How Funds Are Allocated in the New Funding Model
The Global Fund launched its new funding model in late February, and since then we have received a lot of questions about how funding decisions were made. There is considerable interest in how to access the US$1.9 billion available for the new funding model’s transition period, in 2013 and 2014. The main criteria give priority to countries positioned to achieve rapid impact, to countries facing service interruptions and to countries that have received less than they should under new allocation principles that look primarily at disease burden and national income level. Adjustments are also made to take into account external financing levels provided by other donors. And for the six countries invited as “early applicants” to go through all steps of the application process (from submission of a concept note to creation of a new grant) region and country size are considered, too. We need a diversity of programs and settings and conditions so we can see how the new funding model works during the transition this year and next. That way, we can make refinements and changes as needed.
The Global Fund’s approach to allocation carefully follows decisions on the new funding model made by the Global Fund Board. One important requirement made by the Board was that allocations in the new funding model consider both committed and uncommitted funds, so that the Global Fund’s investment as a whole covers the major gaps and needs across the three diseases in a more strategic way. In addition to the US$1.9 billion in uncommitted funds that will be available in 2013-14, allocations also factor in the much larger amount of funds that were already committed in previous years, and may be disbursed in 2013-2014.
A related point about the new funding model may be relevant to the 47 countries that can apply for funding as “interim applicants” for grant renewals, grant extensions or redesigned programs that can rapidly make use of funds in 2013 and 2014. The Global Fund is taking both committed and uncommitted funds into account as it determines allocation amounts for the 2014-2016 period. In practice, that means that funds that come in 2014 will be considered part of a country’s overall 2014-2016 allocation. In all cases, applicants are encouraged to look at how to use all funds in a way that best delivers impact.
Profile: Eliud Wandwalo, Tuberculosis Expert
As a young doctor working in Mwanza, Tanzania, in the 1990s, Eliud Wandwalo came face to face with the devastating effects of tuberculosis. Those were the dark days, in Eliud’s memory. HIV infection was sharply on the rise across Africa, and tuberculosis was rapidly infecting people whose immune systems had been compromised by HIV. TB was suddenly killing people in droves. In just three years, between 1994 and 1996, the TB burden increased fivefold in Mwanza, Tanzania’s second-largest city. It was there and then that Eliud made a decision to dedicate his life to helping people fight the deadly effects of TB. To have greater impact, he left clinical practice to work in public health, where he believed he could reach people across the world with TB control messaging.
Now working as a Senior Specialist for TB at the Global Fund, Eliud provides leadership and strategic guidance on technical aspects of TB. He also supports the Global Fund country teams on technical issues regarding tuberculosis investments. “We are at a unique time in TB control,” says Eliud. “With availability of new technology to diagnose TB and advances in implementation, we will change the trajectory of the disease.” He adds: “My goal is to use my field-based experience and knowledge to support the Global Fund’s investment in TB to save more lives.”
Previously, Eliud worked for Management Sciences for Health (MSH) as the Principal Technical Advisor with special focus on the African region. Before that, Eliud was TB/HIV coordinator for the Ministry of Health in Tanzania and a medical doctor in Mwanza. Now 43, he earned his medical education at University of Dar es Salaam and did his Masters and PhD studies at the University of Bergen in Norway. He is married and has a 13-year-old daughter.
A Sliver of Light in Ukraine
The International HIV/AIDS Alliance in Ukraine released a piece of really good news earlier this month: In 2012, for the first time since 1999, Ukraine saw a decrease in new cases of HIV. The Alliance deserves major applause here. It has been implementing large scale HIV prevention programs among vulnerable populations in Ukraine for years, with support from the Global Fund. Ukraine has faced a sharp increase in new cases of HIV in recent years, and now has 230,000 people living with HIV, the most severe HIV epidemic in Eastern Europe. So stopping the increase of new infections is very encouraging, even if the actual decrease in numbers was minor. The number of new cases of HIV in Ukraine in 2012 was 20,743, the Alliance said, down from 21,177 in 2011. The Alliance has worked hard, with a program that reached 302 cities, towns and villages all over Ukraine. Services include syringe exchange, information and condom distribution, testing and counseling for HIV and sexually-transmitted infections. Epidemiologists have been observing a steady decline of HIV incidence among people who inject drugs, the Alliance says, and access to testing has made a big difference.
The Alliance, a leading nongovernmental organization in Ukraine, has been sharply critical of the Ukraine Government for not doing enough. “As of today, Ukraine is nearly the only country in the world allocating ‘zero’ state funding for HIV prevention,” the Alliance said in a release. The Alliance suggests that its experience in Ukraine may be instructive across the region. Programs and smart implementation can have a significant effect on the HIV epidemic. It is difficult work. Yet progress is being made.
