Global financing facility

DR.

MARIAM CLAESON: The Global Financing Facility for every woman, every child was launched to close that gap to eliminate preventable deaths in mothers, children, and, of course, improve the health and well-being of adolescents. And the way that the Global Financing Facility will close the gap is through support through country-driven investment cases across reproductive, maternal, newborn child health and nutrition. And by having a strongly highly prioritised country investment plan and a finance plan, the purpose of the global financing facility is then to help mobilise the resources for those plans.

And what the global financing facility does is to get that effect through a combination of different ways of increasing the resources first and foremost, domestic resources, secondly, through complimentary financing, aligning the many bilateral and other fundraising countries around those results and highly prioritised plan, and thirdly, through the leveraging that the trust fund provides, leveraging IDA, World Bank lending, and, finally, by also bringing in private capital towards this one investment case. So it’s a combination of domestic money, private, public, overseas development aid, but also, most importantly, trying to really unlock resources in countries.

Instead of having a blueprint for how countries would go about that, what they do is looking at evidence, looking at evidence, where are the greatest burden? which communities are having the greatest burden by death or disability? So it takes a very careful analysis of what the situation is in countries. What are the biggest obstacles and constraints to scaling up high impact interventions? And based on that plan, they’re looking at what are the financial needs to actually unlock or remove those barriers to scale. So that’s what we mean by country investment plays a case. And, of course, that means that you need to rely on a number of partners. So what countries do is the government leads the effort.

But civil society plays a very key role as looking at the accountability of whatever the results to which the government commits itself, but then also technical partners. You have the UN, UNICEF, WTO, UNFPA are members in all these country platforms. As I mentioned, also civil society. But all will have an interest in actually achieving results or at the table. So it really is a new way of thinking about development assistance.

First of all, there are 62 eligible countries and they are chosen on the basis of need but also on their willingness to provide domestic resources. And that’s not conditionality. But that the interest in securing strong government ownership and sustainability is really at the heart of this. What’s unique also with this financing facility, which is the reason why we are housed and hosted by the World Bank, is this link to financing. So what the trust fund, the GFF, the Global Financing Facility trust fund contributes with is really that link to the budget, national budgets, the financing reform, and trying to build that capacity to actually finance for priorities of this sector in ministry, in this case, the Ministry of Health.

But what’s also unique is, as you well know, if you focus on outcomes, then you open up for many sectors. So, for example, what we care about here is what happens around birth, what happens in the early years, and adolescence. So we are looking at outcomes across these critical moments in the life cycle. And some of these are determined by things happening in the health sector. But it’s also determined by things happening in education and the social sectors. So this is a multi-sector trust fund.

Smart means having really highly prioritised interventions and approaches where you can get the greatest impact. And when you look across reproductive, maternal, and newborn child health, much of what’s identified as smart is really looking at some of these key constraints to scale up. It could be commodities having the human resource capacity. It is, what outreach platform do you have? So it’s really around being smart about how you invest to get results. The sustained and scale comes from actually engaging with a minister of finance and looking at domestic resources and get complete ownership around this so that you can bring things to scale. We work a lot with the private sector too and bringing in and crowding in private capital.

So the reason for that is really to tap into the big resources that exist in the private sector. And, of course, for them, the interest is increasing efficiencies, ensuring not just smart but scaled.

I think one of the best examples is Senegal. In Senegal, the government asked the Bill and Melinda Gates Foundation and Mercks for Mothers to help with a problem they had, getting commodities out to people who really wanted it. They had great stock up in central medical stores for commodities like contraceptives. But where women actually needed them, they didn’t have that ability to bring these commodities the last mile. So that’s where the private sector come in. They usually know how to get commodities to the end users. So the private sector worked out a great model for getting commodities out. And then what the GFF does is taking that innovation and bringing that to scale, so it’s that scaling factor.

But what’s interesting about this, it’s government-led. It’s the government’s national programme of securing supplies but then using wisely a private sector partner and then the GFF for scale-up.

So, of course, when you have a programme or a national investment case which is so results-focused, then it’s very important to monitor results because we even disperse against results. And some of this is paying for performance. So there are two ways that’s interesting around how the GFF ensures that we actually monitor results. It is to have an independent monitoring and evaluation of the results that we claim to achieve, number one. And, secondly, that’s a role for civil society. That’s where we see civil society coming in and making sure to hold us all accountable for the results that we want to achieve through this mechanism. So that’s the exciting role that I feel that the civil society can play.