1. health and fitness

Funding the Future of RMNCAH: The Global Financing Facility (GFF) A Mid-­‐Process Civil Society Briefing
THURSDAY, MARCH 19, 2015
10:00 AM EST
10:00 – 10:05 AM EST Welcome & Webinar LogisPcs Liz Kohlway, GHC
A
10:05 – 10:10 AM EST
Welcome (IntroducPon of Speakers & Broad Overview of GFF Development Process Timeline)
ChrisAne Sow, GHC
G
E
N
D
A
10:10 – 10:40 AM EST The GFF Process:
-­‐Context & Process
-­‐Thoughts on Civil Society ParPcipaPon Thus Far -­‐Accountability
-­‐Upcoming OpportuniPes & Next Steps
Robert Clay, Save the Children; John Townsend, PopulaAon Council; Joanne Carter, RESULTS
10:40 – 10:50 AM EST
Every Woman Every Child Strategy 2.0 & GFF (Thoughts on IntersecPons, PosiPoning, Accountability & Civil Society OpportuniPes)
Betsy McCallon, White Ribbon Alliance 10:50 – 11:20 AM EST QuesPons & Discussion Moderated by ChrisAne Sow 11:20 – 11:30 AM EST Conclusions & Closing (Lightening Round with Speakers)
Moderated by ChrisAne Sow
Welcome IntroducPon of Speakers & Broad Overview of GFF Development Process Timeline CHRISTINE SOW, GLOBAL HEALTH COUNCIL
The GFF Process: Context & Process Thoughts on Civil Society ParPcipaPon Thus Far Accountability Upcoming OpportuniPes & Next Steps
ROBERT CLAY, SAVE THE CHILDREN
JOHN TOWNSEND, POPULATION COUNCIL
JOANNE CARTER, RESULTS GLOBAL FINANCING FACILITY IN SUPPORT OF EVERY WOMEN EVERY CHILD Robert Clay 18 March 2015 7
Impossible to reach the SDGs without significant growth in
domestic investments
All Countdown Countries
8
Funding Commitments to Date
CANADA
$200 million contribution is part of Canada’s $3.5 billion
commitment (2015-2020) to maternal and child health,
announced in May 2014
NORWAY
$600 million
UNITED STATES
Up to $400 million in leveraged resources through financing
mechanisms and public-private partnerships
IDA International Development Association
Low-interest loans and grants, leveraging up to $3.2 billion
9
The financing model is driven by overall GFF approach
•  Focus on high impact, costeffective interventions and
results
Smart Scaled Sustainable •  Financing RMNCAH
at scale through
significantly
increased domestic
and international
financing
•  Support transition to longterm sustainable domestic
financing for RMNCAH
10
Workstream 1: Scope of Financing for RMNCAH Results
Financing for RMNCAH Results (3-5 year horizon)
Reductions in MMR, U5MR, IMR and improvements in the health and quality of life of
women, children, and adolescents
Health (RMNCAH)
Criteria
•  Need to demonstrates impact and/or
contributes to building evidence base
Broad areas
•  Reproductive health
•  Maternal health
•  Newborn health
•  Child health
•  Adolescent health
•  CRVS
•  Nutrition
•  Water & Sanitation
• 
Health System
Strengthening
Criteria
•  Targets system bottlenecks
related to RMNCAH
•  Leverages other funding for
HSS (GF, GAVI, etc.)
