Global Fund contributions to health security in ten countries, 2014-20: mapping synergies between vertical disease programmes and capacities for preventing, detecting, and responding to public health emergencies.
Lancet Glob Health
; 9(2): e181-e188, 2021 02.
Article
in English
| MEDLINE | ID: covidwho-1036096
ABSTRACT
BACKGROUND:
The Global Fund to Fight AIDS, Tuberculosis and Malaria is a robust vertical global health programme. The extent to which vertical programmes financially support health security has not been investigated. We, therefore, endeavoured to quantify the extent to which the budgets of this vertical programme support health security. We believe this is a crucial area of work as the global community works to combine resources for COVID-19 response and future pandemic preparedness.METHODS:
We examined budgets for work in Kenya, Uganda, Vietnam, Democratic Republic of the Congo, Guatemala, Guinea, India, Indonesia, Nigeria, and Sierra Leone from January, 2014 to December, 2020. These ten countries were selected because of the robustness of investments and the availability of data. Using the International Health Regulations Joint External Evaluation (JEE) tool as a framework, we mapped budget line items to health security capacities. Two researchers independently reviewed each budget and mapped items to the JEE. Budgets were then jointly reviewed until a consensus was reached regarding if an item supported health security directly, indirectly, or not at all. The budgets for the study countries were inputted into a single Microsoft Excel spreadsheet and line items that mapped to JEE indicators were scaled up to their respective JEE capacity. Descriptive analyses were then done to determine the total amount of money budgeted for activities that support health security, how much was budgeted for each JEE capacity, and how much of the support was direct or indirect.FINDINGS:
The research team reviewed 37 budgets. Budgets totalled US$6â927â284â966, and $2â562â063â054 (37·0%) of this mapped to JEE capacities. $1â330â942â712 (19·2%) mapped directly to JEE capacities and $1â231â120â342 (17·8%) mapped indirectly to JEE capacities. Laboratory systems, antimicrobial resistance, and the deployment of medical countermeasures and personnel received the most overall budgetary support; laboratory systems, antimicrobial resistance, and workforce development received the greatest amount of direct budgetary support.INTERPRETATION:
Over one-third of the Global Fund's work also supports health security and the organisation has budgeted more than $2â500â000â000 for activities that support health security in ten countries since 2014. Although these funds were not budgeted specifically for health security purposes, recognising how vertical programmes can synergistically support other global health efforts has important implications for policy related to health systems strengthening.FUNDING:
Resolve to Save Lives An Initiative of Vital Strategies.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Global Health
/
Financing, Organized
/
International Cooperation
Type of study:
Experimental Studies
/
Observational study
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
Lancet Glob Health
Year:
2021
Document Type:
Article
Affiliation country:
S2214-109X(20)30420-4
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