Freezing in Zambia

zambia-malaria-indicators-2008.jpgZambia was one of the first recipients of Global Fund support and since Round 1, it has received 3 HIV grants, 2 TB grants and 3 Malaria grants. The chart here shows that Zambia has performed fairly well on achieving Roll Back Malaria coverage indicators. In fact, though not yet reaching the 2010 targets of 80%, Zambia has been seen as one of the top performers in its efforts to control malaria as highlighted in a panel presentation at the recent Women Deliver Conference.

Therefore it comes as a surprise to read the press release from the Global Fund stating that, “Global Fund confirms freeze on cash disbursements to Zambia’s ministry of health, grants to be transferred to UNDP.” This decision was made in August 2009, though not announced until June 2010. The press release stated …

The freeze in disbursement came after Zambian authorities last year uncovered fraud within its own Ministry of Health. Further investigations by the Global Fund showed that the Ministry of Health was not able to safely manage grants. The organization has demanded the return of US$8 million in unspent funds from the Ministry of Health. The Global Fund has also demanded that Zambia takes action against individuals found to be involved in the unaccounted expenditures that led to the freezing of grant disbursements.

A news source reported that, “Money is still being paid to civil society organisations (CSOs).” As noted above the government component of the grant will be managed by UNDP for the meantime. Sarah Boseley of the Guardian points out threats to continued funding translates to more deaths from the three diseases. Furthermore, “The Global Fund is Zambia’s main donor to the health sector, and the suspension of aid will likely hinder the nation’s efforts to fight Aids, tuberculosis and malaria.”
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It is interesting to reflect on the Global Fund 2007 Progress Report which showed that 83% of CSOs as principle recipients of grants scored ‘A’ or ‘B1’ on their grant performance progress reports compared to 75% of grants managed by UNDP and 72% by government agencies. There has been overall improvement in performance in recent years, but the 2009 results reported this year still place CSOs ahead at 84% performing at ‘A’ or ‘B1’ level compared to 75% for governments and 79% for UNDP. Transferring Zambia’s support from government to UNDP is certainly not a long term solution to its problems.

There seemed to be some confusion about the suspension in Zambia. “Zambia’s Health Minister Kapembwa Simbao denied the suspension of funds and said there had been no indication from the organisation to halt donations,” even though the GFATM Board apparently made the decision official at an April 2010 Board meeting. Zambia’s efforts to fight corruption have been undermined when a former president was charged, though acquitted of corruption charges and the Netherlands suspended aid also because of alleged corruption.

Radio France International explained that, “The freeze became public when Aidspan, a group which works with the Global Fund, posted the decision on its website on Monday. The fund issued a statement two days later.” The GFATM is usually known for its transparency, and so the delay of the announcement about the Zambian funding freeze is almost as perplexing as the problem in Zambia itself.

Since GFATM money comes from taxpayers around the world, public accountability is expected. Shining a light on corruption can preserve disease control funding and save lives.

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PS – see relevant article in Global Fund Observer: http://www.aidspan.org/index.php?issue=127&article=4

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