Six-monthly progress report on responsibilities as Global Fund Board Member of the Latin American and the Caribbean Constituency: December 2020

December 8th, 2020.

Honorable Ministries and Secretaries of Health,

It is my honor to address you on presenting the progress report on the key actions undertaken during my managerial responsibilities as Global Fund Alternate Board Member for the Latin American and Caribbean constituency for the period 2019-2021.

The LAC delegation participating in the Forty Fourth Board Meeting and the second one held virtually on November 11-12, 2020, was headed by myself, as Acting Board Member, with ad interim delegation of authority from Hon. Dr. Mary Isella Isaac, Senator, Minister of Health and Wellness (Saint Lucia), Haiti, due to her non availability to attend the meeting; Mr. Rosmond Adams, Director of PANCAP, CARICOM Secretariat and Caribbean Communication Focal Point (Guyana) as Acting Board Member, with ad-interim delegation of authority; Dr. Gabriela de la Iglesia, LA Communication Focal Point (Argentina); Mr. Javier Luis Hourcade Bellocq, LA CSO Member (Argentina); Mr. Edner Boucicaut, Caribbean CSO Member, Former Chair of CCM Haiti (Haiti); Mr. Lucien Govaard, CariFLAGS Co- Chair, Youth Representative (Suriname); Ms. M. Joan Didier, OECS RCM Representative (Saint Lucia); Hon. Dr. Alejandra Acuña, Technical Cooperation Horizontal Group (TCHG) Chair, Vice- Minister of Health (Costa Rica); Mr. Dereck Springer, Former PANCAP Director (Guyana) and Mr. Guillermo Birmingham, Audit/Finance, AFC member (Panama). LAC Delegation welcomed the Global Fund ongoing actions under COVID-19 Response Mechanism as well as the Grant Flexibilities, making US$1 billion available to help countries fight COVID-19, to protect Global Fund’s core mandate by ensuring adequate response and program continuity. LAC Delegation appreciated the ED comprehensive report which reflects well the progress made in 2020 and the challenges we face due to COVID-19. We also congratulated the Global Fund ongoing actions under the innovative COVID-19 Response Mechanism and the Grant Flexibilities, to protect Global Fund’s core mandate of ensuring adequate response and program continuity. At the same time, the LAC Delegation noted with concern the impact of the increased workload on mental health of the Secretariat, this should be carefully considered especially at the time of defining the GF role in the GHS landscape.

In addition, we commended the Executive Director and the Global Fund Secretariat for their commitment and early measures to mitigate the impact of COVID-19 on health product supply chains and to accelerate access to COVID-19 commodities including diagnostics, laboratory equipment, and PPEs; also for their involvement in the development, production and equitable access to safe, quality, effective and affordable COVID-19 diagnostics and therapeutics, and coordinated work on vaccines. We recognized the ED’s proactive commitment to working with partners to determine how to best engage with companies to respond to COVID-19, while protecting existing diagnosis availability for the three disease programs. We also supported the new partner working modalities like ACT-Accelerator in which the GF is playing a leading role in its operations.

Despite the uncertainties, we agreed with GFS priorities identified for 2021.

The LAC Delegation flagged a key message: “Our challenge as the Global Fund partnership is not just to mitigate the negatives of COVID-19 on HIV, TB and malaria, but to use the pandemic to challenge assumptions about what should be done and what can be done. We should see this moment, not just as the battle against one virus, but as a commitment to close the unfinished fights against HIV, TB and malaria and to protect everyone from future infectious disease threats”.

At its meeting, the Board also discussed development of the next Global Fund Strategy and the need to adapt to the new challenges posed by COVID-19 and by climate change. On GHS, in the LAC Constituency GF Strategy statement, we raised the need to avoid presenting only the negative side of the impact of COVID-19 on HIV/AIDS, TB and Malaria. This is also the opportunity to leverage on the investments made, the capacity built and the lessons learned by the GF over the last 20 years (i.e.: community systems, surveillance, contact tracing, behavioral communication, acceptance and proper use of condoms and bed nets to inform communities about risks and use of protective measures, adherence to treatment and measures), and not only protecting from the epidemics impact, since the Global Fund (GF) has become one of the most powerful and well-resourced organizations in global health and the largest multilateral investor in grants for health systems. The GF’s future contributions to GHS should primarily build on the GF’s current mandate and deliver its mission against HIV, TB and malaria in a way that supports and strengthens countries ‘capacities for prevention, preparedness and response.