Broad Areas
•  Human resources
•  Infrastructure
•  Health info. systems
•  Supply-chain &
Commodities
•  Supervision and M&E
Multisectoral
Criteria
Mutual leverage of
funding (co-financing)
Broad areas
•  Nutrition
•  Water and
sanitation
•  Education
•  Social protection
•  Transport
•  Governance
•  Justice
•  …
Equity, gender, and rights
Needs to be explicitly addressed in interventions and delivery modes
•  Needs to be measured
11
Packages for integrated care for women, children and adolescents
12
Financing strategies: accelerated and sustained progress towards universal
coverage of RMNCAH interventions
Money Benefits package Public finance and payment systems RegulaFng out-­‐of-­‐pocket expenditures Costs Accelerated progress towards universal coverage of RMNCAH intervenFons Financial sustainability for RMNCAH and health sector DomesFc resources Private sector investment and service delivery Taxes earmarked for health General taxaFon and natural resources profits Time 13
Timeline
Feb BPT face-­‐to-­‐face mee;ngs Mar May Jun Jul Aug 4-6
Oversight Group meetings
Development of Business Plan draBs Apr 18
Draft 1
Draft
2
15
Draft 3
Discussion on Global Public Goods Business
Plan final
Discussions on governance Final Business Plan GFF Launch prepara;ons Front-­‐runner countries •  Diagnos;cs phase •  DraB 3-­‐5yr Investment Cases •  Resource alignment decisions GFF
Launch in
Addis
•  Development of 2030 Financing Strategies Other related events Global Strategy consulta;ons WB Spring WHA Mee;ngs Financing 4 Development 14
The GFF Process: Context & Process Thoughts on Civil Society ParPcipaPon Thus Far Accountability Upcoming OpportuniPes & Next Steps
ROBERT CLAY, SAVE THE CHILDREN
JOHN TOWNSEND, POPULATION COUNCIL
JOANNE CARTER, RESULTS GLOBAL FINANCING FACILITY IN SUPPORT OF EVERY WOMEN EVERY CHILD Oversight Group mee;ng 18 March 2015 16 Country ConsultaFons: Progress in Frontrunner countries Kenya • 
• 
• 
• 
Country consulta;on took place from Jan 21-­‐23 with broad par;cipa;on Country led task force is leading on the development of RMNCAH Investment Case Support to finalize health financing strategy (by June) Significant new investments from government and mul;ple partners (US$11 per capita) Tanzania •  Recently developed One Plan II and Big Results Now is the basis of the RMNCAH Investment Case •  Health Financing strategy already near finalized •  Country consulta;ons scheduled for the end of March Ethiopia •  Country consulta;on took place from Mar 3-­‐6 •  RMNCAH Investment case will finance part of the Health Sector Transforma;onal Plan; review process has started •  Support to help finalize health financing strategy DRC •  Ini;al in-­‐country discussion have taken place; broad consulta;on planned for 1st April •  Will build and expand on already strong joint approach towards MDG 4 & 5 •  Significant support needed for development of health financing strategy 17 Themes from the consultaFons: principles Global GFF governance should … •  Remain lean and rigorously focused on GFF’s core mandate of ensuring aligned co-­‐
financing of country level investment cases by all key GFF partners and oversight of the TF at the World Bank •  Only include in global level governance what cannot be effecFvely achieved at country level •  Reflect GFF’s role in RMNCAH but also as a pathfinder for DRM in the broader health sector (and even cross-­‐sectoral perspec;ve) •  Ensure membership in governance is based on acFve contribuFon (“co-­‐investment” principle) and promotes meaningful parFcipaFon of criFcal stakeholders •  Remain flexible and able to adapt based on learnings and the SDG evolving architecture 18 GFF Governance: Themes from the consultaFons – funcFons and structures •  Global GFF governance should cover two linked but disFnct elements: 1.  Strategic steering of GFF as a financing facility 2.  Oversight of the GFF Trust Fund -­‐> Emerging majority view that governance arrangements needs to ensure a structural connecFon between these funcFons •  Emphasis that governance arrangements need to ensure effecFve leveraging of IDA •  MulF-­‐stakeholder nature par;cularly important for GFF as financing partnership •  PMNCH’s global advocacy, knowledge and accountability role seen as highly complementary with the GFF; GFF should not take on advocacy/ tracking of global resources for RMNCAH 19 GFF governance at the global level should be designed to support two key funcFons FuncFon 1: Ensure GFF as a financing partnership succeeds in mobilizing and co-­‐financing high-­‐quality RMNCAH investment cases in GFF countries by • 
Driving partner agreement on effec;ve strategies/policies to support aligned financing and efficient resource alloca;on in/across GFF countries • 
Monitoring performance of the GFF as a partnership, and ensuring accountability for aligned financing and for achievement of RMNCAH results in focus countries • 
