In an unprecedented show of solidarity, world leaders from developed and developing countries rallied round President Joe Biden of the United States of America to fight for what counts at the 7th Global Fund Replenishment Pledge Conference which held in New York on the 21st of September 2022. The headline news is that $14.25 billion was raised to support the Global Fund’s Investment Case for 2024-2026 which projects that 50 million lives would be saved with $18 billion. This is indeed what counts!
This success was preceded by a well-coordinated global advocacy tagged “Fight For What Counts” which was kicked off in February 2022 by five African Presidents (DRC, Kenya, Rwanda, Senegal and South Africa) and civil society advocates amplified it globally. Nigeria’s Country Coordinating Mechanism and the Federal Ministry of Health collaborated with the United States Embassy, UNAIDS and WHO to host a pre-conference event to advocate for at least 30% increase on previous contribution by donor countries through their ambassadors to Nigeria.
Though the world is still $3.75 billion short of the target (with the United Kingdom and Italy yet to pledge), we must build on the positives from the 7th Replenishment to advance the cause of saving lives, averting new infections, strengthening health systems and reducing health inequalities. For example, the donor base expanded by eight new and returning countries, five of which are African countries. This signals increased interest in the health of the citizens by domestic governments. This is an important development given that the Global Fund Investment Case targets assumed that domestic resources would contribute 45% of the total amount needed to achieve 78% coverage of the unmet need.
Our expectation is that African leaders will extend this prioritization of citizens’ health to their domestic budgets by increasing their annual health budgets closer to the Abuja Declaration target of 15% of annual budget and improve efficiencies within their health systems to ensure that the target to save 50 million lives is achieved despite the shortfall in the Global Fund’s finance pool. The efficiency agenda must commence immediately with the Funding Request development by countries. Country priority setting for investment and implementation strategies must be guided by the objectives to achieve more impact with less resources, value-for-money and accountability. Whilst the Africa Constituency Bureau for the Global Fund (ACB) will collaborate with partners and countries to achieve these, it joins The Global Fund, world leaders and other advocates to appeal to the Governments of United Kingdom and Italy not to let the global health community down by announcing their pledges immediately to make it more realistic for us all to save 50 million lives over the 2024-2026 period.