BACKUP Health - implementing global health financing

Project description

Title: BACKUP Health - advising partners in the implementation of global health financing
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Countries: Global
Lead executing agency in selected focus countries:

  • Ministère de la Santé Publique (Ministry of Public Health), Cameroon
  • Ministry of Health of the Kyrgyz Republic, Kyrgyzstan
  • Ministry of Health and Population, Malawi
  • Federal Ministry of Budget and National Planning, Nigeria

In other countries, BACKUP provides demand-oriented, flexible support without executing agencies.
Overall term: 2020 to 2023


HIV, tuberculosis and malaria cause several million deaths each year and are responsible for a high burden of disease in many countries around the world. In 2002, the international community founded the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM). In addition to preventing and treating these three diseases, it strengthens health systems, human rights and gender equality.

GFATM resources and those of other financing mechanisms, such as the Global Alliance for Vaccines and Immunisation (GAVI) and the Global Financing Facility for Women, Children and Adolescents (GFF), have enabled recipient countries around the world to improve and expand their health services over recent years.


State and civil society organisations in selected countries are able to make efficient use of the resources provided by global financing mechanisms in the area of health.


BACKUP supports state and civil society organisations in making efficient use of the resources provided by global financing mechanisms (GFATM, GAVI and GFF) to support their national health systems. This boosts the effectiveness and sustainability of the measures receiving financial support. Since 2021, the project has also been supporting Providing for Health (P4H), a network dedicated to health financing.

The objectives of the project are:

1. To improve national coordination of global health financing:
The objective is that management (planning and implementation) of globally financed programmes is coordinated nationally and based on national strategies.

2. To support the institutions of national health systems:
Selected institutions in partner countries are supported in making use of their scope to influence global financing and to strengthen their national health systems. This may include developing and enhancing both HR and organisational skills.

3. To develop management of community-based health services at decentralised level:
This includes, for example, analysing existing models of community-based health services and incorporation of the results in a model for integrated management of health services.

4. To mitigate the risks that the COVID-19 pandemic poses for GFATM programmes and national health systems:
BACKUP provides technical support for reprogramming of GFATM grants, coordinating the COVID-19 response with other health sector processes and conducting risk assessments.

5. To support sustainable, resilient and equitable health financing:
The P4H network assists countries in reforming their national health financing and effectively integrating external sources of funding.

On behalf of the German Federal Ministry for Economic Cooperation and Development (BMZ), BACKUP has selected four focus countries with personnel in country: Cameroon, Kyrgyzstan, Malawi and Nigeria. Further countries are eligible to apply for demand-based support. In the context of cofinancing by the UK’s Foreign, Commonwealth & Development Office (FCDO), BACKUP has selected six additional focus countries with personnel working in country: Democratic Republic of Congo, Mozambique, Nigeria, Zimbabwe, Tanzania and Uganda. The Swiss Agency for Development and Cooperation (SDC) has been cofinancing BACKUP since 2013. The focus countries of the SDC are Ethiopia, Niger and Tanzania (without personnel working in country). Since 2021, BACKUP has been receiving additional funding from the French agency Expertise France for training to strengthen national health systems. P4H covers six focus countries with local personnel. Cambodia, Cameroon and Tanzania were selected on behalf of BMZ. Chad and Mozambique were selected for SDC cofinancing.


From 2002 to 2020, BACKUP supported governmental and civil society partners in around 90 countries with over 600 measures to implement GFATM programmes more effectively. The following case studies illustrate the work and impact of BACKUP. In 2019, BACKUP supported partners in 26 countries in the implementation of programmes financed by the Global Fund.

Cooperation with international non-governmental organisations, such as Aidspan and Frontline AIDS, has helped to improve the capacity of grant recipients to manage risk and prevent the misuse of funds. A country study by Aidspan investigated the opportunities for better integrating national audit institutions into the evaluation of Global Fund country programmes and organised a round-table forum in which the supreme audit institutions were able to share their knowledge. The audit institutions of Ghana, Kenya and Rwanda are now conducting independent financial audits of Global Fund programmes. In cooperation with the International Planned Parenthood Federation, analyses of the situation regarding integration of mother-and-child health, adolescent health and HIV have been carried out in Cameroon, Guinea, Malawi and Togo, with the objective of promoting demand-oriented health services.

BACKUP contributes to the implementation of programmes to boost the participation of civil society and promote human rights and gender equality in the health sector. In Burkina Faso, Cameroon and Malawi, BACKUP has supported the participation of population groups with particular health needs, including sexual minorities and serving prisoners, in Global Fund processes at country level.

Last update: March 2021

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