Falling foul of the Global Fund

Funding to beneficiary countries is based on performance, and failure to meet targets can lead to delays, suspension, discontinuation or termination of grants. Below is a list prepared by IRIN/PlusNews of some of the countries — including Zimbabwe — that have fallen foul of the Fund’s strict accounting procedures: 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.

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.

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. 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”. 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. Several other countries, including Bolivia, East Timor, Namibia, Sierra Leone, Tanzania, Togo, South Africa, Senegal, Pakistan and Ukraine 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.