Accelerating the prevention, control and elimination of communicable diseases through integration: optimizing support from Gavi and the Global Fund

1. 1
Accelerating progress on
communicable diseases
through optimizing
support from the Global
Fund and Gavi
Director, UHC/Department of Communicable Diseases
Dr Yvan Hutin

2. 2
Vaccination outreach
Can we accelerate progress towards the SDG targets for
communicable diseases?
Gavi and Global Fund allow scaled up activities…
2020
estimate
2030
SDG
target
Relative
coverage
gap
Incidence
excess
DPT3 coverage (%) 81 90 -10% -
TB incidence per 100 000 112 58 - 93%
HIV incidence per 1000 0.06 0.025 - 140%
Malaria incidence per 1000* 11 0.93 - 1104%
* Among at risk population
Impregnated
bed nets
distribution
…yetwearerunningoutof time
toclosethegaponSDGtargets

3. Objective:
Optimize return on investments from Global Fund and Gavi
3
Global Fund and Gavi grants in Region,
2000-2019: A substantial investment
Gavi: 2.4 billion
Global Fund: 2.2 billion
Can Member States do things
differently in collaboration with
WHO, Gavi and the Global Fund?
 Seize the opportunity of new Global
Fund and Gavi strategies
 Reduce inequities though people-
centred approaches
 Collaborate as per the Global Action
Plan

4. 4
Analysis for a health system approach
Communicable diseases programmes
Health systems
1. Governance 2. Financing
3. Service
delivery
4. Health
workforce
5. Access
to commodities
6. Health
information
system

5. 5
What are the missed opportunities
to do more with what we have?
Separate plans and insufficient coordination
Insufficient domestic financing and fragmentation
Narrow programme- or project-based approaches
Specific in-service training and financial incentives
- Limited understanding of labour market
Missed opportunities to apply best practices
Fragmented data systems

6. 6
Actions proposed in
the draft Regional
Committee resolution

7. What if everything started with
the national health strategy?
7
1. Governance
 Allow the national health vision to
direct contributions
 Integrate governance under Ministry
of Health
Harmonizing the work of coordinating
mechanisms and committees to align
programmes with the national strategy

8. 8
2. Financing
What if we mitigate consequences of excessive
earmarking?
 Increase domestic public financing
 Improve cross-programmatic
efficiencies
Consolidating contributions
from donors and lenders in the
national health account to
address fragmentation

9. 9
3. Service delivery
What if we switch from a
programme-focus to a person-focus?
 Include interventions in essential packages
 Use integrated PHC for UHC, people-
centred approaches to increase coverage,
starting with underserved/vulnerable
communities
Integrating outreach to package more
antigens and interventions with COVID-19
vaccination campaigns

10. 10
4. Health workforce
What if we go beyond siloed
training and incentives?
 Comprehensive human resources for health
(HRH) approaches
 Policies for health care workers:
 Attract, build capacity and retain
Building a cadre of mid-level managers to
integrate supportive supervision in the field

11. 11
5. Commodities
What if we replicate international
good practices in countries?
 Develop integrated capacity for
procurement
and supply chain management
Ensuring quality at low prices:
• International tenders, pooled procurement
• Pre-qualification
• Optimized supply chain management

12. 12
6. Health
information systems
What if we used data for decision-
making in more programmes and
services?
 Consolidate data systems used for
surveillance,
monitoring and evaluation
Integrating data systems electronically to
replace paper-based registers

13. 13
We have a clear way
forward to make it happen
Annex 1
• Country outcomes – recommended actions presented so far
• WHO contributions to facilitate these country outcomes
• Baseline and target indicators
Engaging the Global Fund and Gavi
Costed implementation plan

14. 14
Call for action:
A system-wide,
health for all by
all approach
THANK YOU – MERCI - ‫شكرا‬
Driven by the national health sector strategy
De-fragment and integrate services and functions
Reach the unreached and vulnerable, reduce
inequities, achieve the SDGs