Atupele Muluzi on Global Financing Facility: ‘New financial input to Malawi health system’

I have just returned from a series of critical meetings in Oslo, Norway.  I was one of a handful of senior ministers and Heads of State that were invited to partake in discussions around the Global Financing Facility (GFF).  The Global Financing Facility is supported by a number of strategic organisations to include the Global Fund, the World Bank, GAVI among others. This in support of Every Woman Every Child is helping governments in low and lower middle incomecountries transform how they prioritize and finance the health and nutrition of their people. This will contribute to saving up to 35 million lives by 2030, and greatly improve people’s and countries’ abilities to thrive in the global economy.

Malawi has recently been accepted to join just 27 other nations with additional financial support for key interventions within our health sector.  This is in recognition for some of the new policies and programmes that we have introduced over the last 18 months, and our leadership to making turning policies into action.

The meeting was attended by some very senior leaders from many of our key international development partners. I was able to enjoy direct discussions with Mrs Melinda Gates of the Bill and Melinda Gates Foundation, with Norway’s Prime Minister Mrs Erna Stolberg and Mrs Kristalina Georgieva the CEO of the World Bank. These meetings were not simply gesturing or for a good photo.  The discussions were vital to building consensus and support for continued investment into our health sector.

Our focus on seeking to do more with what we already have, has attracted real attention.  The priorities we have been highlighting over the last 12 months, match entirely with the focus of the GFF.  As we seek to align all of our development partners, whether it be through streamlining the medical supply chain, or it is developing more comprehensive plans that all our partners can work within.  If we can reduce the management overhead required to support unilateral programmes by demonstrating a more robust and honest Malawian management system, then we can free up resources to spend on more medical drugs, more staff or more infrastructure.

Then there is a need to accelerate how programmes that will improve the delivery of healthcare. Our new e-health and power for health programmes were seen as transformative and match the aspirations of the GFF entirely.  The work we have been doing with the UN Development Programme on Power to Health means we now have a robust survey on the current situation regarding power across our health facilities.

It must be understood that while we must accept that we face some real challenges with national power generation and distribution, there is a need to try and ensure our health facilities as self sustaining as possible.  Over the last five years or so, our development partners have delivered hundreds of Solar (PV) systems for our health facilities, indeed we are in the process of installing 85 systems through the support of the Global Fund.

However, as with many countries in the region, we lack the expertise to properly install, operate and maintain these systems.  The result is that many of these systems are no longer serviceable, meaning that our health facilities then again struggle without sustainable power.  Our priority is to now develop an effective and capable structure within the Ministry of Health that can work with our development partners to deliver, install, operate and maintain reliable and sustainable power for all health facilities.

For some time now the Bill and Melinda Gates Foundation have supported a project to try and improve the management of health data.  This project has faced a number of challenges, but Malawi must now move to the 21st century.  If we can standardise all patient records and digitise them, then we can start to pull together accurate data on the health challenges that Malawi is facing, where and how serious the problem is.  In turn this will mean we can then prioritise spending on the biggest issues, and reduce wastage, again to free up funds for more medical drugs, more staff and more infrastructure.

Finally, we are seeking to increase our investment and capacity in prevention based activities and specifically in behaviour change. As we all know, prevention is better than cure, however, humans are funny things, very irrational.  We all know that smoking tobacco is bad for us, indeed it kills, but globally millions still smoke every day.  If we can all take more responsibility for our own health and that of our families, we will free up resources to treat serious issues such as cancer.   We are not going to get everyone to change overnight, but we have to start somewhere, particularly as our population continues to grow and the scale of the challenge grows with it.

These are all Malawi driven initiatives and they have attracted real support internationally.  We have seen this recognition with the recent appointment of His Excellency, the President as the Global Fund’s champion for the 6th replenishment round; as well as invitations to meetings such as this recent trip to Norway.  This recognition is not of the President or I as individuals, but of us all.

We must now make the most of the support that we are receiving and ensure that we don’t waste the opportunity it affords us to improve the health of Malawi for a generation.

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