In order to avoid duplication and fragmentation, clear language is needed on the ability of the Global Fund, CEPI, Gavi, and other relevant global institutions to act as implementing entities, and to outline how to effectively align them to complement and catalyze each other within the existing global health financing architecture and across various populations and countries.Ģ022 will see several global health resource mobilization campaigns and replenishments including for the GFF, the Global Polio Eradication Initiative, and the Global Fund to Fight AIDS, Tuberculosis, and Malaria. There is no clarity on whether other health financing mechanisms are eligible to apply or participate as implementing entities, although this was previously indicated in dialogues on the FIF, but instead references that a waiver would be required to be eligible for funds. The document does not outline clearly who the “implementing entities” are that would receive the transferred resources and leaves that and other determinations solely to donors. The FIF claims to draw on good practices to ensure streamlined processes and strong accountability through all its implementing partners to deliver its promised results. The Bank and the FIF can best address such concerns through transparent strategies and processes and meaningful and inclusive governance. Framing narrow governance that excludes central stakeholders and implementers as managing “perceived conflict of interest” is incredibly problematic. The proposed governance structure of the FIF would likely exclude critical and central stakeholders from meaningful decision-making, including implementing country governments, civil society, affected communities, and other key institutional partners such as the WHO, Global Fund, Gavi, and CEPI. However, given the budget constraints countries are facing, the FIF would be in direct competition with ongoing resource mobilization efforts for current levels of health ODA. The document explicitly expresses that resources mobilized for the FIF shouldn’t substitute existing overseas development assistance (ODA) flows, and mentions that the FIF would catalyze private funding. It’s important that the FIF create true additionality and be nimble to the current fiscal space. Even more concerning, the document does not provide a strategic analysis of existing global health institutions and platforms’ capacities, and how the FIF will support and enhance those vs. However, a clear roadmap for collaboration with other organizations and funds is completely lacking. It is claimed that the FIF will complement existing financing mechanisms and institutions. With so many existing funds and mechanisms, some of which are very well-suited to take on PPR strengthening, the Bank runs the risk of creating increased competition for limited resources and adding additional layers of opacity and complexity in an already muddled global health financing landscape. Although newer Bank arms like the GFF provide some semblance of country leadership in development finance, with the new fund, the World Bank is making regressive, potentially harmful decisions around the FIF’s governance structure and implementation.īeyond the FIF’s many shortcomings, it is simply not needed to achieve global PPR goals. It is no secret that for decades, the World Bank has received criticism for its failure to meaningfully engage implementing countries and civil society in their funding, allocation, and implementation decisions. But the multibillion-dollar question is whether the FIF is the right mechanism and whether the World Bank is the right entity to help us achieve that. The pandemic has taught us that capabilities to prevent and respond to global health threats must be expanded globally. The World Bank sought input on a document on the development of a Financial Intermediary Fund (FIF) on May 17, giving only 15 days for the international community to give feedback on a jargony, unclear, and complex proposal that will have massive financial and health implications globally.Īccording to the World Bank, the purpose of the FIF is to assist developing countries in becoming better prepared for future pandemics by strengthening Pandemic Prevention, Preparedness and Response (PPR) capacities.
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