Geneva Health Forum Archive

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Do Global Funds Really Facilitate Access to Health?

Presenter(s): Lola Dare, Marcos Cueto, Wibulpolprasert Suwit
Chair(s): Elisabeth Fee, Bernardino Fantini
Author(s): Elisabeth Fee1, Bernardino Fantini2, Marcos Cueto3 Lola Dare4, Wibulpolprasert Suwit5
Affiliation(s): 1Chief, History of Medication Division, National Library of Medicine, USA, 2Director, History of Medicine and Health Institute, Faculty of Medicine, University of Geneva, Switzerland, 3Professor Principal, Universidad Peruana Cayetano Heredia, Peru, 4Executive Secretary, African Council for Sustainable Health Development, Nigeria, 5Ministry of Public Health Advisor, Ministry of Health, Thailand
Summary (max 100 words): Numerous international funds have been set up in recent times to address global health challenges such as HIV, TB and malaria, in an effort to provide sustainable funding for selected diseases affecting billions of people in the poorer regions of the world. Despite impressive investments in terms of money and stakeholders  involvement at national and international levels, enabling the scaling up of specific health initiatives, the collective impact of these initiatives has sometimes created or exacerbated problems such as the poor coordination or duplication of programmes, heavy burdens on local health practitioners, variable degrees of country ownership, and a lack of alignment with country systems. Relying on the establishment of inclusive partnerships, financial institutions like the Global Fund to Fight AIDS, Tuberculosis, and Malaria do not take full responsibility for implementing funded programmes which require the active participation of partners in proposal development and realization (through Country Coordinating Mechanisms). One of the major reasons for the apparent ineffectiveness of global interventions is the historical weakness of the health systems of underdeveloped countries, which contribute to bottlenecks in the distribution and utilisation of funds. What are the pros and cons of the global funds from different country perspectives? In theory, the global funds programmes are to be continued and sustained in the long term by the countries themselves. Is this a reasonable expectation? Is the money coming into the global funds programmes (from the donors and also the recipient countries) new money, or is it simply being shifted from one health programme to another? How can the funds best support equity, universal coverage, and sustained improvement in health systems? performance? What are the key steps needed to implement the Paris declaration, with its guiding principles of ownership, harmonisation, alignment, results, and mutual accountability? This round table session will debate the pros and cons of the ways the global funds work (or fail to work) in practice and try to answer the above questions.

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