Addressed to the Ministers of Health of Central African region and the Country Coordinating Mechanisms, the ACB Secretariat and the Global Fund Secretariat.
Introduction
In a context of shrinking international funding and increasing requirements for accountability and sustainability, Central African countries reaffirm their commitment to strengthening health sovereignty and the sustainable management of Global Fund grants.
Gathered in Bangui on 13–14 November 2025 during the Cluster-Based Learning Network (CBLN) organized by the African Constituency Bureau for the Global Fund(ACB), representatives of governments, CCMs, civil society and technical partners identified regional priorities, recent progress and key levers for strengthened governance and improved preparation for GC8.
- Key messages from the regional dialogue
1.1. National ownership and progressive exit from the ASP
Participants noted that although the Additional Safeguard Policy (ASP) can be useful in high‑risk contexts, it limits government visibility and slows the strengthening of national systems.
A strong consensus emerged to initiate a progressive transition out of the ASP towards national, transparent management aligned with international standards.
1.2. Inspiring advances
– Chad: transformation of the Program Management Unit into a national Principal Recipient.
– Central African Republic: strengthened CCM and establishment of the UGPPS to improve fiduciary governance.
– Gabon: domestic funding exceeding Global Fund allocation.
– Côte d’Ivoire & Togo: successful exit from the ASP and removal of the fiscal agent.
- Domestic financing and tax exemptions
Countries reaffirmed the urgent need to strengthen national health financing, secure predictable and harmonized exemption mechanisms, and recognize CEMAC taxes as co‑financing.
Chad’s Exemption Committee mechanism was highlighted as a regional model.
- Strategic recommendations to Ministers of Health
3.1. For exiting the ASP
– Personally steer ASP exit roadmaps.
– Strengthen national capacities.
– Promote orthodox, rules‑based financial management.
– Ensure a functional and credible CCM.
3.2. For financial sustainability
– Increase national health budgets.
– Mobilize additional domestic resources.
– Document and showcase performance.
3.3. For GC8 readiness
– Clearly define national priorities.
– Support civil society engagement.
– Request targeted technical assistance where needed.
- Expectations of the ACB Secretariat
– Sustain peer‑learning mechanisms.
– Provide political support to Ministers and technical guidance.
Countries commit to supporting the ACB in the execution of its mandate.
- Message to Global Fund Country Teams
Align support with national priorities, strengthen domestic resource mobilization,
urgently promote increased use of national systems, and adapt requirements to the realities of the region.
- Conclusion
Participants call on Ministers to institutionalize this regional dialogue and promote orthodox, transparent and sustainable grant management.
They also call on the Global Fund to intensify its support for strengthening national systems and to adapt its engagement to the specific realities and context of the Central African region.
