Malaria – following the money

Two global financial issues appeared online today – accounting for Global Fund grants and reduced IMF loans. What do they mean for malaria control?

Three years ago Global Fund grants in Uganda were suspended basically because money was stolen. After highly visible firings of top officials and efforts to audit the program and improve accounting, the grants were allowed to continue and new grants have been awarded. A recent visit by a Global Fund official reported in the Monitor reminded the Ugandans that the US$ 1.6 million still missing has not been returned.

After sacking of 3 top officials and transferring another, some funds were returned, but no further action has been taken. 24 priority cases are yet to be prosecuted, but 373 cases should be investigated according to the Monitor. In short, the people who perpetrated the theft and mismanagement are still at large and presumably still involved in the management of the Global Fund-supported programs. The excuse is financial – no funds to investigate the cases! Will this unresolved problem jeopardize Uganda’s international malaria funding again?

ghana-nmcp.jpgWhile many countries are expanding their malaria efforts using external funding, the question arises concerning long term ability of countries to maintain programs. Overall IMF loans have dropped from US$ 117 billion in 2003 to only US$ 16 billion in 2007. The Washington Post article identified malaria endemic countries like Ghana that “had joined a long list of developing countries in Africa and beyond enjoying record periods of growth, with the robust economy leaving it no longer in need of more IMF cash.” Ghana is even issuing its own bonds to improve infrastructure. Specifically the Post says that, “The economy here turned as hot as the local pepper soup earlier in the decade, with soaring global demand for the nation’s riches — gold, cocoa and bauxite — sparking a rush to modernize Ghana’s decaying roads, rails and power grid.”

Whether Ghana will also turn some of its profits to disease control now or in the future remains to be seen, but these experiences point out the importance of promoting equitable global trade as a long term solution to helping countries fund their disease control efforts and wean countries from foreign assistance that appears too sweet and easy for some government officials to avoid tasting.

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