Sustainability Bridge Funding: Case Study from Bosnia and Herzegovina, Montenegro and Serbia

In the last decade, an increasing number of donors are withdrawing their support for healthcare. This has been especially true for middle-income countries, where the growth of domestic resources was one of the triggers for donor funding reduction. The Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) has termed this process as “transition”.

Sustainability Bridge Funding (SBF) is an idea that has been discussed among donors and civil society organizations as a way of mitigating the negative effects of transition and in providing support for key essential services for communities and key populations. As a safety net mechanism, it should respond to gaps in funding and mitigate adverse effects of donor funding withdrawal.

Open Society Foundations (OSF) first piloted the idea of SBF in Southeastern Europe — a region where the withdrawal of Global Fund has led to the collapse of services in countries including Romania, Bosnia and Herzegovina and Serbia — by supporting civil society to navigate the transition process and engage in effective budget advocacy.

Building on this work, in 2018 OSF, through the Eurasian Harm Reduction Association (EHRA), initiated the project, Budget Advocacy and Monitoring in countries of South East Europe . It provided funding to ³ three transitioning countries in the Balkan region – Bosnia and Herzegovina (BiH), Montenegro, and Serbia — through the sub-regional network organization, Drug Policy Network South East Europe (DPNSEE), to support budget advocacy for harm reduction services

“Sustainability Bridge Funding: Case Study from Bosnia and Herzegovina, Montenegro and Serbia” looks at the implementation of this project as one of the demonstrations of the SBF mechanism, with the objectives to:

·       Document the SBF pilot in 3 Balkan countries and to analyze the strengths and weaknesses of this approach and to develop suggestions for improvement; and,

·       Document the results, successes, and challenges of the budget advocacy projects supported through the SBF approach.

Please find the full version of the Case Study.

The Global Fund Human Rights Complaints Procedure. Brochure

The Global Fund is committed to protecting and promoting human rights in the context of AIDS, tuberculosis and malaria.

That means removing human rights barriers to accessing health services for women and girls, sex workers, people who use drugs, men who have sex with men, transgender people, people in prison, migrants and refugees, indigenous peoples and others who are particularly impacted by one or more of the three diseases.

The Global Fund has tasked its Office of the Inspector General with the responsibility of investigating some kinds of complaints of violations of human rights in programs which it supports.

The brochure on the human rights complaint mechanism explains the Global Fund’s minimum human rights standards for all grant recipients, and the complaints procedure. It is available in the following languages (click links for the files):

Also you can read and download the recently-published Global Fund Human Rights Complaint Mechanism Assessment.

The assessment was commissioned by the CRG department to understand why uptake of this complaint mechanism has been low. One of the findings is lack of information/awareness of the mechanism.

Projected Transitions from Global Fund support by 2025 – projections by component

The Global Fund proactively supports countries in planning for the sustainability of programs and successful transitions from Global Fund support and has produced a list of country components projected to transition fully from Global Fund financing by 2025 due to improvements in income classification and based on current eligibility criteria. These projections are not intended as binding determinations or statements of Global Fund policy, and are only provided as an additional resource to assist countries in preparing for transition.

Transition Readiness Assessment Tool (TRAT)

The TRAT has been created to help assessors to take available information and data and to process it in a standardized manner to analyze a country’s readiness for, and risks of, transition from donor funding to sustainable domestic financing. This process also helps assessors to identify key barriers that must be addressed before sustainable transition is possible. The TRAT may be applied in advance of the development of a country Transition Plan to help to structure its content as well as at the stages of implementation of the Transition Plan, and may be re-administered periodically to help analyze the ongoing process of transition, as well as to capture both its positive and negative consequences. This version of the tool focuses specifically on assessing the sustainability of harm reduction services through and beyond the transition period.

