Last week, APHA, along with 58 other organizations, put its John Hancock on an open letter to the board of the Global Fund (pdf), calling on the Fund to “to fully fund the current mandate of the Global Fund; to strengthen the Global Fund’s engagement in maternal, newborn, child, and reproductive health (MNCH); and to mobilize additional resources to support such engagement.” Family Care International, which authored and coordinated the letter, reported an encouraging response from the Global Fund: the board committed to providing guidance to countries on how to integrate MNCH into their requests and to exploring the possibility of “broadening its engagement” as it develops its strategic plan for the next five years.
The prospect of adding MCNH to the Global Fund, while popular, is not without controversy. MCH advocates have been calling on donors to scale up these programs for many years, and proponents argue that organizations like the Global Fund have the drive and resources to implement and coordinate the programs that are so desperately needed to prevent the millions of needless maternal and newborn deaths each year. Others maintain that the Fund’s vertical approach is not appropriate for this issue: Alanna Shaikh argues that a narrow approach focusing on a few factors that affect maternal mortality would not be very effective, and that the funds would be better used by improving health systems in general. The Fund’s shortage of funds is an additional complication – it made headlines this past October when pledges from donors reached a meager $11.7 billion, short of the $13 billion it had set as the bare minimum to maintain its current programs and miles away from the $20 billion it had hoped to raise to expand operations.
IH members raised some very good points in the discussion leading up to the sign-on. MNCH is obviously a top priority and well deserving of attention, and the Global Fund’s current scope is limited in what it can currently do to address these issues. However, the call to expand the Fund’s activities must come with a commitment to help raise the funds needed to do so and to ensure that the energy put toward maternal health works with, and not against, the other programs. It will interesting to see the direction the Fund takes with this as it moves forward.