On 23 July in Nairobi, Kenya, WACI Health and KANCO hosted CSOs from Kenya who were joined by GFAN Africa representatives from South Africa, Zimbabwe, Cameroon, Rwanda and Tanzania  for a candid discussion on the 6th Replenishment of the Global Fund and Domestic Resources for Health. The event – a panel discussion by representatives of communities, youth, civil society, and embassy of France, the Global Fund and Government discussed Kenya’s health financing status and why the Global Fund is a worthwhile investment.

There was emphasis on the need for a successful 6^th replenishment of The Global Fund because it is efficient and effective. In addition a successful replenishment will contribute to:

• Reduce mortality from HIV, TB and malaria
• Saving millions of lives
• Reduce and avert new infections

Inaction will result in the loss of millions of lives and loss of gains made so far.

Participants thanked France for its leadership by offering to host the replenishment conference scheduled for 9 October 2019 in Lyon, France and for calling on other donors to step up their fight in order to ensure a successful replenishment.

France is a big investor in the Global Fund because the Fund’s work saves and improves lives. “Increasing funding for the replenishment of the Global Fund will move us to a better place in healthcare. Tax payers in France, sacrifice for others to improve their lives through better health’ Said Dr Pierre Bello – Health Advisor, Embassy of France. He added that Kenya has a strong political will for a successful UHC and must take advantage of the external funding opportunities, to build stronger and stable systems of healthcare.

Through the support of the Global Fund, Kenya has better healthcare – systems, disease interventions and programs for the most vulnerable populations. Support to Kenya reaches those who need it – communities. Grace Adego, a community health volunteer – a panelist expressed her gratitude for the free ARVs she receives.

Regina Ombam – the Deputy Director, HIV Investments National AIDS Control Council noted that Kenya is a lower middle income country so donor financing is gradually dwindling. There is need for increased allocation of domestic resources for health so that existing funding gaps do not grow bigger. She noted that the Government of Kenya is increasing health financing and giving healthcare more attention and focus.

Ms Obam challenged those present:

• To think of the possibility of a replenishment conference for Kenya – with Kenya government & stakeholders, to discuss the health of Kenyans and how to fund it in future.
• That civil society should keep government in check more vigorously
• Civil society voices are needed to end corruption in public finance management systems and to push for more resources.
• There should be emphasis of integration within Government to stop wastage while implementing healthcare interventions.
• The private sector should play a bigger role in complementing healthcare financing.
• The Government should consider entering into social contracts with major funders of health programmes
• There should be focus on disease prevention

Ms Fahe Kerubo a young girl note that HIV interventions are commendable. However, infections among adolescent girls and young women remain unacceptably high. Increased funding for health should address this challenge.  The youth must be prioritized and put at the center of the HIV response.

There was a rallying call for additional resources for health from donors and the Government of Kenya and other implementing countries. The need for preventing healthcare was emphasized. Increased focus on health will lead towards a successful UHC and progress towards SDG3 on the health and wellbeing of all.

On 19^th September, 2019 Global Fund Advocates Network in Africa (GFAN_Africa ) in collaboration with WACI Health organized a day of advocacy dubbed Day of Action for African Governments. Members of the Network delivered letters to Presidents of African Countries asking them to contribute to the 6^th replenishment of the Global Fund and to allocate additional domestic resources for health.

The replenishment conference will take place on 9 October in Lyon, France and seeks to raise at least 14 billion to be able to #getbackontrack to defeat HIV, Tuberculosis and malaria as epidemics. These resources will help save 16 million lives, cut the mortality rate from HIV, TB and malaria by half, and build stronger health systems by 2023. Further, resources for health will contribute to achieving Universal Healthcare Coverage (UHC) and Sustainable Development Goal 3 on the health and wellbeing of all.

The ambitious target to eradicate the three epidemics in Africa can only be achieved if there is greater government ownership in ensuring that their countries fund programs and meet their national target in the global progress to eliminate the diseases to sustain gains made so far and make further progress.

GFAN Africa members in the following countries delivered letters to their presidents with copies to the Ministers for Finance, Ministers for Health and parliamentary committees for health and budget – Kenya, Namibia, South Africa, Tanzania, Zimbabwe, Botswana, Nigeria, Eswatini, Cameroon, Chad, Gabon, Guinea Bissau, Congo and Ghana.

