Release Type: News Article

Key takeaways

• The Global Fund will facilitate a series of consultations to help shape the next multi-year Global Fund strategy.

• Key areas of focus include how the Global Fund can strengthen its impact and contribution to the 2030 Sustainable Development Goal targets for HIV, Tuberculosis (TB), Malaria, build strong community and health systems, increase focus on equity, human rights, gender and the most vulnerable, and respond to the COVID-19 pandemic which threatens to reverse the health gains of the last two decades.

GENEVA – More than 300 representatives from across the world convened virtually today to kick off the Partnership Forums, a series of consultations to help shape the next multi-year Global Fund strategy. The Partnership Forums are unique in the global health sector, providing a broad and inclusive platform for representatives from all Global Fund implementers, partners and people affected by diseases to discuss the organization’s future strategic direction.

Key areas of focus include how the Global Fund can strengthen its impact and contribution to the ambitious 2030 Sustainable Development Goal targets for HIV, Tuberculosis (TB), Malaria, build strong community and health systems, increase focus on equity, human rights, gender and the most vulnerable, and respond to the COVID-19 pandemic which threatens to reverse the health gains of the last two decades.

Participants in the Partnership Forums are drawn from a wide range of stakeholders that make up the Global Fund partnership, from government to civil society representatives to members of the affected communities to technical partners. As representatives of the Global Fund partnership, this diverse group of participants will help shape the direction of Global Fund investments in the years ahead.

Due to the pandemic, the Partnership Forums will convene virtually. They started today with a joint global opening session, which will be followed by three regional meetings: Eastern Europe and Latin America, 9-11 February; Africa and parts of the Middle East, 17-19 February; and Asia, the Pacific and parts of the Middle East, 3-5 March. The closing session will take place on 15 March, bringing together participants from across the world to wrap up the discussions.

Twenty years after its creation in 2002, the Global Fund partnership has achieved remarkable progress. At the end of 2019, the partnership had saved 38 million lives, including six million in 2019 alone. However, with less than 10 years until the Sustainable Development Goals deadline, the world is off-track to reach the global targets for HIV, TB and Malaria and the COVID-19 pandemic is threatening to further derail progress. Participants in the Partnership Forums will engage in discussions on ways for the Global Fund to catalyze greater progress against HIV, TB and Malaria in partnership with governments, communities, civil society, technical partners and other stakeholders and put the world back on track to end these diseases.

“We face the sobering prospect that if we don’t mount an effective response to the pandemic, we could find ourselves losing maybe a decade’s worth of gains in terms of reduced deaths and infections,” said Peter Sands, Executive Director of the Global Fund. “The stakes are extremely high, so we must work together to devise a strategy to safeguard and accelerate the gains we have made against the diseases while building resilient health systems that can respond effectively to both the current and future pandemics. The Forums are an opportunity to listen and to learn from all corners of our partnership.”

“Welcoming diversity of opinion is an essential element of strengthening the Global Fund and growing our impact, it is why we value the Partnership Forums,” said Dr Donald Kaberuka, Chair of the Global Fund Board. “We want to hear what we should keep doing, what we can improve on and what we should let go. We want to hear all opinions on choices and trade-offs. Every voice matters. Developing our next strategy is not just about the Global Fund, but about all of us – our countries, our communities, and the people we serve.”

Views shared in the Partnership Forums will add to perspectives received through the strategy development process to date, including the input gathered through the Global Fund’s 2020 Open Consultation on strategy development, which engaged more than 300 individuals and groups from different regions and backgrounds. The views collated from participants will be channelled into the strategy development process, which will culminate into a new multi-year strategy document that will be finalized in November 2021.

The current “Global Fund Strategy 2017-2022: Investing to End Epidemics” was developed through a similar participatory process. With the new strategy, the Global Fund will be looking to the future, asking how the partnership can reinforce its unique country-driven and inclusive model, grow its impact against infectious diseases, and strengthen health systems and building global health security for all people.

(Georgetown, Guyana)  Global vaccine mechanism, COVAX plans to deliver 104,000 doses of the novel coronavirus vaccine to Guyana soon.

This was announced today by Health Minister Dr Frank Anthony during the COVID-19 update.

“We have received correspondence from COVAX indicating that they have been able to do an indicative allocation of vaccines to Guyana…and that is going to be close to 104,000 doses of vaccines that we will be getting shortly,” the Health Minister revealed.

