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A Differentiated Approach in the Middle East

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Differentiated approaches are required to increase the impact of health investments, particularly in settings that face special challenges, such as armed conflict or an influx of refugees. To improve efficiency and offer more flexible and simplified responses, the Global Fund is launching an initiative in the Middle East that will use one integrated grant management platform. The Global Fund currently has separate grants through country allocations in Syria, Iraq, Palestine and Yemen, and provides emergency funding to support TB care among Syrian refugees in Jordan and Lebanon. By managing all grants through one system to be managed by a qualified international organization with experience on the ground, the Middle East HIV, TB and Malaria Response aims to increase coverage of HIV, TB and malaria services and reach key and vulnerable populations.

Preventable diseases like HIV, TB and malaria strain health systems that are already overburdened, leaving fewer resources to provide basic health services or prepare for emerging health threats. In refugee situations, stopping diseases from spreading not only protects already weakened refugees from falling ill, it frees up critical resources to treat other illnesses or provide other health services – care that is desperately needed for families who have lost everything, and for communities that may be struggling to host them.

Mark Dybul, Executive Director of the Global Fund, said the Middle East initiative marks a fundamental shift from the way the Global Fund has managed grants in the past.

“To reach the people we need to reach and have more impact, the Global Fund needs to change the way we engage in challenging operating environments,” Dybul told a recent meeting of donors, technical partners, government representatives and civil society organizations in Amman, Jordan. “Tailored approaches are the future of the Global Fund.”

Joseph Serutoke, the Global Fund’s Regional Manager for Middle East and North Africa, said the new approach fits the needs and challenges of the region. Advantages of bringing the grants together include increasing efficiency through consolidated reporting, a more integrated approach, and supporting stronger regional partnerships that can deliver in hard to reach areas. Because of conflict these countries face constantly shifting needs, limited capacity and severe constraints to provide essential services. In Yemen, Iraq and Syria, most of the health facilities have been destroyed. Health infrastructure in countries hosting displaced populations is overstretched. As part of the new approach, typical Global Fund procedures and in-country coordinating measures will be adapted to meet the individual situation of each country. “The whole idea of this grant is to be agile and to adjust to the changing situation in the countries we serve,” Serutoke said.

The Global Fund is calling for proposals from qualified international organizations to assume the role of Principal Recipient. The grant is expected to start in July and will have a duration of two years, with the possibility of an extension.

The Global Fund is putting a stronger focus on challenging operating environments with the aim of increasing coverage and reaching key and vulnerable populations affected by HIV, TB and malaria.

Challenging operating environments, which may experience disease outbreaks, natural disasters, armed conflicts and weak governance, has been identified as an important priority for the Global Fund. Challenging operating environments account for a third of the global disease burden for HIV, TB and malaria, and for a third of Global Fund investments