
Titre
Strengthening health systems
Help build sustainable health systems
Complementing Global Fund investments, L’Initiative supports health systems strengthening (HSS) to build sustainable systems and provide quality health services to all. Through its work, L’Initiative improves the response of its partner countries in the fight against pandemics by mobilizing high-level expertise and funding projects.
Health systems consist of all organisations, people and actions whose primary intention is to promote, restore, maintain and improve the health of populations. Health systems strengthening provides access to a comprehensive, structured and user-centred health care system. This comprehensive approach consists of acting simultaneously on the 6 essential pillars of health systems identified by the World Health Organisation:
- availability of care
- human health resources
- information systems
- medical products,vaccines and other technologies
- financing
- leadership and governance

The strong international support for the fight against HIV, tuberculosis and malaria since the early 2000s has helped save millions of lives and prevent millions of new infections. Nevertheless, health system weaknesses in some countries continue to challenge the sustainability, effectiveness and long-term impact of specific pandemic interventions. The Global Fund has therefore decided to invest in activities to help health systems overcome the obstacles that are slowing down progress in the fight against the three pandemics.
Over the years, HSS has become a fourth and complementary component of L’Initiative's action on HIV, tuberculosis and malaria: between 2011 and 2020, almost one in two technical assistance missions dealt with cross-cutting and structuring issues, and 42% of the projects funded concerned HSS.
We want to promote an integrated and cross-cutting approach to the three pandemics that is articulated at different levels of the health pyramid, from national strategies to actions at regional and local levels in communities.
With this in mind, since 2016, a call for projects has focused specifically on strengthening health systems at all levels (community and national). This variation of the same theme over several years makes it possible to better anticipate the development of projects by applicants, to facilitate the funding of complementary initiatives from year to year, while developing synergies between projects.
Thus, the 2020 call for projects made it possible to select programs to continue and consolidate the work already carried out by the French Red Cross in the Central African Republic on strengthening the supply management system and stocks of medicines and health products, and by the French NGO Santé Diabète in Burkina Faso and Mali, to continue the integration of prevention and co-management of diabetes/tuberculosis and diabetes/HIV.

Expertise France, and its German and British counterparts, GIZ/BACKUP Health and the British Foreign, Commonwealth & Development Office, as well as the Global Fund have developed a joint initiative to strengthen health systems.
The objective: to enhance the impact of the Global Fund’s investments in the fight against HIV, tuberculosis, and malaria, and to contribute to structuring care services by providing technical, programmatic, and operational capacity building to the people working in the health systems of our partner countries. Training sessions will be implemented with African universities to form a task force dedicated to the issue of health system strengthening for the Global Fund’s next cycle.