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Pushing the envelope through the Global Financing Facility: potential impact of mobilising additional support to scale-up life-saving interventions for women, children and adolescents in 50 high-burden countries
  1. Victoria B Chou1,
  2. Oliver Bubb-Humfryes2,
  3. Rachel Sanders3,
  4. Neff Walker1,
  5. John Stover3,
  6. Tom Cochrane2,
  7. Angela Stegmuller1,
  8. Sophia Magalona4,
  9. Christian Von Drehle2,
  10. Damian G Walker4,
  11. Maria Eugenia Bonilla-Chacin5,
  12. Kimberly Rachel Boer5
  1. 1 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  2. 2 Cambridge Economic Policy Associates, London, UK
  3. 3 Avenir Health, Glastonbury, Connecticut, USA
  4. 4 Bill & Melinda Gates Foundation, Seattle, Washington, USA
  5. 5 Global Financing Facility/World Bank, Washington, District of Columbia, USA
  1. Correspondence to Dr Kimberly Rachel Boer; kboer{at}


Introduction The Global Financing Facility (GFF) was launched to accelerate progress towards the Sustainable Development Goals (SDGs) through scaled and sustainable financing for Reproductive, Maternal, Newborn, Child and Adolescent Health and Nutrition (RMNCAH-N) outcomes. Our objective was to estimate the potential impact of increased resources available to improve RMNCAH-N outcomes, from expanding and scaling up GFF support in 50 high-burden countries.

Methods The potential impact of GFF was estimated for the period 2017–2030. First, two scenarios were constructed to reflect conservative and ambitious assumptions around resources that could be mobilised by the GFF model, based on GFF Trust Fund resources of US$2.6  billion. Next, GFF impact was estimated by scaling up coverage of prioritised RMNCAH-N interventions under these resource scenarios. Resource availability was projected using an Excel-based model and health impacts and costs were estimated using the Lives Saved Tool (V.5.69 b9).

Results We estimate that the GFF partnership could collectively mobilise US$50–75  billion of additional funds for expanding delivery of life-saving health and nutrition interventions to reach coverage of at least 70% for most interventions by 2030. This could avert 34.7  million deaths—including preventable deaths of mothers, newborns, children and stillbirths—compared with flatlined coverage, or 12.4  million deaths compared with continuation of historic trends. Under-five and neonatal mortality rates are estimated to decrease by 35% and 34%, respectively, and stillbirths by 33%.

Conclusion The GFF partnership through country- contextualised prioritisation and innovative financing could go a long way in increasing spending on RMNCAH-N and closing the existing resource gap. Although not all countries will reach the SDGs by relying on gains from the GFF platform alone, the GFF provides countries with an opportunity to significantly improve RMNCAH-N outcomes through achievable, well-directed changes in resource allocation.

  • child health
  • health systems
  • maternal health
  • nutrition
  • public health
  • health financing
  • low- and middle-income countries
  • global health

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Handling editor Seye Abimbola

  • Contributors KRB and MEBC conceptualised the study. The resource modelling was done by OBH, CVD and TC. The Lives Saved Tool analysis was done by VBC, AS and NW. RS and JS analysed the costing outputs. KRB, MEBC, DGW and SM contributed to inputs and assumptions for the modelling as well as interpretation of the data. All authors contributed to drafting the manuscript and all authors reviewed and approved the final version before submission.

  • Funding This work was supported by the Global Financing Facility.

  • Competing interests MEBC and KRB are employees of the Global Financing Facility, and DGW and SM work for the Bill & Melinda Gates Foundation, an investor in the GFF.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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