ABOUT AFRICAN CONSTITUENCY BUREAU FOR THE GLOBAL FUND (ACB)

The Global Fund to fight HIV/AIDS, Tuberculosis and Malaria (GFATM) has two constituencies representing Africa namely the Eastern and Southern African (ESA) and West and Central Africa (WCA) constituencies. The two constituencies took a joined-up approach in 2012 with a twofold intent: to ensure that constituency priorities are reflected in Global Fund strategy and operational plans; and to strengthen the presence, voice and contributions of the constituencies, through their delegations, in all Global Fund governance deliberations and processes. The constituencies adopted a new governance framework that amongst other things, established a joint ESA and WCA Bureau – the African Constituencies Bureau, ACB – a policy think tank that support ESA and WCA Global Fund board members, committee members and delegations. Its primary functions include ensuring effective engagement, representation and participation of African constituencies in Global Fund processes. It also seeks to enhance the capacity of the African constituencies to shape Global Fund policies and processes. The constituencies comprise a total of 47 countries.

The ACB, based in Addis Ababa, Ethiopia, ensures effective engagement, representation and participation of African Constituencies, ESA and WCA, in Global Fund Board processes.

Background to this Opportunity

The Global Fund, the biggest multi-lateral mechanism, is at the centre of the global community’s efforts to end AIDS, TB and malaria by 2030. The fund is in the process of developing its post-2022 strategic plan. There is so much at stake for this plan given it will be the last before the 2030 goal of ending the three epidemics. It cannot be business as usual and the margin for error is therefore extremely limited.

Africa bears the biggest share of the global burden of malaria and HIV and a considerable burden of TB. As the epicenter of the epidemics, it is critical that the continent is at the forefront of developing evidence-based interventions that will turn the tide of these epidemics and engage in discussions on the Global Fund’s next strategy. This will be a huge demonstration of the continent’s ownership of global strategies towards ending the three epidemics in 2030.

According to the 2019 WHO World Malaria Report, most malaria cases in 2018 were in the World Health Organization (WHO) African Region (213 million or 93%), followed by the WHO South-East Asia Region with 3.4% of the cases and the WHO Eastern Mediterranean Region with 2.1%. Nineteen countries in sub-Saharan Africa carried almost 85% of the global malaria burden. Six countries accounted for more than half of all malaria cases worldwide: Nigeria (25%), the Democratic Republic of the Congo (12%), Uganda (5%), and Côte d’Ivoire, Mozambique and Niger (4% each).

The WHO African Region accounted for 94% (380,000) of all malaria deaths in 2018. Although the region was home to the highest number of malaria deaths in 2018, it also accounted for 85% of the 180 000 fewer global malaria deaths reported in 2018 compared with 2010. Nearly 85% of global malaria deaths in 2018 were concentrated in 20 countries in the WHO African Region; Nigeria accounted for almost 24% of all global malaria deaths, followed by the Democratic Republic of the Congo (11%), the United Republic of Tanzania (5%), and Angola, Mozambique and Niger (4% each).

The WHO African Region had the largest absolute reduction in malaria deaths, from 533, 000 in 2010 to 380, 000 in 2018. Despite these gains, the malaria mortality reduction rate has also slowed since 2016. Although there has been substantial reduction in the burden of malaria between 2010-2015, a resurgence since 2015 has been observed. The challenges facing the global malaria response are many, and as highlighted since 2017, immediate barriers to achieving the fast-approaching GTS milestones for 2020 and 2025 are malaria’s continued rise in countries with the highest burden of the disease and inadequate international and domestic funding. At the same time, the continued emergence of parasite resistance to antimalarial medicines and mosquito resistance to insecticides pose threats to progress. Key challenges including continued rise of incidence and mortality in countries with the highest malaria burden, inadequate international and domestic funding and antimicrobial resistance (AMR) to malaria medicines and insecticides. In 24 out of 41 high-burden countries, which rely mainly on external funding for malaria programmes, the average level of funding available per person at risk declined in 2015–2017 compared to 2012–2014. This ranged from a 95% reduction in the Congo (highest) to a 1% decrease in Uganda (lowest) over the time points compared.

Africa stands to gain most from investing in the fight against malaria. Malaria already costs the continent’s economy US$ 12 billion per year in direct losses, and 1.3% of lost annual GDP growth. The resources needed to achieve malaria elimination are paltry compared to what will be required if malaria resurges, particularly in the context of drug and insecticide resistance. Beyond the financial return, investments in fighting malaria will have enormous positive effects on agriculture, education, women’s empowerment, poverty eradication and other Sustainable Development Goals.