The documents were originally published by Eurasian Harm Reduction Network

Download document

Transition Readiness Assessment Tool (.xlsx)

Eligibility List 2018

The Global Fund 2017 Eligibility List identified which country components (HIV/AIDS, tuberculosis or malaria) were eligible to receive an allocation for the year 2018.

Eligibility does not guarantee an allocation. If a country has no eligible components, it does not appear on the list.
Eligibility is determined by a country’s income classification, as measured by Gross National Income (GNI) per capita (World Bank Atlas Method), and official disease burden categorization.

To download the full version of the text, please see the Global Fund 2018 Eligibility List.

Sustainability, Transition and Co-financing of programs supported by the Global Fund. Guidance Note

This document covers definitions and principles of sustainability and transition within the Global Fund context, as well as other terms related to the implementation of the STC policy.

Guidance on what is recommended for all countries to embed sustainability considerations into planning and program design as well as an overview of what is required for applicants to align with the STC policy:

  • Co-financing requirements – for all countries
  • Focus of application requirements – for middle income countries
  • A transition work-plan to submit with the funding request – for components applying for “transition funding” .

Full version of the document can be found here: http://eecaplatform.org/wp-content/uploads/2018/04/core_sustainabilityandtransition_guidancenote_en.pdf

Eligibility List 2017

The Global Fund 2017 Eligibility List identifies which country components (HIV/AIDS, tuberculosis or malaria) may be eligible to receive an allocation for the 2017- 2019 period.

Eligibility does not guarantee an allocation. If a country has no eligible components, it does not appear on the list.
Eligibility is determined by a country’s income classification, as measured by Gross National Income (GNI) per capita (World Bank Atlas Method), and official disease burden categorization.

The Global Fund 2017 Eligibility List can be found here: http://eecaplatform.org/wp-content/uploads/2018/04/core_eligiblecountries2017_list_en.pdf

Update on Sustainability, Transition, and Co-Financing

An updated document consists of the latest data and key pillars across the sustainability, transition, and co-financing (STC) Policy of the Global Fund.

Given the breadth of themes, this document provides a framework for key focus areas across the STC Policy, principles and main aspects of transition preparedness, a number of transversal, cross-cutting themes related to STC policy and the future priorities for STC policy implementation.

The full version of the document can be found by link: http://eecaplatform.org/wp-content/uploads/2018/04/bm37_17-sustainabilitytransitionandco-financing_update_en.pdf

The Global Fund Sustainability, Transition and Co-financing Policy

This paper presents the Sustainability, Transition and Co-financing Policy that the Strategy, Investment and Impact Committee recommends for Board approval.

Long-term sustainability is a fundamental aspect of development and global health financing. It is essential that countries are able to scale up and sustain programs to achieve lasting impact in the fight against the three diseases and to move towards eventual achievement of Universal Health Coverage. Countries that have experienced economic growth over the last decade are able to move progressively from external-donor financing for health toward domestically funded systems that deliver results but must be supported to do so. The 2017-2022 Global Fund Strategic Framework recognizes this and includes a specific sub-objective committing the Global Fund to “support sustainable responses for epidemic control and successful transitions.”

This paper requests the Board to approve the Sustainability, Transition and Co-financing Policy set forth in Annex 1 to this paper, based on the recommendation of the Strategy, Investment and Impact Committee (SIIC). Upon approval by the Board, the Secretariat will implement the Sustainability, Transition and Co-financing Policy.

The full version of the document can be found by link: http://eecaplatform.org/wp-content/uploads/2018/04/BM35_04-SustainabilityTransitionAndCoFinancing_Policy_en.pdf

Eligibility List 2016

The countries’ list set forth below reflects the eligibility of the determination for the year 2016.

Eligibility does not guarantee an allocation. If a country has no eligible components, it does not appear on the list.
Eligibility is determined by a country’s income classification, as measured by Gross National Income (GNI) per capita (World Bank Atlas Method), and official disease burden categorization.

To download the full version of the text, please see the Global Fund 2016 Eligibility List.