Preparations for sustainability and transition from Global Fund support in the Eastern Mediterranean Region

Background: HIV, tuberculosis and malaria (HTM) services receive financial support from the Global Fund and need to plan for sustainability and transition from external funding. Aim: To recommend actions for addressing key sustainability and transition issues in 15 countries receiving Global Fund grants in the WHO Eastern Mediterranean (EMR) Region. Methods: We reviewed documents, interviewed key informants, and conducted case studies in Sudan and Tunisia to highlight key considerations for sustainability and transition from Global Fund that is tailored to the EMR and the health system building blocks. Sustainability considerations should align with the health system building blocks, including governance, financing, service delivery, workforce and health product management, with the addition of considerations for key and vulnerable populations because of their particular importance for HIV and tuberculosis services. Conclusion: While hoping for economic growth and reduction of the burden of HTM, EMR countries need to prepare for transition from Global Fund support. Proactive steps that are tailored to the health system building blocks and address the needs of key and vulnerable populations should progressively increase national capabilities as well as resources dedicated to HTM.