Malaria-affected countries must priorities investment in health and tackling malaria. To end malaria and mitigate its toll on Africa, endemic countries have a crucial role to play in speaking with a unified voice to:

• Build political support and engage high-level government, private sector, partners and civil society leaders on public awareness around the multi-faceted benefits of malaria elimination;
• Advocate for an increase in external and domestic funding for malaria elimination;
• Increase awareness and ownership at the community level;
• Engage with parliamentarians, state and local government leaders to budget and expend the necessary financing for the country’s plans;
• Support timely and optimal use of malaria funds from all sources by promoting effective grant management, data reporting, procurement and supply chain management, and the public financial management system for malaria interventions;
• Promote the effective use of appropriate tools and the development of new ones as situations change (either to replace failing tools or to address new situations, such as a move from control to elimination);
• Analyze in-country bottlenecks to effective implementation; and
• Invest and improve the overall health system and strengthen disease surveillance systems. Countries that increasingly invest their own funds, draw on a variety of local private sector and innovative sources, and improve their public financial management systems will additionally succeed in attracting increasing external financing on the path to malaria elimination.

As can be seen from the foregoing, therefore, addressing the challenges of malaria resurgence in Africa is an important priority if the region is to end malaria by 2030. The ACB is therefore seeking to hire a consultant that will support the organization to provide a critical analysis of the malaria epidemic in Africa and provide evidence-informed recommendations and guidance on how the Global Fund can work with the region to accelerate progress against malaria and end it by 2030.

Scope of work:

Below is the Scope of Work under this assignment:

• The consultant is expected to undertake a desk review of the latest available evidence on countries faced with displacement, fragility and instability (COEs) and implications of this phenomena on delivery of HIV, TB and malaria programmes. The consultant must review applicable literature from peer-reviewed and published articles, normative evidence and guidance from leading technical organizations and policy and research think tanks, evaluations and reviews such as the Global Fund, technical organizations like the World Bank, WHO, UNHCR, etc. and other organizations such as the African Union. The consultant will be expected to share these resources for the ACB’s intranet which countries can access to further their work around COEs.
• An in-depth mapping of countries affected by displacement, fragility and instability in Africa detailing the key trends, the progress and gains being made to meet objectives against HIV, TB & malaria, what’s working and what’s not working, remaining gaps and bottlenecks, best practices, enablers and the opportunities for streamlining HIV, TB and malaria programming in these regions;
• Identify key global and African commitments relevant to displacement, fragility and instability;
• Identify, review, analyze and compare applicable policies (similar to the Global Fund’s COE policy) from relevant organizations working in environments fraught with displacement, fragility and instability;
• Where possible, the consultant shall be expected to interview and engage with key stakeholders to probe for, and validate, research findings. This shall include participating in the planned Constituency engagement sessions being organized by the ACB to identify the continent’s priority health issues and interventions, as part of a process to provide input to the next strategy for the Global Fund; and
• Make evidence-informed recommendations on how Africa can maximize investments towards ending Malaria, TB and AIDS in regions affected by displacement, fragility and instability. The recommendations must address strategies, gaps, opportunities, enablers and actions needed to be taken by the Global Fund in its post-2022 strategy to streamline implementation of HIV, TB and malaria programs.

Deliverables:

• Under this assignment, the consultant is expected to deliver the following deliverables:
• Provide an inception report detaining how the work will be conducted. This should be provided one week after signing the contract.
• A draft report detailing priority issues identified as strategic to Africa towards the next Global Fund strategy, the key findings and recommendations in word format.
• A final report, no more than 50 pages[1], and making use of annexes, detailing the key findings, including:
• A 3-paged Executive Summary of the research providing a synopsis of the key findings and recommendations;
• Document some best practices globally and in Africa in particular
•  Recommendations relevant for African countries towards integrating climate change and environment thinking as part of efforts to end the three epidemics by 2030. The recommendations
• A PowerPoint presentation detailing the key findings and recommendations of the desk review.

Terms of the appointment:

The successful consultant will be expected to complete this assignment within 30 calendar days and should be willing and available to participate in a dissemination meeting with various stakeholders, including countries, technical partners and funders.

Qualifications:

• An advanced university degree in health policy, public policy, public health, climate change, environmental health, epidemiology, social sciences, or infectious diseases.
• A PhD in a relevant field will be an added advantage.

Experience:

• Preferred: a climate change and health subject matter expert with a minimum of 10 years of relevant experience, including program design and implementation, research and policy development in Africa.
• Experience with undertaking evaluations of climate change and environment and/or health programs in Africa;
• Proven experience in conducting qualitative assessments including policy analysis;
• Experience with publishing peer-reviewed scholarly articles, including on various aspects of climate change and health;
• Experience with disseminating research findings and making conference presentations with relevant stakeholders; and
• Good presentation skills.