The vaccines will come from manufacturer, AstraZeneca.

Presently, the said vaccine is before the World Health Organisation (WHO) for emergency use listing.

“Once the WHO greenlights the vaccine, then we will be able to get those vaccines in Guyana,” the Health Minister said.

The European Union, along with several countries including India and the United Kingdom, have already approved the AstraZeneca vaccine for emergency use authorisation.

With Guyana expected to get some 104,000 doses, Health Minister indicated that Guyana is prepared to start the rollout when the doses arrive.

“We’re very happy that they’ve indicated to us that we will be getting 104,000 doses as an initial start…and we would be working closely with them to see when these vaccines would actually arrive in Guyana, and as soon as we get them, we will start rolling out,” he said.

The Health Minister said Guyana is prepared to start delivering the vaccine to the population.

(Port-of-Spain, Republic of Trinidad and Tobago, 28 January 2021) Since the COVID-19 disease was declared a pandemic in March 2020, at least six (6) variants have emerged. However, three new variants of concern are spreading rapidly. The United Kingdom variant known as B.1.1.7; a variant called 1.351 which emerged in South Africa; and the variants P.1 and P.2 which surfaced in Brazil.

The “UK variant” (B.1.1.7 variant), which emerged in September 2020, has been identified in 60 countries globally and recently, in some Caribbean countries. Initial data suggest that the UK variant is more transmissible, and studies and analysis of the transmission and severity of the variant are underway.

“This increased ease of transmission of the UK variant is of grave concern for its impact on public health, and the fight to contain and end the COVID-19 pandemic. This is further heightened by the fact that, at present, the vaccines developed have not yet been proven to stop disease transmission but rather to lessen the severity of infection. There is no reported evidence of a reduction in the effectiveness of vaccines approved for the
COVID-19 virus in providing protection from any variants. However, it is important to note that vaccinated persons may still spread COVID-19,” said Dr Joy St. John, Executive Director of the Caribbean Public Health Agency (CARPHA).

With the discovery and proliferation of multiple COVID-19 variants, it is crucial to properly and consistently employ and increase the public’s adherence to COVID-19 control measures, which have been shown to reduce the spread of the disease.

Dr St. John further stated “CARPHA is committed to supporting its Member States to stopping the spread of the virus. We urge Member States to enhance surveillance in residential institutions and face to face educational settings. There must also be strict adherence to the requirements of negative COVID-19 results for entry to the ports in the Member States, to effectively continue combating COVID-19 spread in the Caribbean. Mandatory quarantine has become even more important to curb the spread of the virus.”

Community surveillance should also be enhanced thereby strengthening public health control measures. Individuals must continue practicing the measures of wearing face masks and covering, physical distancing, and hand sanitation in all face-to-face settings.

It is critical to remember that as most cases will have no or mild symptoms, COVID-19 cases may quietly increase in the community and result in sudden increases in hospitalisations and deaths. The first line of defence continues to be isolation of infected persons and quarantine of travellers and any person with known or possible exposure to infected persons.   These measures must be practised by all individuals as asymptomatic persons are known to be able to spread the virus. Adequate testing is critical to surveillance measures for residential institutions, face-to-face schooling, celebratory and religious gatherings, and other potential spreader and super-spreader events and activities.

The CARPHA Medical Microbiology Laboratory (CMML) remains committed to delivering prompt COVID-19 test results to the Region and is working with its Member States in their submission of positive SARS-CoV-2 to be sequenced. The CMML has been guiding laboratory action through testing protocols based on the latest recommendations by the World Health Organization (WHO) and the Pan American Health Organization (PAHO). With the emergence of the UK variant in the Region, it is of critical importance for CARPHA Member States to conduct genomic sequencing to identify this variant.

Currently, COVID-19 samples are received by the CMML from Member States. The CMML performs acceptance testing before they are sent to the University of the West Indies (UWI), St Augustine, Trinidad and Tobago, for genomic sequencing to be performed. Following the sequencing process, the UWI sends the results to CARPHA for final review and reporting. Sequencing is a lengthy process that includes experimental and sequence analysis procedures, and the estimated turnaround time to obtain any relevant conclusions can take up to 2 weeks from the receipt of samples at CARPHA.