Following the first part of the Board Retreat on Strategy Development on November 5th & 6th, the Board agreed on the imperative to leave no one behind, stressing the critical role of communities in keeping people safe and leading monitoring, especially when facing this new wave of challenges, an also recognizing the severe danger posed by COVID-19 to progress made against HIV, TB and malaria, the Board asserted a strong commitment to striving for equitable access and protecting the most vulnerable. Furthermore, the Board identified the need to advance on global health security and strengthen systems for health, as central issues to protecting the Global Fund’s core mission and to fight new and emerging diseases like COVID-19. In the same line, the Board discussed measures to make sure that mitigation and response strategies will protect people with an integrated people-centered approach, by leveraging the power of multi-stakeholder engagement and partnerships including civil society, communities, government and private sector partners.

In advance of the second part of the Board Retreat on Strategy Development on December 11th, the Board requested that the Secretariat draft a paper summarizing where we are, what are the options, the trade-offs, and the remaining topics to discuss in-depth and ask for the Secretariat’s response to Strategic Review 2020 and would request that this response be reflected in the Secretariat´s paper on Strategy Development.

The Board most relevant decision was the approval of the 2021 Corporate Work Plan and Operating Expenses Budget. There was an Executive Session in which the Inspector General Nomination Committee presented the final candidate and recommendation to the Board for appointment.

Before the actual Board meeting, both the Implementers Group and the LAC Delegation held preparatory meetings on November 9 and 10, respectively, to review key issues and agree on common positions particularly about the New Global Fund Strategy Development; COVID19 and Business Continuity other critical agenda items of shared interest.

2020 is an open consultation year for the Global Fund on the development of the Global Fund’s post-2022 strategy. LAC GF Representation reinforced the process around the global consultation through a survey to capture the governmental sector of implementing countries and their multilateral partners, to obtain in-depth information on experiences, contributions and technical assistance needs/gaps in priority areas for the Region. Only three Regions issued reports on in-depth consultations: Francophone Africa, Anglophone Africa, and Latin America (45 individuals participated). The GF open consultation accounts for a total of 246 respondents to-date, across regions globally. LAC Constituency members and main stakeholders integrated a LAC Steering Committee to increase effective communication, their meetings were held on July 6th and 16th with the participation of: a) National Health authorities; b) Representatives from Civil Society networks, technical partners PAHO/WHO and UNAIDS; and c) Global Fund LAC Regional Manager and country teams responsible for country and regional grants. The LAC Steering Committee worked in fluid and constant communication/consultation with subregional structures, such as, PANCAP/CARICOM, SICA/COMISCA and ORAS/CONHU Andean Region; as well as in close collaboration with GF LAC Platform to convene and conduct virtual meetings.

In the first phase, a self-administered semi-structured questionnaire consisting of 34 Questions (14 questions were those suggested by the GF), most open-ended without preassigned response options, was launched. The survey compiled information on LAC priority areas: i) Sustainability, Transition and Co-Financing, ii) Alignment of Global Fund grants with National Strategic Plans; iii) Participation of LAC countries in the governance of the Global Fund; iv) Role of the Global Fund in strengthening the generation of data and strategic information at the country level; v) Response articulated with the Community/Civil Society and bridge financing. The questionnaire was completed online between July 28-August 17, 2020 and responded by 45 people from the Region. The results of the survey on experiences and contributions from implementing countries and partners were submitted to GFS in a preliminary report on September 2nd. In the second phase, in-depth consultation through 4 interviews to selected key actors from the Region (three government officials and one from UNAIDS) were conducted; followed by a focal group discussion composed of 5 government, 4 PAHO/WHO and 1 ORAS/CONHU. The participants were strategically selected to secure representatives from top management level (governments, national program managers for the three diseases and UN technical partner agencies). The final report was submitted to the Strategy Committee on September 28th (Please see attached the “Report on the LAC constituency consultative process on the development of the New Global Fund Strategy 2023-2025” – Executive Summary).

Recently, the dates for 2021 Global Fund Partnership Forum were announced; the EECA & LAC will take place on February 9-11, 2021.

