Integrated Regional Information Networks - February 22, 2012
CAPE TOWN, 22 February 2012 (PlusNews) - More than seven months
overdue, the Global Fund to fight AIDS, Tuberculosis and Malaria
grant will finally be released to key South African AIDS
organizations that have been struggling to survive. Some were on
the verge of shutting down.
The Global Fund released US$7,106,426.91 to the South African
National Treasury on 6 February, the same day seven of the
grant's sub-recipients delivered an open letter to Minister of
Health, Aaron Motsoaledi, pleading for intervention to bring the
Fund's "life-threatening delays" to an end.
Signed by the Treatment Action Campaign (TAC) and six other
sub-recipients of the Fund's Round 6 HIV grant to South Africa,
the letter warned of imminent closure of vital community-response
programmes across South Africa, a country with one of the world's
highest HIV burdens.
The payment, of which US$2,722,555 will be released this week to
the sub-recipients, represents about half the total owed by the
Global Fund to these community organizations for July-December
2011. It covers human resources only and no programmatic costs.
The Fund cancelled its Round 11 funding last November after a
funding crisis and allegations of corruption, and early this year
executive director, Michel Kazatchkine, resigned. The new general
manager, Gabriel Jaramillo, is expected to spearhead a reform
The South African sub-recipients of Round 6 funding would like to
see some change. "Almost every tranche has been late since the
beginning," said TAC treasurer Nathan Geffen. He said that when
the July 2011 tranche failed to appear, TAC was initially
unsurprised. However, as weeks and then months passed, the
situation became untenable.
The blame game
"What has become patently clear is that the Global Fund systems
are so complex that neither the Fund nor its principal recipient,
the Department of Health, is able to manage the system properly,"
Geffen told IRIN/Plus News.
Organizations such as TAC, which deliver services on the ground,
are not funded directly by the Global Fund. Instead it contracts
with a single principal recipient, the health department,
encouraging organizations from different sectors to work
In theory, this system should simplify administration. But with
multiple organizations trying to meet complex reporting
requirements, the result appears to have been additional
complications that TAC says the health department is not
adequately equipped to administer.
According to the Global Fund Observer (an independent newsletter
on the Global Fund produced by Aidspan), the situation was
further complicated by the South African Country Coordinating
Mechanism's (the implementing body for the grants, made up of
government and local stakeholder organizations, including TAC)
desire to consolidate the Round 6 grant with its Round 9 and new
Round 10 funding, all of which would then be managed by the
Thus the department and Fund embarked on implementing a
"singe-stream-of-funding" negotiation, a process that took longer
than expected and was not finalized until 15 December 2011.
"Yesterday, in a formal meeting, the Global Fund people admitted
that the main reason for the delay was the attempt to consolidate
the round 6, 9, and 10 grants into a single system," Geffen told
The Fund acknowledges that the single stream funding did slow the
grant disbursement, but maintains the fault lay with the
grantees. "The Single-Stream-of-Funding grant was delayed as the
grant documents did not contain information requested by the
Global Fund," Fund spokesperson Marcela Rojo told IRIN/Plus News
Meanwhile, Minister Motsoaledi, who acts as chair of the Country
Coordinating Mechanism, told IRIN/Plus News he was not "very
sure" if the funding stream was the reason. "We are looking at
what [caused] the delay, and we tried to correct everything that
could have been wrong," Motsoaledi said.
David Garmaise, a senior analyst at Aidspan, told IRIN/Plus News
that most people working on Global Fund programmes agreed that
single stream funding was preferable, but that in practice, it
was not easy to realize. "The Global Fund, as the agency pushing
for this change, has a responsibility to ensure that the
transition is handled smoothly, and that care, treatment,
prevention and other services are not disrupted in the process,"
Regardless of who is at fault, services in South Africa have been
disrupted, and the reality on the ground is grim. Nearly all the
sub-recipients have dug deep into reserve funds. Furthermore, the
ability to plan activities has been hamstrung.
One of the casualties of the delayed funds has been Soul City, an
organization that uses mass media for public health. Soul City's
HIV prevention radio programme, broadcast in nine languages
across the country, has been scrapped for the time being. "It
means that we're not reaching poorer, more rural people in their
There's a whole range of things we're having to do away with,"
said programme director Sue Goldstein.
Jack Lewis, director of the Community Media Trust (CMT), a fellow
Round 6 sub-recipient, is concerned that the ultimate result of
the collapse of programmes like Soul City's and CMT's own popular
"edu-tainment" offerings, as well as major programmes such as
TAC's treatment literacy campaign, will mean reversing gains in
reducing new infections and increasing ART adherence.
"If all these programmes were to collapse, there's no doubt in my
mind that there would be a negative impact on the reduction in
new infections, which is the holy grail of HIV programmes. We'd
also see a worsening of adherence. The need to maintain adherence
through motivation versus policing is a vital component of these
programmes, so you'd expect to see more problems with that, which
means more people have to go on second-line treatment, which is
more expensive and adds the possibility of the passing on of the
resistant virus," Lewis said.
Meanwhile, the sub-recipients still do not know when they can
expect the balance owed from 2011, or 2012's first payment. "I
don't see any light at the end of the tunnel. After the meeting
[with the Global Fund], we are feeling as hopeless as when we
entered," said Geffen.
The Fund maintains that now that single stream funding is in
place, recipients will see some change. "The Global Fund is
working with the [primary recipient] to improve the quality of
grant documents so that the disbursement processes can go more
smoothly in the future," said Rojo.