Results received from the UWI are sent by CARPHA directly to the Chief Medical Officers at the Ministries of Health, who are responsible for dissemination through nationally established channels of communication.

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Key takeaways: 

• The Global Fund needs additional funding to continue supporting the coronavirus disease 2019 (COVID-19) response and mitigate the impact of the pandemic on HIV, tuberculosis, and malaria programs in the countries where it invests.

• After deploying all available COVID-19 funds, nearly $1 billion in total, most of it to sub-Saharan African countries, it has run out of funding. Without this support, implementer countries risk facing significant disruptions to their three disease programs while COVID-19 cases continue to rise.

The Global Fund has disbursed close to $1 billion to support the COVID-19 response and mitigate the impact of the pandemic on HIV, Tuberculosis (TB), and Malaria programs. The institution recently announced that it had fully deployed all the funds to 106 countries and more than ten multi-country programs. However, it still has to honor country requests amounting to over $355 million, which is likely to increase as more countries submit their requests.

The Global Fund is yet to raise an additional $5 billion to continue supporting these countries. Without the additional resources required to safeguard the three disease programs amid rising COVID-19 cases, countries are likely to face more disruptions to health service delivery and lose the gains made in the response to the three diseases.

Of the $1 billion, $500 million was raised through portfolio optimization and made available through the COVID-19 Response Mechanism (C19RM), $221 million was made available through grant flexibilities, and an additional $259 million was received from donors (Canada, Denmark, Germany, Italy, Sweden, Norway, and the FIFA Foundation) and channelled through the C19RM.

This funding has supported these countries to mitigate damage to HIV, TB, and Malaria programs due to COVID-19, recruit healthcare workers, equip them with personal protective equipment (PPE) and strengthen fragile health systems.

Information for this article comes from the Global Fund Data Service Page, the World Health Organization (WHO) COVID-19 Explorer, and the Global Fund Secretariat.

Global Fund fully deploys its COVID-19 funding

The Global Fund has disbursed $979 million, of which $757 million is through the C19RM and $221 through grant flexibilities (Table 1), respectively. Of the 119 countries and multi-country programs that benefited, 48 countries in sub-Saharan Africa received 74 percent ($725 million) of COVID-19 funding. They received 79 percent of the C19RM funds and 56 percent of the total amount of funding awarded through grant flexibilities. Sub-Saharan African countries that received a significant portion of funding include Nigeria ($73 million), South Africa ($65 million), Mozambique ($63 million), and Uganda ($62 million). Eastern Europe and Central Asia (EECA), Latin America and the Caribbean (LAC), and North Africa and the Middle East (MENA) each received the smallest proportion (3 percent) of the funding.

Countries only accessed $221 million of the $500 million allowable through grant flexibilities. A previous Aidspan analysis showed a slower uptake of grant flexibilities than C19RM funds (as discussed in a previous edition, the Global Fund’s COVID-19 emergency funding is running out). It attributed the slower uptake to challenges in the application process, or to countries having already used up most of their savings.

The Global Fund had allowed countries to use grant savings to the value of 5 percent and reprogram up to 5 percent of the grant’s current value. However, most countries obtained these funds through grant savings rather than reprogramming, in a bid to ‘protect their programs.’ The Aidspan analysis indicated that more than half of the countries received between 2 and 4 percent of their total grant value.

The countries used a third of the funding awarded through the C19RM to mitigate the pandemic’s impact on the three diseases (Table 1). These efforts aimed to address COVID-19 related disruptions to delivering health services and avert the millions of deaths predicted due to the pandemic. More than half (55 percent) of the funds were used to support the COVID-19 response, particularly in the procurement of COVID-19 diagnostic tests, while the remaining 11 percent was used to support health and community systems.

Similarly, countries have used 59 percent of the grant flexibilities to reinforce the COVID-19 response, 32 percent in mitigating its impact on the three diseases, and the remaining 9 percent on health and community systems.

The funds have also supported door-to-door services such as TB testing, contact tracing, and mosquito net distribution in Vanuatu, and antiretroviral therapy and health services to mothers with HIV and pregnant women in Uganda. A local HIV community network in Ukraine has used part of the funds to deliver antiretroviral therapy and other medicines to people living with HIV via the postal service.

Countries have also leveraged laboratory infrastructure, notably Cepheid’s GeneXpert molecular diagnostic devices and the technicians trained to operate them, initially designed for HIV and TB services. However, this has raised concerns in various quarters on the effect this has had on HIV and TB services.

