Civil Society and Youth Statement on the GFF Resource Mobilization Effort

GFF Investors Group Meeting, March 23-24, 2021

This statement was developed in collaboration with and on behalf of the 370+ members of the CS coordinating group and youth constituency of the GFF.

Protecting Essential Services and Investing in the Future

The Civil Society and Youth constituency applauds the Global Financing Facility’s leadership, investors, and strong country-led approach which has led to the realization of a track record of success and key learnings that informed the GFF’s new five-year strategy. Among the remarkable progress to date is the fact that 32% of the 36 GFF countries are using domestic resources to fund 50% of the current investment cases, with a target goal of 75% between 2021-2025.

We further appreciate the GFF’s early and quick pivot to support countries’ strategic responses to the COVID-19 pandemic disruptions through the provision of essential services for women, children, and adolescents. Recent WHO data from 105 countries show that 90 percent of countries have experienced disruptions to health services, with low- and middle-income countries reporting the greatest difficulties. Due to the contracting global economy, the total number of women and girls living in extreme poverty is expected to reach 435 million with no possibility of reverse to pre-pandemic levels until 2030.

Against this backdrop, the GFF CS and youth constituency enthusiastically supports the GFF’s USD 1.2 billon resource mobilization ask for 2021, to support to national COVID-19 responses and protect essential services, which aligns with the recent PMNCH and partners COVID-19 Call to Action. Supporting governments to address inequalities not only saves lives but protects decades of investments that the world cannot afford to lose. Maintaining the provision of essential services for women, children, and adolescents, and scaling up what works today requires the kind of financial resources, strong partnerships, and efficient leadership that the GFF facilitates.

A Vision for Success: Celebrating Progress and Committing to Build on Lessons Learned

Fully funding the GFF resource mobilization ask of USD 1.2 billion in 2021, as well as the larger USD 2.5 billion investment needed from donors between 2021-2025, will help ensure that the GFF and partners can build on recent progress and realize new strategies and commitments.

We celebrate and commend the GFF Investors Group and Trust Fund Committee’s leadership in approving an updated CS and youth engagement framework and associated funding envelope of USD 6 million, spanning two years. We also recognize the cooperation and alignment between the GFF, Gavi, the Global Fund, UHC2030, and PMNCH in implementing the Joint Learning Agenda for CSO engagement in health financing, accountability, and advocacy in COVID-19. This new collaboration to strengthen CSO knowledge and capacity in budget advocacy and accountability for health financing translates the Global Action Plan (SDG GAP) commitment into action and responds to the call from CSOs to align funding to improve health for all.

Alongside these exciting developments, CS and youth remain committed to supporting the GFF in planning, implementation, resource mobilization, monitoring, and accountability. The community continues to generate results in improved country Investment Cases, multi-stakeholder coordination, domestic resource mobilization, monitoring and evaluation, impact measurement, and accountability. However, increased resources are urgently needed to ensure that the CS and youth constituency can continue to work in partnership with the GFF and country governments to bear equitable, scaled, sustained results that respond to community needs. The new GFF 5-year strategy and the accompanying updated CS and youth engagement framework provide exciting plans to facilitate continuous improvement across the GFF architecture. The USD 1.2 billion ask in 2021 is needed to fully realize these plans and we commit to working with the GFF, country governments, donors, and other partners to realize a collective vision for success, which includes the following areas:

