The Global Financing Facility (GFF) launched its new 2026-2030 strategy ‘Transform 2030: Transforming Health Systems, Saving Lives‘ during the Universal Health Coverage (UHC) High-Level Forum on December 6th in Tokyo. The strategy had been unanimously endorsed by the GFF’s governing bodies last month in Dakar. Going through the final strategy, we notice that the GFF did take into account some of the points we raised during the process, but that some of the more structural asks are still only partially reflected.
Back in October, we welcomed the publication of the draft GFF Strategy 2026–2030 and encouraged civil society, youth and country actors to use the consultation as an opportunity to strengthen it. We highlighted five areas where the GFF could be more ambitious:
- Intersectionality and inclusivity
- Domestic resource mobilization with a political economy lens
- Equity safeguards for private sector engagement
- Regional production of medical products and tech transfer for resilient supply, and
- Sustained funding for civil society and sexual and reproductive health and rights (SRHR) advocacy.
Three strong points in the strategy
Now, let’s see what the GFF has strengthened. We identify three positive elements:
1. Hard numbers on services
Where the consultation draft still had placeholders, the final strategy now names the population to be reached and quantifies five core services. That’s positive for accountability because it tells us what we can expect from the GFF in terms of results and what we can keep them accountable to.
2. SRHR maintains key role
One of our concerns was always that, in a tense global context, SRHR could quietly be diluted. We are glad to see it wasn’t. SRHR plays a key role in the strategy, and it stays linked to gender and equity — which we welcomed in our first blog as well.
3. Country ownership and alignment stay central
The final strategy maintains the approach we liked earlier: to align with national plans, get financing on budget, and build on the “one plan – one budget – one report” spirit even if it’s not always named as such. That is consistent with what we called for. Moreover, after piloting it, the new strategy makes the Joint Financing Framework a standard mechanism available to all GFF-eligible countries, which can greatly improve alignment of donor contributions and enable external financing to flow though government channels.
Missed opportunities
However, in some instances, the text moved sideways, not forward:
1. Rights language was smoothed
In the consultation draft, the GFF said quite straightforwardly that it would promote legal and policy reforms for SRHR. In the final version, the wording is more diplomatic — supporting countries to create an “enabling environment.” Although not bad, it is one step further away from backing frontline SRHR advocates in hostile contexts, like we recommended. Our October recommendation was: “Provide sustained, long-term funding for civil society and youth engagement at country level and to support SRHR advocacy.” Although increased funding is there, it is only for two years. And we miss the support for SRHR advocacy beyond funding: the necessary legal and policy reforms.
2. Intersectionality still isn’t explicit
In our October blog we said that it is positive that the GFF is talking about equity, but it should name intersectionality and work with more granular, overlapping identities and vulnerabilities, such as gender, geography, disability, age, and marginalization. The final strategy still mostly talks about “those furthest behind” and “high-burden/fragile, conflict-affected and vulnerable settings” — which is good, but does not grasp the full concept.
3. Domestic resource mobilization remains mostly technocratic
We argued that, in a world of shrinking aid and rising debt, you can’t stop at public financial management fixes. As one of the largest global health initiatives, the GFF should also use its platform to speak about tax justice, progressive taxation and debt relief, together with other global health actors. The final version of the strategy emphasizes the importance of domestic resource mobilization, but does not add that bolder political-economy language. This is a missed opportunity, because without those levers, countries will struggle to finance the very public healthcare and SRHR reforms the strategy aspires.
4. Private sector guardrails still thin
We welcomed the more cautious stance on blended finance in the draft strategy in October — especially after critical findings around the Africa Medical Equipment Facility (AMEF) and its weak link to Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition (RMNCAH-N). We asked the GFF to “establish equity criteria for private sector engagement.” The final strategy does not spell out those criteria. Therefore, although the tone on private sector is less prominent than in the past, the accountability architecture we asked for is still to be built. To unpack a bit further:
- The basic framing did not change: governments should become better stewards of a mixed system (public and private funding) because around 40% of women in low-and middle-income counties use private providers for RMNCAH-N.
- The core operational line also remains: the GFF will integrate private providers into public financing schemes and use/advance strategic purchasing so that contracting and procurement can include private actors.
- The final version tweaks one sentence from “design systems aligned with national equity goals” to “help to ensure that their services are aligned with national equity goals.” That’s a very small, service-level, country-led rephrase — not a new safeguard.
- The strategy even adds a forward-looking element about “identifying other opportunities to harness private sector expertise, innovations, and capital,” which slightly widens the door.
What is still missing is what we and others asked for: clear, spelled-out equity and affordability conditions for private/blended arrangements, and some reflection of lessons from weaker blended-finance cases. So, the GFF kept the direction (public stewardship of private delivery) but did not hard-wire the accountability architecture.
5. Regional manufacturing and tech transfer still at the margins
We suggested that if we want resilient, sovereign health systems, the GFF must consider local/regional production and tech transfer — not only better procurement and supply chains. The final strategy stays closer to the latter. That means progress on commodities, including with the new Sustainable Commodity Access Challenge programme, but not yet the systemic shift we proposed. The GFF seems to prefer to leave this area of work with organizations that have expertise on this topic, like Gavi, rather than spreading their own efforts too thin.
Good goals need strong enablers
For strategies to succeed, good goals are not enough; we also need strong enablers. The goals of the GFF’s new strategy are good — public healthcare, SRHR, equity. However, without stronger language on rights, a bolder approach to domestic resources, and clearer safeguards around private actors, there’s a real risk that countries and their partners will expect civil society, youth and women’s rights organizations to “carry” the harder parts — advocacy, accountability, reaching marginalized groups — without matching support or space to do it, given the shrinking funding and civic space. And because 2030 is the end of the SDG era, this strategy is effectively the last GFF cycle that can still move the needle on those promises. That’s why we keep pushing: not to complicate the strategy, but to make sure the people it names can actually benefit from it.
What we’ll be watching for next
1. The results framework
The strategy says this framework will be finalized and endorsed in spring 2026. Intersectional equity indicators, SRHR advocacy support, and CSO participation metrics, can still be anchored here.
2. The Joint Financing Framework
As the Joint Financing Framework scales beyond the 2024 pilot, we will be watching whether it turns its promise for aligned, on-budget financing with lower transaction costs into measurable public healthcare and SRHR gains at country level.
3. Alignment and coordination
We aim to monitor that through the new strategy, the GFF improves alignment and coordination at country and global level, following the recommended strategic shifts of the Lusaka Agenda and the Accra Compact.
4. Sustainable financing for civil society
The GFF has committed USD 18 million for civil society participation for the next two years, with already two global consortia selected to facilitate civil society engagement through the GFF X CIVIC Platform. This is an important step, but it’s time-bound. We’ll need to see whether this becomes a stable, multi-year mechanism that CSOs can plan around, especially for SRHR and accountability work that requires continuity.
To conclude, the GFF realized the expected “tightening” between consultation and finalization of the strategy. It contains clearer targets, a cleaner structure, and the same equity/SRHR backbone. However, most of the civil society asks we set out in October — explicit intersectionality, integrating political economy into domestic resource mobilization, stronger private-sector safeguards, local production, and sustained SRHR advocacy funding — still need to be hard-wired into the instruments that come after the strategy. So, that is what we will be monitoring and acting on next. We are looking forward to seeing the positive impact that the new GFF strategy can bring to the lives of millions of women, girls and adolescents across the world.