COVID-19 resource needs for implementer countries continue to rise

The pandemic among some Global Fund implementer countries, particularly in the African region, has been growing in recent months. Of the 106 countries that benefited from the Global Fund’s emergency funding, more than half (61 countries) experienced a rise in the number of cases from the preceding week, as reported by the WHO on 12 January 2021. Sierra Leone reported the largest increase: 2 109 percent, although the caseload remains low (2 834 cases as of 12 January 2021). The number of cases in other countries grew by between 1 percent in Panama and 494 percent in Côte d’Ivoire, with Sierra Leone reporting an exceptional increase.

The majority of the remaining countries reported a decline, while only a few reported no change.

However, there are still fears that the actual caseload may be higher than the current statistics reported due to low testing availability. BBC estimates that in Africa, which has the lowest testing rate compared to other regions, only 10 countries account for 70 percent of the total tests: South Africa, Morocco, Ethiopia, Egypt, Kenya, Nigeria, Cameroon, Rwanda, Uganda, and Ghana.

The absence of additional funding leaves the programs vulnerable

This rise in the number of cases and lack of adequate resources to mitigate the pandemic’s effect is likely to further disrupt the delivery of health services in these countries. Indeed, implementer countries are still experiencing significant disruptions to health services, with TB services being the most affected. Furthermore, the rise in cases increases the need for restrictions, including nationwide lockdowns, which are significant barriers to access health services. According to the COVID-19 Situation Report published on 23 December 2020, 36 percent of countries where the Global Fund invests still had nationwide lockdowns on 15 December 2020. Other countries (25 percent) had local restrictions that affected the implementation of Global Fund grants.

The Global Fund intensifies resource mobilization efforts

The need for additional funding for the Global Fund to continue supporting its implementer countries cannot be emphasized enough. In an email to the Global Fund Observer, the Secretariat noted that it is intensifying resource mobilization efforts to raise the additional $5 billion it needs to continue supporting its implementer countries. In the meantime, it has asked countries to continue submitting funding requests to the C19RM, so their requests are ready once additional funds become available. Countries can still use grant flexibilities to support their COVID-19 response. However, the Secretariat further explained that most countries appear to have already exhausted this mechanism.

Countries with new grants starting in January 2021 have some respite. The Global Fund has allowed countries to use standard allocations to procure PPE for health workers working within the three disease programs, which they can procure through the online platform wambo.org. Overall, the countries should adopt more efficient and innovative ways of using the funds available. This includes the adoption of digital modalities that have become common since the emergence of the pandemic.

Global COVID-19 response remains underfunded

The global COVID-19 response has been grossly underfunded as traditional global health donors prioritize their domestic responses. The $5 billion the Global Fund intends to raise is part of the overall financing needed by the Access to COVID-19 Tools Accelerator (ACT-Accelerator), of which the Global Fund is a co-founder. Overall, the ACT-Accelerator, launched in April 2020, has only attracted 15 percent ($5.8 billion) of the $38 billion needed to accelerate development, production, and equitable access to COVID-19 tests, treatments, and vaccines.

The Global Fund welcomes the United States’ recent commitment to support the international COVID-19 response and mitigate the impact of the virus on the world. Advocates are calling for the United States government to allocate $4 billion to the Global Fund’s COVID-19 response in the next COVID-19 emergency supplemental bill. Similar calls in the past have been unsuccessful. However, the United States’ $4 billion allocation to Gavi, the Vaccine Alliance, in the December supplemental bill, for the procurement and delivery of the COVID-19 vaccine, provides a glimmer of hope.

Even though the Global Fund is not directly involved in the rollout of the COVID-19 vaccine, the Secretariat explained to the Global Fund Observer that additional funds would help to support the rollout of the COVID-19 vaccine by providing PPE to health workers, mobilizing community leadership, and strengthening the health facilities, supply chains and data systems that will be critical for the vaccine distribution.

Further reading:

• GFO 385, The Global Fund’s COVID-19 emergency funding is running out, 25 August 2020
• The Global Fund COVID-19 Situation Report, 23 December 2020
• The Global Fund COVID-19 Situation Report, 13 January 2021.

(Georgetown, Guyana) Health Minister, Dr Frank Anthony yesterday stated that Guyana’s main focus for procuring COVID-19 vaccines is through the COVAX facility.