1. Effective, inclusive multi-stakeholder country platforms (MCP’s): To-date, most GFF countries still lack well-functioning MCPs, leading to (1) duplication of activities; (2) interventions that are not aligned with the RMNCAH+N Investment Case; (3) poor peer learning, monitoring, and review; and (4) a lack of accountability among constituency members. To strengthen MCPs, CS and youth will continue to support quality planning, implementation, progress review and information sharing, clear MOUs and TORs, and consistent engagement of CS and youth members to ensure planning is responsive to community needs. We call on governments to support transparent selection processes for CS, youth, and other platform members, including their consistent engagement, and transparent information-sharing practices.
2. Robust, transparent data/information sharing and accountability: Timely information sharing and dissemination of key data in GFF countries remains a significant challenge. Data on budgets and expenditures remain largely unavailable to facilitate meaningful review and accountability processes. We call on governments to improve transparency and sharing of financial, process, and results data. CS and youth commit to advocating for the tracking, disaggregation, and sharing of country financial health data, through the GFF’s RMET[1] We also commit to using key lessons to elevate CS and youth voices to strengthen GFF processes.
3. Sustained, increased, efficient domestic resources for health: The backbone of the GFF model is sustainable domestic resource allocations and efficient use by countries. Amidst the COVID-19 response, country CS and youth partners report a lack of transparency on the part of governments in sharing how COVID-19 response resources have been used. We call on country governments to prioritize domestic funding for health, and efficient use of funds, including allocations for essential SRMNCAH-N services. We encourage the GFF to work with countries to explore innovative and progressive policy and funding options including those that focus on tax strategies, tax justice, addressing illicit financial flows, and supporting international debt relief. We commit to leverage our in-country relationships with government partners to advocate for domestic resources and to engage with country government partners to track and improve spending efficiency.
4. Gender-transformative approaches: The current Global Health 50/50 report showcases a lack of gender-transformative COVID-19 responses. We ask for an urgent review of country COVID-19 responses to ensure resources are addressing gender-differentiated needs. We commit to supporting the implementation of the new GFF roadmap for advancing gender equality by promoting community representation, and in particular women’s representation, in leadership on health planning processes, and encouraging gender sensitive budget tracking.
5. Effective, meaningful CS and youth engagement: In October, the GFF Trust Fund Committee appropriated USD 6 million over two years to support CS and youth engagement, capacity strengthening, monitoring, and advocacy efforts. While we celebrate this significant improvement, this amount remains insufficient to cover the resource gap and ensure effective engagement across all 36 GFF countries. We call on the GFF, donors, and country governments to further increase this resource envelope to fully fund the updated CS and youth engagement framework across all GFF countries, while fully leveraging the power of CS and youth voices and expertise. We look forward to leveraging the CS and youth framework to strengthen coordination and cross-country learning and impact sharing among the youth constituency. We commit to work with the GFF secretariat, donors, and country governments to implement the updated CS and youth engagement framework and support mutual accountability.

CS and Youth Engagement in the Resource Mobilization Effort

We support and call on donors to honor the GFF’s additional USD 1.2 billion resource mobilization ask by the end of 2021 to support the delivery of essential services targeted at the most vulnerable. Specifically, we will support the campaign by:

1. Advocating to GFF country governments and donor countries to commit the USD 1.2 billion by the end of 2021.
2. Coordinating and elevating voices of the constituency to share lived experience in support of the resource mobilization campaign at national, regional and global levels
3. Serving as and mobilizing champion speakers in support of donor and domestic resource mobilization efforts.
4. Synthesising and sharing country evidence, lessons, and on-the-ground realities to ensure the GFF and partners continue to learn and improve, in alignment with best practices and in response to community needs
5. Driving monitoring and accountability in countries, including budget tracking, to ensure that resources are disbursed and utilized effectively, and reach communities with the greatest needs – supporting the journey towards self-reliance.

The next five years represent a critical period of investment to counter the health and economic impacts of the pandemic and to enable partner countries to get back on track. Failure to mobilize these resources by end of 2021 will bring coverage gaps in  lifesaving health interventions for women, children and adolescents in 36 GFF countries. This means that more than 82 million children will not receive oral rehydration for the management of enteric and diarrheal diseases; over 4 million pregnant women will lose access to skilled childbirth care, over 17 million children will miss DPT vaccinations (diphtheria, pertussis and tetanus), and unwanted pregnancies in adolescents will rise—all while overall out of pocket costs will continue to skyrocket. We cannot afford to lose more lives due to a lack of investments in preventable essential health interventions.

[1] RMET = resource mapping and expenditure tracking tool