Introduction to the GFF September 2017
Two trends led to the creation of the GFF Insufficient progress on maternal and child health (worst among MDGs), and traditional sources of financing are not enough to close the gap + The world is changing Development assistance is at record levels but is only a fraction of private financing from remittances and FDI Domestic financing far exceeds external resources Need for a new model of development finance 2
GFF is a financing partnership supporting country leadership to achieve results for Every Woman, Every Child Country leadership 3
Countries leading the way Bangladesh Cameroon DRC Ethiopia Guatemala Guinea Kenya Liberia Mozambique Myanmar Nigeria Senegal Sierra Leone Tanzania Uganda Vietnam The 16 countries account for 46% of the total financing gap across all GFF countries 4
GFF objective: bridging the funding gap for women s, adolescents, and children s health 5
What results do we want to achieve? Overall objective: End preventable maternal, newborn, child and adolescent deaths and improve the health and quality of life of women, adolescents and children SDG targets MMR <70/100,000 U5MR <25/1,000 NMR <12/1,000 Universal access to SRHR services [Universal health coverage] Closing the financing gap would prevent 24-38 million deaths by 2030 6
1. Prioritizing How the GFF drives results 3. Learning Country ownership and leadership Identifying priority investments to achieve RMNCAH outcomes Identifying priority health financing reforms Strengthening systems to track progress, learn, and course-correct 2. Coordinated Getting more results from existing resources and increasing financing from: -Domestic government resources -IDA/IBRD financing -Aligned external financing -Private sector resources financing and implementing Support countries to get on a trajectory to achieve the SDGs: Accelerate progress now on the health and wellbeing of women, children, and adolescents Drive longer-term, transformational changes to health systems, particularly on financing 7
1. Driving improved results through prioritization Current trajectory SDGs Objective: identify what needs to happen to get on a trajectory to reach the SDGs 2005 2010 2015 2020 2025 2030 Short-term: key investments (prioritized within resource constraints) needed to achieve RMNCAH results (Investment Cases): - Health systems strengthening and multisectoral approaches alongside high-impact RMNCAH interventions - Focusing on equity Long-term: key reforms to health financing systems (health financing strategies/implementation plans) 8
Current US dollars (billions) Current US dollars (billions) 2a. Mobilizing domestic resources for RMNCAH Resources that can be mobilized by increasing general government revenue as a share of GDP 9 8 7 6 5 4 3 2 1 0 or by increasing prioritization of health in government budgets 1.20 1.00 0.80 0.60 0.40 0.20 0.00 Conduct analytical work to assess the options for DRM (e.g., fiscal space analyses) Develop approaches for DRM (e.g., strategy for introduction of a sin tax) Provide implementation support (e.g., TA to translate high-level strategies into implementation plans) 9
2b. Financing from IDA and IBRD Operational link between GFF Trust Fund and IDA/IBRD creates enormous opportunities: IDA commits ~US$19 billion annually (set to increase after largest IDA replenishment in history US$75 billion for next three years) IBRD commits ~US$24 billion annually Mutually beneficial link: IDA/IBRD financing benefits from analytical work and engagement of partners behind common set of priorities GFF benefits from connection with large scale financing to health sector, broader economic policy dialogue, reduced administrative costs, World Bank governance and fiduciary standards 11 agreements linking US$307 million in GFF Trust Fund financing with ~US$1.8 billion IDA/IBRD financing every $1 grant financing linked to $5.8 IDA/IBRD financing 10
2c. Aligned external financing GFF process makes external financing more efficient and effective by: Strengthening dialogue among stakeholders under leadership of government Supporting identification of priorities that partners commit resources to achieving Identifying duplications leading to increased harmonization, highlighting areas for programmatic synergies Strong engagement by a range of financiers, both bilateral (Canada, Denmark, France, Germany, Ireland, Japan, Sweden, UK, US) and multilateral (EC, Gavi, Global Fund, Islamic Development Bank, UN) At least 3 financiers aligning financing in 8 GFF countries to date 11
2d. Leveraging private resources for RMNCAH Poor women and children already rely heavily on the private sector for care and development assistance is now dwarfed by private flows 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% FDI Remittances Private debt & equity ODA Share private (for-profit and not-for-profit) Share public Three-pronged strategy to leverage private resources: 1. Developing innovative financing mechanisms to catalyze private sector capital for Investment Cases 2. Facilitating partnerships between global private sector and countries 3. Leveraging private sector capabilities in countries to deliver on Investment Cases Sources: DHS data from PS4health; World Bank 2016 12
3. Strengthening systems to track progress, learn, and course-correct Core and optional indicators: - Programmatic, health financing, health systems strengthening, and M&E capacity - Taken largely from Global Strategy, SDGs, and WHO Core 100 Capacity building central: initial rapid assessment of gaps in M&E systems enables inclusion of priorities in Investment Cases Dedicated resources for strengthening civil registration and vital statistics Cross-country sharing of experiences (in-person and virtual) 13
Practical examples of how the GFF drives results Identifying priority investments to achieve RMNCAH outcomes Identifying priority health financing reforms 1% Getting more results from existing resources and increasing financing from: -Domestic government resources -IDA/IBRD financing -Aligned external financing -Private sector resources $9 $18 4.2% 2.35% 14
Country platform Not prescriptive about form build on existing structures while ensuring that these embody two key principles: inclusiveness and transparency Government Civil society (notfor-profit) Private sector Multilateral and bilateral agencies Technical agencies (H6 and others) 15
Bringing together partners at the global level: GFF Investors Group 16
Mechanism to support the GFF partnership: the GFF Trust Fund US$573 million pledged to date from the governments of Canada, Norway, and the United Kingdom, the Bill and Melinda Gates Foundation and MSD for Mothers Flexible grant resources operationally linked to IDA/IBRD financing - 11 projects approved: ~US$1.8b in IDA/IBRD financing and US$307m in GFF Trust Fund financing $5.8 concessional financing to every $1 grant financing - 8 additional projects under preparation: ~US$770m IDA/IBRD, ~US$107m GFF Trust Fund Country selection - Eligibility: 67 low and lower-middle income countries - Must be willing to commit to increasing domestic resource mobilization and interested in using IDA/IBRD for RMNCAH 17
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