Robert Filipp is Head of Innovative Financing at the Global Fund.
The Australian Government’s recent decision to implement a Debt2Health swap with Indonesia will permit Jakarta to invest considerably more resources into fighting tuberculosis – one of the most serious health issues currently confronted by Indonesians throughout the archipelago.
Strengthening healthcare systems in Indonesia is both a noble cause and good foreign policy. As infectious diseases continue to hinder the development prospects of millions of Indonesians, establishing more effective prevention and treatment procedures is fundamental to improving the lives of one of Australia’s closest neighbours.
Moreover, as the swine flu pandemic has shown, halting the spread of infectious diseases in one community can help insulate other communities from harm. Given Australia’s proximity to Indonesia, and the free flow people between the two countries, the Government’s initiative makes good geostrategic sense.
How can Australian taxpayers be sure that the money from the debt swap will be well spent in Indonesia?
First, the debt swap will be implemented and overseen by the Global Fund to Fight AIDS, Tuberculosis and Malaria, an international financing institution with an excellent track record in health policy and an equally strong reputation for combating corruption. Since its establishment in 2002, the Global Fund has helped detect and treat 4.6 million cases of tuberculosis worldwide, placed more than 2 million AIDS patients on ARV treatment, distributed more than 70 million bed nets to prevent against malaria, and made enormous inroads in educating communities about the dangers posed by these three diseases.
Second, the Global Fund works on a very strict performance-based funding system, where funding continues to flow to recipients only as long as agreed targets are reached. Equally important is the governance and decision-making structure both at the Board and Country levels. For each recipient, a Country Coordinating Mechanism (CCM) manages the funds and oversees targets, and is held accountable to the Global Fund. The CCMs are composed of all sectors of society: from civil society and the private sector, to government officials and communities living with the diseases. This innovative and broad-based approach to health policy governance is certainly not straightforward, but provides the best structure to guarantee transparency which, in turn, is critical in achieving excellent results.
Finally, the Indonesian Government should be congratulated for consenting to a debt swap that would be implemented under the auspices of the Global Fund. This is a testament to a new way of thinking among the progressive individuals in government who recognise that participation and democracy are the only ways forward when tackling large issues such as health.