COVAX is one of three pillars of the Access to COVID-19 Tools (ACT) Accelerator, which was launched in April by the World Health Organization (WHO), the European Commission and France in response to the pandemic. It strives to ensure that people in all corners of the world get access to COVID-19 vaccines once they are available, regardless of their wealth.

Eight persons, including Prime Minister Mia Amor Mottley, have received their first round of the COVID-19 vaccine.

Prime Minister Mottley disclosed this last evening during a COVID-19 update to the nation from Ilaro Court, where she spoke about the level of public education that would occur to educate the population on the importance of getting the vaccine.

Stressing that she would not encourage anyone to do something she would not, the Prime Minister said: “I’m happy to report that therefore, in the course of the last few days that there were five of our medical people at the front line who have taken the vaccination – the first dose, and myself, the Minister of Health and the Attorney General also, were the other three people who took it. My arm is a little sore, but other than that I am in good shape; you see me talking with you and I’m due to take the second dose in a few weeks time as are they.”

While noting that there is concern not just in Barbados but throughout the world about receiving the vaccine, Prime Minister Mottley stated that in order to ensure that the country gets back to a level of normalcy a level of herd immunity would need to occur.

“There will be some people who are a little ambivalent or anxious, and over the course of the next few weeks, we will engage to be able to answer people’s questions, not just in these formal processes, but also through public education that we will do in different media and at the community levels in order to give people the comfort that they need,” the Prime Minister explained as the way forward, in carrying out public awareness on the importance of receiving the COVID-19 vaccine.

Watch the video below.

The Society Against Sexual Orientation Discrimination (SASOD) has lauded the Government’s decision to implement self-testing for HIV. At the launch of the National HIV Strategic Plan, on 5 January 2021, Minister of Health, Dr Frank Anthony, announced that the government is looking to implement HIV self-testing in Guyana.

During an interview with the Guyana Chronicle on Wednesday, Managing Director of SASOD Guyana, Joel Simpson, commended the initiative and noted that SASOD is ready and willing to support the initiative by providing counselling services to persons impacted.

“It’s a laudable initiative because HIV self-testing is showing results in other parts of the world.  It encourages persons that would not normally utilise HIV health services, to test in the privacy of their homes and know their HIV status,” Simpson explained.

Simpson highlighted that self-testing would increase HIV testing coverage since it can be made available to persons far and wide.  “This will inevitably help curtail the spread of HIV”, stated the SASOD Director.

“It’s a very innovative and effective prevention strategy; it could be targeted to those groups that are not reaching out to health services to get an HIV test,” he said. He explained that persons generally have concerns about stigma and discrimination and are usually unsure about the confidentiality of information they share during the HIV testing process.

Further, he highlighted that studies have revealed that Caribbean men are less likely to utilise health services until they are severely affected.

“HIV self-testing provides an opportunity to improve confidentiality and reach persons that are not coming forward. If targeted to the right groups, it can increase HIV testing coverage in Guyana,” Simpson explained.

MISUNDERSTANDING

Responding to the criticism of the initiative by some persons that Guyana is not equipped and ready for such an endeavour, primarily because persons would not be able to access counselling services when self-testing, Simpson opined that this is a misunderstanding.

He explained that the World Health Organization (WHO) guiding principles on HIV testing and counselling stipulates that testing and counselling should be voluntary and must adhere to the five Cs. The five Cs are consent, confidentiality, counselling, correct test results and connections to care, treatment and prevention services. The SASOD Director noted that the organisation is ready and willing to provide counselling services and render psycho-social support to persons of all genders and sexual orientation when the initiative commences.

“SASOD would be interested in providing counselling services.  We want to ensure that persons have counselling to prepare for the results after taking an HIV test.  It’s important that persons have psycho-social support if they test positive,” Simpson related. He is also hopeful that in rolling out the initiative, the government will implement different methodologies in relation to counselling to ensure the initiative’s success, such as a hotline number.

Simpson noted that organisations such as SASOD would play a significant role in creating awareness about the initiative through relationships established with persons who utilise their services. He urged the ministry to connect with these groups that already provide social support and counselling to develop partnerships.

“I would encourage the ministry and national programme to conduct extensive consultations with civil society groups that work in the HIV response to establish these groups as partners in the HIV self-testing initiative,” Simpson said.