On 15 June 2021 the Global Fund Strategy Committee (SC) met virtually at an Extraordinary Meeting to discuss their recommendations to the Extraordinary Board meeting to be held on 22 July 2021. Its aim was to review and recommend to the Board the Strategy Framework presented in Annex 1 of GF/ExtraordinarySC01/02. Based on the clear Board direction at its 45th Meeting, the Strategy Framework has been updated and the explanatory paper explains in more detail the intent behind the revised draft Strategy Framework. The explanatory paper provides critical background and context for the discussion of the Strategy Framework and was the basis for informing the Strategy Committee recommendation that will be presented to the Board meeting in July. The key aspects of the paper are described below. Background During the past 18 months of discussions on Strategy development, three fundamental precepts have become clear. First, the Global Fund was created with the mission of ending HIV/AIDS, tuberculosis (TB) and malaria among the most impacted communities worldwide and it must remain committed to completing that mission as its primary goal. Second, the Global Fund partnership should be working to protect and promote the health and wellbeing of people and communities. To that end, the people and communities living with and most affected by the three diseases and emerging health threats must be at the center of all the Global Fund’s efforts. Third, to achieve its mission to end the three diseases requires disease and health investments that maximize people-centered, integrated national and community systems for health, community engagement and leadership, and improvements in health equity, gender equality and human rights. These three mutually reinforcing, contributory principles are the main tenets of the next Global Fund Strategy, supported by essential work to mobilize increased international and domestic resources for health. The work to prepare for Strategy implementation before the next cycle of grants as well as Key Performance Indicators (KPIs) and monitoring and evaluation (M&E) frameworks will build from this greater clarity of purpose. The COVID-19 pandemic has been the single largest set-back in the fight against HIV, TB and malaria since the creation of the Global Fund. The pandemic’s actual death toll is likely to far exceed the 4 million official deaths and the health, social and economic impacts have been the severest among the poorest and most vulnerable people and communities. This pandemic is far from over and the impact is catalyzing a far-reaching G7/G20/UN debate about the shape, architecture and priorities of global health. These will affect all global health organizations, in particular the Global Fund as the largest multilateral provider of grants in global health and the only agency specifically created to fight pandemics. Given the extraordinary and continuing impact of COVID-19, the Secretariat, Strategy Committee and Board have had extensive discussions on the Global Fund’s potential future role in supporting pandemic preparedness and response (PPR). Underpinning these deliberations has been the imperative of protecting gains and the Global Fund’s mission against HIV, TB and malaria, ensuring that the three diseases – three of the largest global pandemics - are not forgotten in a shifting global health agenda. This means applying the lessons the Global Fund has learned from responding to COVID-19 to strengthen the resilience of HIV, TB and malaria programs and build system resilience and sustainability for the future. The revised Strategy Framework As a result of the Partnership Forum (Voices of the people I: EECA and LAC partnership forums: Voices of the people II: Sub-Saharan Africa and MENA 1 partnership forums; and Voices of the people III: Asia Pacific & MENA II) held earlier this year, and the considerable inputs received from the various stakeholders, a revised version of the framework is now available and is depicted in Figures 1 to 5 below.

Figure 2. Strategy goal and objectives

Figure 3. Mutually reinforcing contributory objectives and sub-objectives

Figure 4. Evolving objective for contributing to Pandemic Preparedness and Response

Figure 5. Equipping the Global Fund Partnership to deliver the new Strategy: Strategic Shifts and Partnership Enablers

You can read more of our articles on the Partnership Forum deliberations here: Voices of the people IV: Africa calls for investments in health systems at the sixth global fund partnership forums and Voices of the people V: civil society and community reflections on the global fund partnership forums to inform global fund strategy development. There now appears to be an acceptable degree of alignment among constituencies on the question of how the Global Fund should engage on PPR and its specific placing of PPR within the Strategy Framework. In brief, there is broad agreement that the Global Fund should be more intentional in building PPR capabilities through its existing mission to end AIDS, TB and malaria and through related efforts to strengthen resilient and sustainable systems for health (RSSH).  In turn, this requires integrated, people-centered approaches, support for the engagement and leadership of communities living with and affected by the three diseases, and maximizing health equity, gender equality and human rights. Given the ongoing coronavirus pandemic, the Global Fund should remain adaptable in its Strategy on engaging in both the continuing COVID-19 response and in discussions about better preparing for future pandemics. The Board has provided clear parameters for this flexibility to ensure any efforts to support PPR are: (i) synergistic with and do not dilute efforts towards the Global Fund’s core mandate on HIV, TB and malaria; (ii) built upon the Global Fund’s country and community-led model and equity, gender equality and human rights principles; and (iii) conducted in full partnership and coordination with the World Health Organization (WHO) and other global health actors. To further inform the Strategy Committee and wider constituency reflections on the updated draft Strategy Framework, the paper provides more on the aims and intent behind the text and boxes of the corresponding draft Strategy Framework.