countries to develop the Funding Landscape, budget gap analysis, and other key tables that countries will have to submit with their applications for C19-RM supplementary funding. A template for the country profiles/prioritization reports was agreed at the start of the assignment, to help focus the work of our country experts toward what is most important in view of the very limited time available to do this work.

LOOKING AHEAD

This project assisted in-country stakeholders and CCM affiliates to submit strong funding requests for the C19RM grant in 2021. The nineteen countries submitted fourteen C19RM applications requesting a total of USD 93 million. Ninety percent of all C19RM funds requested were approved, summing to USD 84 million. These relief funds should assist each country greatly to contain the pandemic and adapt to changing circumstances.

Status: Complete, August 2021

Team Members Involved: Robert Hecht, Nathan Isaacs, Joan Tallada, Catalina Gutierrez, Lorena Prieto, Sandra McLeish, Etoile Pinder, José Francisco Pacheco-Jiménez, Marina Cardenas, and Pedro Bivona

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