Tropical Health Matters

Simbarashe Musiyiwa of The Herald of Harare, Zimbabwe focused on HIV/AIDS in critiquing the slow progress being made in accessing money for two rounds of Global Fund projects in the country. “The Global Fund for HIV/Aids, Tuberculosis and Malaria has been challenged to stop politicising HIV and Aids funding and distribute the amount due to Zimbabwe in time as is has done for other countries in the region. Since Zimbabwe’s standoff with London began at the turn of the millennium, the illegal Western sanctions have been used to have the fund either deny Zimbabwe assistance for flimsy reasons or allot it amounts far below what other African countries get.”

The recently completed Zambezi Expedition passed through Zimbabwe and noted that, “Ongoing economic difficulties are obstructing malaria control efforts in a country which had historically made much progress in the fight against the disease.”

In addition to HIV, Zimbabwe has two malaria grants from the Global Fund, and a review of the progress reports on the Round 1 and 5 grants is instructive.  The most recent progress report (October 2007) on the Round 1 Grant shows that 70% of the &8.5 million project has been disbursed. The grant currently has an overall rating of B1, which is quite good. Progress has been made on some indicators as seen in the attached chart.

Furthermore the Global Fund has praised the CCM of Zimbabwe. “The CCM in Zimbabwe is considered one of the model functioning oversight structures within the region and is supported by a Secretariat with a full-time Co-ordinator.” In addition the Principal Recipient (PR), the Ministry of Health, is said to be performing adequately. “Overall, the Principal Recipient has demonstrated satisfactory management of the Round 1 Malaria grant. Technical assistance provided by WHO including the assignment of experts to the Principal Recipient, has contributed to the efficient management and oversight of imported commodities.”

This does not mean that there are no problems. One of the biggest concerns is inflation. In fact hyperinflation with rates exceeding 1000% mean that once money is received and exchanged into local currency it quickly looses value unless spent in a relatively speedy and efficient manner – a challenge to PRs in any country. Fortunately the Global Fund has means of buying commodities directly if countries request in order to avoid inflationary effects.

Round 5 Malaria Grant did start late – in October 2007 – but 24% of $28.5 million has been disbursed as of May 2008.  At least for malaria, the picture of disbursement and utilization of funds to achieve targets may not be as dire as the Herald implies for HIV grants. The Herald does report that an auditing team from the Global Fund is due in Zimbabwe soon. Hopefully this team will ensure that the fight against malaria does not stop even amidst the political and economic turmoil in the country.

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