Concerning the methods of work for LA Representation, I would like to recognize the ongoing support received from the Latin America Communication Focal Point for the GF and the Area of Communication Platform support. The Latin American local support group to the Alternate Board Member continues functioning through virtual communication with additional members from NGO Networks, Civil Society, and technical partners such as PAHO/WHO and UNAIDS.

The Caribbean subgroup continues to be supported through the PANCAP/CARICOM platform and there is a fluid and constant communication and consultation among the two sets of countries. PANCAP/CARICOM is also the very capable administrator of the funds received to support the LAC operations and PAHO /WHO provides administrative support to the Latin America representative for the operation and maintenance of a communication platform in Spanish to ensure a continuous flow of information within the Constituency and with other stakeholders in the Latin America sub-region, as well as to provide the technical expertise in analyzing and compiling policy and strategy documents and comments from all stakeholders including PAHO, UNAIDS, CCMs and RCMs, and presenting and /or negotiating the regional position at the Board level.

Beyond my duties as GF Alternate Board member, I have been a member of WHO Strategic advisory group (SAGeM) on malaria eradication (2017-2022) and continued as Member of the WHO MEOC (Malaria eradication oversight committee) since 2018, as well as a Roll Back malaria RBM Board member (2017-2022). In these groups, I have the responsibility of contributing with the individual and collective experiences of disease elimination from the LAC Region, while I keep reminding all parties about the need of protecting the countries achievements, particularly in UMICs and LMICs in the response to the three diseases. Nowadays, with some countries in Latin America recording a resurgence in malaria cases and with the outbreak of COVID-19 Pandemic, a robust surveillance system and the continuous retraining of health workers which enabled Argentina and Paraguay to maintain zero malaria cases must continue to be prioritized in the long-term. On the 21st of February 2020, Dr. Tedros Adhanom, the WHO Director-General appointed me as one of the six Special Envoys on COVID-19, to provide strategic advice and high-level political advocacy and engagement in the LAC Region and to work in close collaboration with WHO Regional Directors and country offices to coordinate the global response to COVID-19. My main functions as Special Envoys on COVID-19 are to: i) Amplify the messages of the Director General; ii) Disseminate WHO guidance on COVID-19 readiness and response; iii) Partake in high-level advocacy and political engagement; iv) Provide strategic advice on preparedness, readiness and response to COVID19 outbreaks; v) Engage with regional bodies and national governments; and vi) Report regularly to the Director-General on my work and the situation in countries.

I am pleased to inform that Guillermo A. Birmingham, LAC Constituency expert and Audit and Finance Committee (AFC) member (2018-2020), was appointed for a second term to the AFC (2020-2022). He also attended the 14th AFC meeting held virtually, on October 8th & 9th. Relevant issues were addressed, and substantial contributions were made on Financial Oversight, OPEX budget, Corporate Workplan, Resource Mobilization, Risk Management Overview, Financial Performance Assessment and Absorption Capacity.

I also note with satisfaction the appointment of other members of LAC Delegation in relevant positions that contribute with their expertise in different areas, as follows: Mr. Dereck Springer chair the IMG Strategy Development Group and Mr. Javier Hourcade, TRP member as expert on civil society and communities.

With reference to the LAC Constituency outreach efforts, I would like to mention the monthly LAC Newsletter, the Alternate Board Member six-month reports; the regular briefings to Permanent Missions of LAC Member states based in Geneva and during the COHSOD and PAHO Directing Council; and regular meetings with LAC Regional Manager and country teams responsible for country and regional grants to improve relationships between GF Secretariat and LAC countries.

I will continue my duties as Alternate Board Member, supporting the Hon. Dr. Mary Isella Isaac in her role as Board Member and with the LAC Constituency members.

The monthly newsletter in Spanish is being published and you can subscribe to it as well as visit the website, and/or use communication channel through Facebook Please do not hesitate to contact me for any enquiry or further information;

I am opened to your guidance, proposals, suggestions for improvement and consultations through my personal e-mail and at the institutional e-mail

I take this opportunity to wish you, your families and all your co-citizens a Prosperous, Happy and Healthy 2021 that bring us a global sense of solidarity.


Dr. Mirta Roses Periago

Global Fund Alternate Board Member

Latin America and the Caribbean Representation