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On 5 September 2019, at the Zeitz Mocaa in Cape Town, GFAN Africa and WACI Health joined in an event organized by The Global Fund and Goodbye Malaria titled; Step up The Fight: How African Private Sector Will Help End AIDS, TB and Malaria by 2030.

After years of remarkable progress in the fight against AIDS, tuberculosis and malaria, new threats have slowed progress and enabled the diseases to gain ground. With its capacity for innovation and collaboration, private sector in Africa plays a crucial role in stepping up the fight to end these epidemics.

The high-level event, also attended by South Africa’s and Namibia’s Ministers for Health, emphasized the important role of partnerships with the private sector in ending HIV, TB and malaria as epidemics and driving impact and economic growth. Partnerships enable different actors work on a common vision to achieve high impact. Critical partnerships do break barriers.

In his remarks, the executive director of the Global Fund Peter Sands emphasized that we must Step Up the fight or slip back. He added “The Global Fund is about collaboration, innovation, data driven execution and resources”.

Noting that health is a human rights issue, panelists posited that for sustainable healthcare, the right product must be available at the right place at the right time to the right people so as to achieve desired health outcomes. Private sector energy is needed to eliminate malaria and indeed, the three diseases. As a result of partnerships, the Coca Cola distribution model which reaches far and wide is being used to deliver medication to far flung areas.

At the event, Goodbye Malaria, which is supported by Nandos, an international restaurant group founded in South Africa, as well as other corporate partners, pledged R85 million (about US$5.5 million) to The Global Fund to expand a grant that aims to eliminate cross-border malaria transmission in Mozambique, South Africa and Eswatini. Project Last Mile, GBCHealth and Zenysis Technologies announced in-kind support and co-investments to increase the effectiveness of health programs through innovations. Africa Health Business pledged to support the mobilization of African business. These co-investments will total more than US$23 million.

These events will also contribute to achieving UHC and SDG3 on the health and wellbeing of all.

On 22^nd of September 2019 in New York, on the side lines of the High Level Meeting on Universal Healthcare Coverage (UHC), WACI Health, Rwanda NGOs Forum, IMRO, GFAN Africa and The Global Fund organized an engaging panel discussion themed: ‘Domestic Resource Mobilization and sustainable Health Financing in Africa’

This side event joined in the worldwide discussions on achieving sustainable financing for UHC in Africa through increased domestic resources for health.

External resources can support as well as be leveraged to increase domestic financing. According to the 2019 Investment Case for the Global Fund, a successful 6^th replenishment of the Global Fund will spur US $46bn in domestic resources from implementing countries towards ending HIV, TB and malaria as epidemics, as well as strengthening health systems. It is critical that African Governments leverage this window of opportunity by supporting the replenishment and also by stepping up their direct investments into health programs.

Panellists discussed the status of domestic resource mobilization for UHC in Africa. Africa’s leaders have in the past shown understanding on the importance of self-reliance through DRM as the primary source of development financing and demonstrated the will to improve the health of its populations (Agenda 2063, Africa Leadership Meeting). Commendably, African Union member states have increased the percentage of their government budget allocations for health, only seven AU states have reached the recommended 5% of GDP to health (2019 Africa Scorecard on Domestic Financing for Health). This is a clear indication that the continent has not moved sufficiently towards sustainability in health financing and as such Africa remains far behind the target it has set for itself of investing US$86.30 per capita, 5% of GDP and 15% of the government budget in health.

On the side lines of the HLM, GFAN Africa met France’s Global Health Ambassador Ms Stephanie Seydoux. The team had cordial discussions on GFAN Africa’s mobilization works for a successful 6^th replenishment of the Global Fund.

Still, while in New York, GFAN Africa, WACI Health, Section 27 joined other partners in health in a protest against the removal of progressive language from the political declaration.

The UHC HLM brought together for the very first time, Heads of State and Governments, representatives of States and Governments, Civil Society, Foundations and Private Sector to re-affirm their commitment to achieve UHC and agenda 2030 for Sustainable Development.