Mixed financing – How we collect funds

Mixed funding combines grant funds with funding from multilateral banks and other financial institutions. He participates in strengthening alignment and coordination between development partners and helps countries of implementation to set up more solid, more resistant and better equipped health systems to fight HIV, tuberculosis and malaria. In parallel, it supports essential health interventions, such as expanding access to treatments, reform of health insurance plans or the damage of vulnerable populations.

Mixed funding completes the conventional financing of the Global Fund by means of subsidies and is part of its global approach to mobilize additional health resources and for the fight against the three diseases. The organization can thus resort to various financial mechanisms to achieve its objectives, which allows it to obtain loans for the social sector and to collaborate more closely with other financial partners to strengthen health and community systems and fight against HIV, tuberculosis and malaria.

Mixed financing transactions do not only contribute to expanding the range of resources available to the Global Fund: they also benefit other partner institutions. When they plan to invest in health systems, they can count on the unique expertise of the Global Fund in the fight against the three diseases and the strengthening of health systems.

Mixed financing case studies

Improve access to malaria case management and preventive malaria treatment during pregnancy

The World Fund contributed 22.9 million US dollars to a mixed financing operation with South Sudan totaling approximately $ 375 million in donor financing. These funding expand access to a set of basic health and nutrition services, including malaria cases and intermittent preventive treatment of malaria during pregnancy. They also ensure a better alignment of partners for response in difficult intervention contexts and should improve the programmatic coverage of the fight against malaria, because they make it possible to extend primary services to more communities, to strengthen health systems essential to sustainable response and to carry out efficiency gains, in particular for the coordination of planning, the distribution of drugs, or even interventions in the event of floods or other complex situations.

Reach migrant populations to provide them with vital services to combat HIV

Since 2013, the economic crisis that affects Venezuela has caused population trips to neighboring Colombia. According to estimates by the United Nations Agency for Refugees (UNHCR), nearly 2.8 million Venezuelan migrants lived in Colombia in September 2024. If many of them benefit from health coverage thanks to their temporary protective status, they also face obstacles likely to restrict their full access to care.

The program for improved access to vulnerable populations to effective health services and reinforced resilience of health systems (Program for Improved Access to Effective Health Services for the Vulnerable and Enhanced Health System Resilience) centralizes US $ 300 million from the World Bank and US $ 5 million in the World Fund. In partnership with the Government of Colombia, this program aims to strengthen the country’s health system and notably provides for certain measures to reach migrant populations and provide them with vital services to combat HIV.

The contribution of the Global Fund has participated in setting up a disbursement indicator to assess the capacity of migrants to access full HIV fighting services, such as antiretroviral therapy. It is added to the overall investment of the Global Fund to fight HIV in Colombia, which has the priority of supporting the key and vulnerable populations that come up against obstacles to access health services.

Transform the fight against tuberculosis by completing funding

Second country most affected by tuberculosis in the world, Indonesia alone represents 8 % of cases worldwide.

The fight against tuberculosis is essentially supported by national funding, which have increased considerably in recent years. However, there remains an important funding deficit and essential reforms are necessary in the health field. To help remove these obstacles, the Global Fund, World Bank and Indonesian government have collaborated in the repurchase of a loan in order to improve the coverage, quality and efficiency of the fight against disease in the country.

With an investment of US $ 21.1 million, the Global Fund helped the Government of Indonesia to develop and approve a World Bank project of US $ 300 million intended to stimulate major health reforms and strengthen the national response to tuberculosis.

In addition to continuous funding provided by the Global Fund subsidies, the initiative aims to support reforms of the health system at the subnational level, in particular in terms of financing of primary care, engagement with the private and digital health sector, objectives which could not be achieved solely by means of subsidies.

Integrate the management of HIV and tuberculosis in the primary health care system

In recent years, the Popular Democratic Republic Lao has made significant progress in health and nutrition services, but maternal and chronic undernourishment rates in children are among the highest in the region. The country has a high morbidity burden for tuberculosis and faces a concentrated HIV epidemic. While national HIV and tuberculosis programs have progressed a lot in recent years and recorded high therapeutic success rates, they have difficult to identify missing cases in the environments that escape their radars and difficult to access areas.

To help solve this problem, the World Fund began in 2020 to support the government project for access to health and nutrition services called Hansa (Health and Nutrition Services Access Project). As such, he concluded a parallel co -financing agreement bringing together US $ 36 million, in which he participated up to US $ 10 million alongside the World Bank (23 million US dollars) and the Australian government (US $ 3 million). Implemented by the Ministry of Health of the Popular Democratic Republic Lao and civil society organizations, the HANSA project has helped women, children and people living in difficult to access and vulnerable areas to access essential health and nutrition and nutrition services, including HIV and tuberculosis programs. Thanks to this single partnership, the Hansa project has strengthened primary health care, in particular by improving the integration of the services to combat both diseases.

Given the success of the first Hansa project, a second phase was launched in 2024, Hansa 2. Totating US $ 62 million, it is involved in long -standing problems that hinder rural communities access to health services, more particularly for women and children belonging to ethnic populations and people that programs fail to reach. The Lao Popular Democratic Republic, as part of a joint investment with the World Bank, GAVI, the Australian Vaccine Alliance and the Australian government, invests all of the US $ 17.5 million allocated by the Global Fund for the 2024-2026 period in the Hansa 2 project.

The Hansa 2 project is always intended to support the improvement in the quality of health and nutrition services in the Lao Popular Democratic Republic as well as access to these services in the country’s poorly served areas. This initiative will strengthen prevention against tuberculosis and coverage of its treatment, and improve access to HIV fighting services for key populations and people living with HIV and AIDS. Hansa 2 will also support the integration of tuberculosis and HIV services in the primary health care system and the establishment of resilient health systems in the climate. Other global health partners will also contribute to the program by providing technical assistance.