Mobilizing domes;c and interna;onal (including private) resources for financing of RMNCAH investment cases at country level • 
Driving learning and innova;on around effec;ve/efficient financing approaches • 
Building high-­‐level support for the GFF FuncFon 2: Ensure the GFF Trust Fund provides financing for RMNCAH investment cases that is aligned and drives innovaFon, sustainability and results • 
Set strategic funding approach and priori;es for financing from GFF TF, including innova;ve use of TF resources to maximize mobiliza;on of IDA and domes;c resources • 
Approve GFF funding alloca;on • 
Agree annual work plan and budget of the TF Secretariat • 
Oversee TF and Secretariat performance to ensure investments deliver results 20 Other global funcFons that were highlighted as beyond the scope of GFF governance but criFcal for the GFF’s success •  Global advocacy, stakeholder engagement and resource mobiliza;on around the new Global Strategy for RMNCAH (including but not limited to the GFF) •  Tracking and accountability rela;ng to global resource commitments and resource flows to RMNCAH and EWEC (including, but not limited to resources through the GFF financing partnership) •  Monitoring of global progress on RMNCAH •  Convening and consensus building on evidence based approaches and interven;ons for achieving RMNCAH targets 21 An emerging majority view: Integrated governance of GFF as a financing facility and of the GFF TF Quality assured, na;onally-­‐
owned, mul;-­‐stakeholder process following IHP+ principles aligned co-­‐investments Investment Case +IDA GFF Trust Fund Trust Fund Commilee GFF Investors Group PMNCH UNSG High Level Champions Group GFF Secre-­‐ tariat World Bank Board Structurally linked governance of GFF financing facility and of GFF TF •  GFF Investors Group leads governance of mul;-­‐stakeholder financing partnership to ensure effec;ve co-­‐
financing of RMNCAH investment cases in GFF countries (Func;on 1) •  GFF TF Commicee: subset of the Council (TF donors) with devolved decision-­‐making on GFF TF alloca;ons (Func;on 2) •  GFF Secretariat manages TF and provides support to Council and TF commilee •  WB Board: final commitment of TF and IDA resources; fiduciary oversight •  PMNCH leads global advocacy and accountability on Global Strategy/
EWEC; conducts broader stakeholder engagement around GFF •  UNSG Champions Group would include GFF as a key financing plamorm for Global Strategy 22 ComposiFon and working mode of Investors Group and TF Commicee •  Challenge: “keep it lean”, but ensure mul;-­‐stakeholder representa;on •  Aim: no more than 20 members •  Members include TF donors and GFF “co-­‐investors” with explicit commitment to provide significant finance or in-­‐kind support to investment cases •  Members should bring experience relevant to GFF’s financing mandate GFF Investors Group (IG) Highly focused … •  3-­‐4 members from par;cipa;ng countries (incl MoF) •  3-­‐4 members from contribu;ng bilateral donors •  1 member from H4+ •  1 member WB/TF •  1 member Gavi; GF •  1 member NGOs •  1 member private sector/founda;ons Total: 11-­‐13 members A bit broader … •  4-­‐5 members from par;cipa;ng countries (incl. MoF) •  4-­‐5 members from contribu;ng bilateral donors •  3 members from H4+ •  1 member World Bank/TF •  2 members Gavi/GF •  2 members NGOs – North/South •  2 members private sector/private founda;ons •  1 member PMNCH Total: 19-­‐21 •  Meets twice/year (and by phone as needed); one includes high level session •  Could be supported through ;me-­‐limited task teams (e.g., on GPGs) Trust Fund Commicee •  Members: TF Donors (also represented on IG) plus Chair or Vice Chair of IG also a member •  Meet twice/yr in person (before/aBer IG mee;ng) and by phone as needed •  Updates the IG on resource alloca;on approach/progress at Council mee;ngs 23 Every Woman Every Child Strategy 2.0 & GFF: Thoughts on IntersecPons, PosiPoning, Accountability & Civil Society OpportuniPes
BETSY MCCALLON, WHITE RIBBON ALLIANCE Global Strategy for Women’s,
Children’s and Adolescents’
Health
(GS 2.0)
Betsy McCallon
White Ribbon Alliance
On behalf of the Partnership for Maternal, Newborn and Child Health
Lessons learned from the Global Strategy since 2010
•  What worked well
–  Political leadership and commitment
–  Multi-stakeholder partnerships
–  Focus on accountability
–  Every Woman Every Child global
movement
•  What could have worked better
–  Country plans and priorities to lead global collective action
–  Coordination and reducing fragmentation with existing and new initiatives,
including funding
–  Coordinated efforts with other sectors
–  Sufficient and effective financing for women’s and children’s health
27
Content work stream proposed sub-groups and lead agencies
related to Conceptual Framework and already formed sub-groups*
