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Funding &Performance Bill Brieger | 03 Nov 2008 09:39 am

Uganda’s troubles with Global Fund continue

Uganda’s New Vision newspaper points out that …

UGANDA has lost $12m (about sh25b) from the Global Fund over poor accountability. Out of $36m allocated to the country in 2003 for HIV/AIDS activities under Round One, over $10m has not been released as the Fund was not satisfied with how the first installments were used. Another $24m was allocated in 2004 for malaria activities under Round 2, but $2m has not been disbursed, according to the Fund’s website

The Round 2 Malaria grant apparently was intended for only 3 years. It started in 2004 and the last progress report was posted in August 2007. In that last report the GFATM rated the project with its lowest grade, a ‘C’.  The currently running Round 4 malaria grant is rated at B1 as of February 2008.  There is no record that a grant agreement has been signed and disbursement commenceD on the Round 7 malaria grant that was awarded a year ago.

The Guardian reminds us that, “In 2005 Uganda was suspended from the Global Fund over irregularities in the administration of funds. This year, the Ugandan government began proceedings to prosecute those accused of embezzling Global Fund money, including two former health ministers.” The Guardian also points to health system challenges may be at the root of some grant performance problems:

Uganda’s decentralised health system is to blame for the poor delivery of health services across the country, according to health minister Stephen Mallinga. Speaking at the 14th health sector joint review meeting in Kampala on Monday, Mallinga said the decentralised recruitment of health workers had led to a culture of “tribalism”, with many health workers recruited and remaining within their own home regions.

Global funds are urgently needed in Uganda because as The Guardian pointed out, “Uganda’s economic woes continued this week with an estimated 114bn Ugandan shillings ($54m) wiped off the local stock market in one day.” The Global Fund website also featured Uganda’s economic problems by explaining that, “The future of Uganda’s recently launched five-year strategic plan aimed at reducing new HIV/AIDS cases in the country is uncertain because of the global financial crisis, which could lead donors to allocate funding more conservatively.”

Currency problems were also highlighted by The Guardian: “Last week the shilling collapsed against the dollar, falling to a low of Shs 2,200. As a result fuel prices have spiked, with a litre of petrol rising by nearly Shs 300.” Inflation is a major challenge to donor funding – assuming the $12 million in HIV fund are ‘found’, they would be worth much less today than when first awarded.

If GFATM malaria funds stop, the burden will likely fall on families. The Uganda Ministry of Health estimated that, “A poor malaria-stricken family may spend up to 25% of its income on malaria treatment and prevention.”

In these times of economic crisis donors like the Global Fund need to stress even greater accountability and performance than before to make every Dollar, Pound and Euro count.

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