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Over the past two years, the Global Financing Facility (GFF) has created a new sustainable model with countries in the driver’s seat that brings together multiple sources of financing in a synergistic way to support national priorities. A key element of this model is drawing on the other sectors that influence health and nutrition outcomes, such as social protection, water and sanitation, and education.
Sixteen countries have benefited from the approach to date, ten further countries have just recently announced they will join the GFF, and many others are in discussions to partner with the GFF. These partnerships are made possible by generous initial contributions to the GFF Trust Fund from governments of Canada and Norway, the Bill & Melinda Gates Foundation, and MSD for Mothers. The first replenishment for the GFF Trust Fund in 2018 will respond to the demand from countries that want to be part of the GFF. It seeks to mobilize an additional US$2 billion to enable the GFF process to be expanded over the period 2018–23 to the 50 countries facing the most significant needs—the existing 26 countries plus 24 new countries.
The opportunity for impact is enormous: GFF-eligible countries collectively account for 96 percent of the US$33 billion annual financing gap and 5.2 million maternal and child deaths each year, with billions of dollars lost each year to poor health.
Each dollar invested in the GFF Trust Fund will catalyze four different additional sources of funding—domestic government resources, financing from IDA and the IBRD of the World Bank Group, aligned external bilateral and multilateral financing, and private sector resources—to generate two types of returns on investment:
Health returns: In terms of the lives saved and improved health, nutrition, and well-being of women, children, and adolescents, with a particular focus on six targets of SDG3 and SDG2, by 2030:
- Reducing maternal mortality ratio to less than 70 per 100,000 live births,
- Reducing under-five mortality rate to at least as low as 25 per 1,000 live births,
- Reducing neonatal mortality rate to at least as low as 12 per 1,000 live births,
- Ensuring universal access to sexual and reproductive health services,
- Achieving universal health coverage,
- Achieving internationally agreed targets for stunting and wasting.
Economic and social returns from the investment in human capital, which both leads to a more productive workforce and improved economic performance (contributing to realizing benefits of the demographic dividend) and to broader benefits for the SDGs, as a healthy population is a precondition to achieving progress in many other areas.
Modeling estimates that the “savings” from the GFF approach (the difference in the resource gaps between a scenario with the GFF and one without) would amount to US$83.5 billion over the period 2015–30. This approach would prevent 24 million–38 million deaths of women, children, and adolescents by 2030. The time to ensure we reach these goals is now.
- First and foremost, far too many women, children, and adolescents die needlessly each day, and the lack of financing is a key barrier. At the national level, the impact of women, children, and adolescents dying and not getting the care they need translates into significant human toll, economic losses and a reduced ability to benefit from the demographic dividend.
- Second, the window to influence progress toward the SDGs is now. The GFF model is based on frontloading grant resources and using them catalytically to assist countries to transition from a reliance on external assistance, but this cannot happen overnight. The work must begin in the next few years to influence countries’ trajectories. Modeling of how to close the US$33 billion financing gap shows that overall need for resources for the GFF Trust Fund increases from now until 2023, but then steadily declines thereafter as domestic public and private resources assume a progressively larger share of the financing (particularly in lower-middle-income countries).
- Third, IDA (the World Bank Group’s fund for least developed countries) just completed its largest replenishment ever, generating US$75 billion for national priorities over the next three years. The GFF Trust Fund is linked to IDA and can enable the use of this financing for reproductive, maternal, newborn, child, and adolescent health and nutrition.
- Finally, it is the right moment for the expansion because the GFF model is already proven to work in practice: today in countries across the world women, children, and adolescents are benefiting from the new financing model that the GFF has developed, which is making a meaningful contribution through a unique approach that complements and adds value to existing efforts. As a result, demand is high from countries that are interested in being part of the GFF.
The replenishment goal of US$2 billion is ambitious, but the potential for impact is great and the GFF is confident that we will seize the opportunity to change the course of financing for the SDGs and improve the lives of millions of women, children, and adolescents across the world.