The government of Senegal and the Global Fund recently concluded a high-level regional meeting aimed at aligning health financing with national public financial management (PFM) systems across Francophone Africa. Over four days, representatives from finance and health ministries, supreme audit institutions, and civil society from 15 countries worked on improving the transparency, effectiveness, and sustainability of investments in the health sector. The meeting addressed critical challenges, including limited national budgets, declining external funding, increasing social pressures on public finances, and the need to strengthen financial sovereignty.
The Global Fund uses its PFM strategy to ensure that countries retain gains in health outcomes, save lives, and strengthen national sovereignty. Effective PFM enables better planning, execution, and control of health spending while preparing countries for sustainable domestic financing. Since its inception, the Global Fund has supported the transition of 52 disease components in 38 countries, with the current cycle involving 12 components in eight countries—the largest transition to date. As 72% of its investments are in sub-Saharan Africa, the Fund focuses on increasing institutional capacity, promoting financial governance, and supporting the transition to fully country-led, resilient health systems.
Adda Faye, Chief Financial Officer of the Global Fund, emphasized that integrating external funding into national systems is crucial for building trust between governments and partners and ensuring sustainable impacts. Countries in the subregion are increasingly combining public resources, private capital, and partner funding to strengthen health systems and align them with national priorities. Senegal highlighted its progress in program-based budgeting, digitalizing public spending, and improving coordination between the finance and health ministries as well as audit institutions. Gorgui Fall, Chief of Staff at Senegal’s Ministry of Economy, Planning, and Cooperation, noted that the meeting renewed dialogue to ensure strategic and credible use of public resources.
Several countries showcased significant progress toward integrating external funding into national systems. Benin highlighted reforms in its PFM system that facilitate better integration of partner funding, while Burkina Faso, Côte d’Ivoire, and Mali focused on digitizing expenditures, strengthening audits, and including Global Fund support in national budgets. Chad, Madagascar, and Togo discussed challenges related to fragmented financial flows and disbursement predictability and shared initiatives such as decentralizing authorizations, enhancing audits, and using public financial information systems to improve consistency and reduce parallel mechanisms.
Supreme audit institutions emphasized reforms in public auditing, including digitizing procedures, adopting international standards, and improving report quality. They highlighted their central role in financial accountability, particularly given the significant reliance on external health funding. Senegal’s Minister of Health, Dr. Ibrahima Sy, stressed that sustaining health progress requires strong, transparent, and accountable national systems, and integrating external support gradually is key to asserting health sovereignty and ensuring quality services for all citizens.
At the conclusion of the meeting, delegations adopted national roadmaps to gradually integrate Global Fund financing into national budgets, strengthen audit and transparency mechanisms, and accelerate digitization of budget and health information systems. Participants emphasized proactive risk management, timely publication of audit reports, and accountability for implementing recommendations. Adda Faye concluded that the collective effort embodies shared responsibility, with every investment translating into measurable and sustainable impacts for populations, reinforcing the principle of building robust systems for Africa, in Africa, and with Africa.
