In line with UNDP’s mission to eradicate poverty and reduce inequalities and exclusion, and consistent with the HIV, Health and Development Strategy 2016–2021: Connecting the Dots, UNDP supports countries to implement large-scale health programmes—including reaching some of the most hard-to-reach populations and strengthening institutions to deliver essential services in challenging and high-risk country contexts.
In doing so, and in close collaboration with governments and partners, including UN agencies, UNDP helps build the resilience of health systems and the sustainability of health responses. This includes enhancing legal and policy environments to tackle the drivers of ill health and sustain health responses. It also includes environmental sustainability, through innovative initiatives that embed sustainability into procurement practices and promote the use of clean energy, while also reducing the carbon footprint of health facilities and enhancing their ability to withstand the effects of climate change.
This report covers the period April 2016 to June 2017. UNDP’s total expenditure in support of implementation of health programmes, including Global Fund grants, agreements with governments for health-related procurement services and other health implementation support amounted to US$516 million in 2016.
As interim Principal Recipient (PR) of Global Fund grants, UNDP manages 36 grants covering 19 countries and three regional programmes (covering another 27 countries). The partnership between the two organizations was further cemented in 2016 with the adoption of a new Framework Agreement that updates, improves and streamlines the terms of UNDP’s engagement with the Global Fund, making it nimbler and further increasing the focus on effective implementation.
The development results of UNDP’s partnership with the Global Fund are significant, not only in terms of health outcomes but also for their direct impact on the ability of individuals to live fuller and more productive lives, support their families, expand their choices and contribute to their communities, in turn generating broader socio-economic benefits for entire countries and regions. UNDP’s partnership with the Global Fund has helped save 2.5 million lives (3.1 million as of December 2017) to date, while 2 million people are currently on HIV treatment through UNDPmanaged Global Fund grants. Zimbabwe has just reached 1 million people on HIV treatment, which constitutes a remarkable milestone and achievement in a challenging context, with measurable impact: life expectancy in Zimbabwe, which had declined starting in the 1980s to reach 41 years in 2003, increased to 61 years in 2015.
In line with its core mandate and role as a founding co-sponsor of the Joint United Nations Programme on HIV/AIDS (UNAIDS), UNDP also supports countries to promote enabling legal and policy environments for effective responses to HIV, and co-convenes activities to empower key populations, meet the HIV needs of women and girls, and stop sexual and gender-based violence (together with the United Nations Population Fund (UNFPA) and UN Women). The results achieved under UNDP’s partnership with the Global Fund in this area make a measurable difference in removing barriers to accessing prevention, treatment and care services—including for key populations—and effectively fighting stigma and discrimination to enable more effective health outcomes.
Building on these results, and UNDP’s experience in the highly specialized procurement of health products and equipment, increasingly governments are asking UNDP to support them with health procurement and capacity develop- ment services, using their own resources. UNDP is supporting governments with procurement and supply management (PSM) support services (outside of the scope of its partnership with the Global Fund), for a total value of US$585 million in signed agreements. The primary focus of this procurement has been medicines and diagnostics for infectious diseases, but it also includes laboratory and hospital equipment. Increasingly, UNDP is also asked to procure medicines for noncommunicable diseases. This is done as a complement to (and in some cases using) existing arrangements of other UN agencies.
In addition, UNDP supports governments to build resilient health systems and strengthen national procurement and supply chain systems, including through the provision of technical expertise to strengthen legal, policy and regulatory frameworks, improve procurement rules and regulations, support supply-chain information systems, and remove potential barriers to equitable access to affordable medicines.
This work complements UNDP’s existing support under the partnership with the Global Fund, which strengthens the capacity of governments to manage sustainable health responses by strengthening national systems and supporting planning for transition of the PR role from UNDP to governments, and for governments to transition out of Global Fund support altogether.
To assist UNDP Country Offices (COs) implementing Global Fund grants, UNDP has created institutional mechanisms and modalities to provide end-to-end support, which can now be expanded and benefit other modalities of health implementation support. This includes rigorous use of audit findings and recommendations to provide guidance and tools for more effective implementation, robust risk management, including an early warning system to detect and mitigate risks, and CO-to-CO support to share lessons of implementation and expertise across Global Fund grants managed by UNDP.
This Annual Report provides an overview of the status of the partnership between UNDP and the Global Fund, and of health implementation and capacity development services provided to governments beyond the Global Fund. It summarizes capacity development and other ongoing initiatives to strengthen the sustainability and resilience of health systems, and provides an overview of the results and performance of Global Fund grants managed by UNDP. Lastly, the report describes the work of the UNDP HIV, Health and Development Group’s dedicated Global Fund/Health Implementation Support Team and support provided to UNDP’s partnership with the Global Fund and the health implementation support work.