The Global Financing Facility: Helping countries achieve Universal Health Coverage and the Sustainable Development Goals

Just a few weeks ago, the Global Financing Facility (GFF) hit a critical milestone in Oslo, raising more than US$1 billion to support country-driven investments in health and nutrition and save the lives of millions of women, children and adolescents. Now is the time to put these funds to work to help countries achieve Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs).

The GFF helps countries reach these ambitious goals and shifts the way we have been investing in the health and nutrition of women, children and adolescents.

Countries in the driver’s seat

One of the main reasons the innovation of the GFF model is different is that countries take the lead in prioritizing investments that will have the highest impact on women and children’s health. The role of the GFF is to bring all partners that support health programs in country together, under the leadership of the government, to develop a prioritized plan to finance interventions like family planning or nutrition. These plans also focus on making sure that the poorest populations are guaranteed access to quality primary health services.

Achieving more with existing resources

The GFF was developed by countries, for countries. Most of the financing for women’s, children’s and adolescent health already comes from a government budget or from people paying out of pocket, oftentimes under very dire circumstances. These out-of-pocket expenses are a financial burden that pushes people that are already poor into deeper poverty. 

What we do is we work with the governments—in cooperation with civil society, the private sector and bilateral donors—to empower people and ensure that the resources available are used more efficiently, with higher impact and a very strong focus on results.  This group constitutes the “country platform.” Local civil society organizations play a key role in accountability, provide technical expertise and implementation support, and represent the voice of the community to ensure that the priorities in the plan reflect the local context.   

There’s very strong country demand to build to capacity for sustainable systems that can be financed by their own resources. The GFF approach combines immediate investments with work on ensuring that countries can finance their systems themselves in the long-term. 

Crucial role of partnerships

Throughout the planning process, we establish a close working relationship with ministries of finance, and we ensure that anything that is being proposed for financing is integrated in the domestic budget. This is really the first step towards sustainability and the goal that over time governments will fund their core health priorities themselves. 

Another critical component is our work with other donors and bilateral and multilateral financiers, like Gavi and Global Fund, to align our resources and efforts behind this prioritized plan.  By aligning and working together in a complementary way, we also make it easier and more efficient for governments to work with financial partners, reduce duplication of efforts, and increase efficiency. The Global Action Plan makes it clear that there’s not one organization or partner that can achieve the global health agenda, UHC or the SDGs by themselves. There’s a real need to work in collaboration and bring partners together around this shared agenda. 

Focus on women, children and adolescents leaves no one behind

The progress on Millennium Development Goals showed that we haven’t done enough for women and girls to improve their health and well-being.  Women and girls were lagging behind more than any other group, largely due to a significant gap in financing for their health and nutrition. At the GFF, we strongly believe that closing this gap and investing in the health of women, children and adolescents is one of the first steps on the pathway to achieving UHC and the SDGs.

We also believe in building well-functioning health systems so that countries are able to take care of the health needs of women and children on their own.  When we invest in services for women and girls, we are also investing in strengthening a system that will also benefit the whole population over time. 

Often, we have to make very difficult decisions because resources are scarce.  So, we are focusing on populations that for one reasons or another have been left behind. They have  the poorest health and nutrition outcomes and live in areas that can be hard to reach or that are affected by conflict—like the northern part of Nigeria or parts of Cameroon.  Ensuring that no one is left behind requires that we make sure that the most vulnerable populations have access to services.

We have just 11 years left to achieve the SDGs , so it’s urgent that we shift the way we have been investing in health and nutrition to focus on priority areas and populations that have been neglected, seize the power of working in partnership, and make sure that our investments are used efficiently to reach women, children and adolescents, no matter where they live.

Monique Vledder

Monique Vledder is the program manager of the GFF. Previously, she managed the Health Results Innovation Trust Fund, the World Bank’s fund for the poorest—which to date has committed $436 million in grants linked to $2.4 billion in financing from IDA—for 36 results-focused programs in 30 countries. Her expertise in maternal and child health, health financing, and health systems strengthening was built over 20 years of in-country experience, with a focus on southern Africa, East Asia, and Latin America for the World Bank, the United Kingdom Department for International Development, and World Vision International. She received her MD from the University of Amsterdam, an MPH in international health from Harvard University, and a diploma in health economics from the University of York.