Many low- and middle-income countries are in the midst of multiple health sector transitions — epidemiological and demographic transitions, transitions away from donor financing of health programs, and transitions in how health services are financed and delivered. All of these transitions can pose challenges as well as provide opportunities for sustaining and improving the coverage, quality and efficiency of priority programs such as those that address HIV/AIDS, tuberculosis (TB) and malaria (together referred to as HTM).
The major global health agencies — including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) — have put sustainability at the forefront of their strategies and investment policies, with sustainability referring to the maintenance of national responses to major health threats as donor funding declines or ends. While each global health agency has its own definition of sustainability for its programs and its sustainability planning, the dialogue on sustainability at the country level should be grounded in a systemwide view of domestic health financing and service delivery.
This guide provides suggested approaches and analytical tools for implementing the Global Fund’s Sustainability, Transition and Co-Financing (STC) Policy in High Impact Africa countries. It is meant to support structured dialogue to inform policy decisions that can help sustain progress on programs that address HIV/AIDS, tuberculosis and malaria as donor funding declines or ends, given the context of a country’s health financing system and reform plans.