Sub-­‐groups Lead agencies 1. Work stream synthesis and core wri;ng team WHO, working closely with H4+ and PMNCH 2. Health Interven;ons WHO and H4+, technical experts 3. Socioeconomic, poli;cal and environmental determinants UNICEF with H4+, technical experts Health Systems Enablers 4. Financing Ray Chambers Office, World Bank, Norway, PMNCH 5. Innova;on Innova;on Working Group, PATH and others 6. Resilient Health Systems Lead partners tbc 7. Human Rights OHCHR, with H4+ and Civil society 8. Humanitarian Considera;ons UNFPA with UNHCR, OCHA, ICRC, WHO and others *Cross cuung – Accountability, Advocacy, Na;onal Leadership Connecting the dots: The Global Strategy process
Jan 2015
WHO
Executive
Board
March 2015
Launch of
EWEC
Progress
Report
Feb 2015
Delhi
consultation
on GS
content
July 2015
F4D with
GFF launch,
Addis
May 2015
South Africa
consultation
GreenTree
retreat
WHA
Oct 2015
Maternal,
Newborn
conference,
Mexico City
Sept 2015
Launch of
SDGs and
Global
Strategy
May 2016
Women
Deliver
Copenhagen
WHA
Synthesis reports: bringing feedback together Global Financing Facility Synthesis Report (December 2014) • Building long-­‐term domes;c financing for women’s and children’s health in the context of an updated Global Strategy for Women’s, Children’s and Adolescents’ Health. •  Mobilise addi;onal financing for RMNCAH •  More and beler RMNCAH harmonisa;on • Commitment to building sound na;onal plans and strong country leadership. •  Commitment to the importance of accountability 30 Building consultations from a proven model
•  GFF consulta;on – December 2014 •  1400 par;cipants – different cons;tuencies and sectors Strategic and opera;onal recommenda;ons GFF reflec;ve of stakeholder priori;es 31 Synthesis reports & dissemination of key messages
Global Strategy lessons learned & future prioriFes (January 2015 report) ●  Equity, quality, access and coverage ●  Country leadership, strengthened alignment ●  Comprehensive con;nuum of care approach ●  Clear human rights commitments ●  Health systems strengthening ●  Community-­‐based working is cri;cal to success ●  Cross sectoral determinants of health 32 How can we be heard?
Key dates: ●  20 March – early April: Updated working papers on line for consulta8on ●  End April: DraB Updated Global Strategy on line for consulta8on ●  TBD: Implementa;on plan consulta;on ●  5-­‐6 May: South Africa Consulta;on ●  18-­‐26 May: WHA Discussion 33 Immediate action to take:
JOIN THE CONVERSATION
www.womenchildrenpost2015.org
SHAPING THE FUTURE
FOR HEALTHY WOMEN,
CHILDREN & ADOLESCENTS
34 QuesPons & Discussion
•  Besides Tanzania, which are the other 3 "front-­‐runner" countries? •  How is this process is looking at the development and introduc;on of new technologies as a public good? Have any viable proposals been discussed for how the financing facility might be used for this purpose? • Regarding country planning, which plans are being used in country? Please ensure that evidence-­‐based nutri;on interven;ons are funded, and nutri;on plans are carefully considered and used in addi;on to health plans. Depending on the country, nutri;on may have a dis;nct plan, a Scaling Up Nutri;on costed plan, a hunger/food security plan that may consider some aspects of nutri;on, etc. •  What is the extended deadline for the consulta;on? •  What role can USAID's implemen;ng partners take in helping countries develop their investment cases?
Might USAID projects provide any funding for this? •  What does a launch at FFD actually mean or look like? What should we expect to see or come out of that mee;ng? •  How have conversa;ons with other health partners like Global Fund and Gavi gone so far? What progress has been made in aligning their investments/strategies with the GFF's?   QuesPons & Discussion
•  Could the speakers tell us a bit about how the private sector has been engaging in the process to date, and where they are fiung in terms of the governance and mul;-­‐stakeholder conversa;ons? • Can you give more details about how the governance and accountability pieces will be opera;onalized? For example, will the GFF use a performance-­‐based financing model to ensure results are achieved? And how will it ensure accountability on the goal to increase domes;c resources -­‐ will GFF disbursements be con;ngent on up-­‐front financing commitments from host countries? •  While domes;c resource mobilisa;on is necessary, how does the GFF seek to strengthen this? • What mechanisms will be in place to hold governments tapping into the GFF accountable? The objec;ve should be to develop programmes specifically with a focus on RMNCAH, and not count other programmes (such as infrastructure, roads etc.) with a small component on one of the aspects of RMNCAH. Conclusions & Closing: Lightening Round with Speakers CHRISTINE SOW, GLOBAL HEALTH COUNCIL Thank You for Ahending!