Global Fund pulls grants from mismanaging countries

Due to the mismanagement and theft of earlier grants, the Global Fund to Fight Malaria, Tuberculosis and HIV/AIDS (GF) has rejected grant applications from a number of African countries, including some that are among the worst hit by HIV/AIDS.

Affected countries, including Kenya, Uganda, Togo, Zimbabwe, Namibia and Tanzania, say the grant freeze will badly affect their HIV/AIDS control programs. Since its inception in 2001, the GF has helped provide antiretroviral treatment to 600 000 HIV/AIDS patients; the new financing over 5 years will support about 200 000.

The GF, a partnership among governments, civil society, the private sector and affected communities to support health-related initiatives, was unable to provide figures on how many people will be affected by the new rules.

GF guidelines stipulate that a country can appeal a grant decision when the same proposal has been rejected in 2 consecutive rounds, and only when the appeal is based on a significant and obvious error made by the technical review panel.

Rosie Vanek, a spokesperson for GF, told CMAJ that they were strengthening management of the grants and the GF Secretariat. This will include improving harmonization with partners to avoid overlap and improved technical support.

The GF's performance-based grant funding model features a number of mechanisms to ensure accountability, including effective use of the funds to meet the recipient's targets with respect to combating disease, and ensuring that funds are used in a transparent and legitimate manner.

“As in the case of the suspension of grants to Uganda in 2005, GF takes any indication of misuse of funds very seriously,” Vanek says.

Togolese authorities say 24 000 people in need of antiretrovirals were desperate in January after the GF halted a US$15.5 million grant citing irregularities in management of the funding. “The Global Fund has said that it would not renew this grant because of the quality of the data provided,” says Rosine Coulibaly, head of the local UN office.

GF grants have also helped treat 1.4 million people with TB, and distributed 11.3 million insecticide-treated bed nets to prevent malaria.