GLOBAL: Falling foul of the fund

Photo: Global Fund

The Global Fund supports 2.3 million people on life-prolonging antiretroviral drugs

NAIROBI, 11 November 2009 (PlusNews) - Programmes supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria reported 2.3 million people on life-prolonging antiretroviral (ARV) drugs in June 2009. Funding to beneficiary countries is based on performance, and failure to meet targets can lead to delays, suspension, discontinuation or termination of grants.

In November 2008, IRIN/PlusNews brought you a list of some of the countries that have fallen foul of the Fund's strict accounting procedures; here is an updated version.

Kenya - In November 2009 the Global fund's technical review panel - an independent team of health and development experts - recommended that the Global Fund Board reject a bid for $270 million in Round 9 of funding. The chair of Kenya's CCM said the main reason given was poor coordination between the country's two health ministries.

The government has experienced difficulties with its Global Fund proposals in the past. In 2008 the Global Fund rejected Kenya's application for $300 million in Round 8, and $37 million was delayed in 2003 after claims of corruption in the National AIDS Control Council.

Mauritania - In September 2009 the Global Fund suspended support to the Executive Secretariat of the National AIDS Committee after finding evidence of fraudulent and unjustified expenditures. The Fund demanded the reimbursement of US$1.7 million within three months, and immediate removal of the people identified as responsible.

The new government, named in September after presidential elections in June, began proceedings against four National AIDS Committee members suspected of embezzlement. The State has promised to return the $1.7 million and account for a further $2 million whose use was questioned, and has committed to re-structuring the Country Coordinating Mechanism (CCM), Mauritania's funding management body; CCM weakness is seen as contributing to the problems.

Philippines - In September 2009 the Global Fund suspended all five of its grants to the Tropical Disease Foundation (TDF) - the principal recipient - after an investigation by the Office of the Inspector General found that around $1 million of $85 million in total disbursements were unauthorized expenditure. The Global Fund has demanded repayment and will transfer the TDF's grants to a new principal recipient.

Zimbabwe - in 2009 the Global Fund decided to bypass the National AIDS Council as the principal recipient of existing and future grants, choosing to channel money through the United Nations Development Programme and paving the way for the country to receive a grant of $37.9 million in August.

Zimbabwe has had a turbulent relationship with the Global Fund; several proposals have been rejected and the government has frequently accused the Geneva-based agency of political bias, which the Fund denies.

Chad - In 2006 the Global Fund suspended support after an audit uncovered misuse of funds and a lack of satisfactory capacity in the principal recipient and sub-recipients to manage the Fund's resources. The suspension was lifted in 2007 after a series of investigations and commitments from stakeholders to put better systems in place.

Nigeria - In 2006 the Fund decided to discontinue its Round 1 support for HIV/AIDS programmes, but awarded other HIV/AIDS grants in Round 5.

Myanmar - In 2005 the global Fund terminated grants worth $98.4 million after the government imposed temporary restrictions on travel and new procedures for reviewing the procurement of medical and other supplies. The Fund said at the time that the restrictions "prevented implementation of performance-based and time-bound programs in the country".

Senegal - In 2005 the Fund cut malaria grants worth $7.1 million over systemic issues that resulted in poor performance. A grant proposal for malaria projects submitted in Round 4 was later approved.

South Africa - In 2005 the Global Fund Board stopped funding for an HIV prevention programme. The Board decided that the grant, received by an NGO named loveLife, had failed to "sufficiently address weaknesses in its implementation".

Uganda - In 2005 the Global Fund temporarily suspended all five of its grants after a review by accounting firm PricewaterhouseCoopers found "serious mismanagement" of one of the grants by the Project Management Unit in the Ministry of Health.

The grants were worth $201 million over two years, of which $45.4 million had been disbursed. The health minister and his two deputies lost their positions and are standing trial with several other government officials for the misuse of Global Fund money.

Ukraine - In 2004 the Global Fund temporarily withdrew grants worth $92 million citing "management issues". The grants were reinstated six weeks later, when a new principal recipient, the International HIV/AIDS Alliance, was put in place.

Pakistan - In 2002 the Fund discontinued support for Pakistan's malaria projects because of weak project implementation, slow procurement of health products, poor data quality, and slow spending of project funds; according to reports, only 15 percent of insecticide treated bed nets were distributed during the grant period.

Several other countries, including Bolivia, East Timor, Namibia, Sierra Leone, Tanzania and Togo, have also had funding proposals rejected, or have had funding withdrawn. Countries can appeal a grant decision when a proposal has been rejected in two consecutive rounds.

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