In raising concerns about the ability of countries to achieve full absorption of Global Fund grants, delegations from the African constituencies on the Global Fund Board pointed to a range of challenges they said need to be addressed, including several that consistently appear at the country level.
The Secretariat has made progress in improving consultant management processes, particularly over the last year and half. Consultant costs, as a percentage of total staff costs, have gone down from 35% in 2015 to 19% in 2016. Processes and compliance have improved. The Secretariat is aware of several outstanding weaknesses and has various ongoing initiatives to remediate them.
According to the Office of the Inspector General (OIG), in-country supply chain mechanisms are neither adequate nor effective in ensuring that the right products are delivered in the correct quantities and condition, at the right place and time, and for the best value cost.
The Global Fund Board has agreed to allow wambo.org to facilitate, on a pilot basis, 10 procurements by principal recipients (PRs) using domestic funding. Each procurement can be for multiple products.
The Global Fund is developing a comprehensive supply chain strategy that will define a scope of responsibility, oversight, and necessary initiatives to address supply chain challenges.
An audit into grants to Mozambique undertaken by the Office of the Inspector General has concluded that both grant implementation arrangements and supply chain controls and assurance mechanisms “need significant improvement.”
“Needs significant improvement” is the second lowest rating in the OIG’s four tier rating scheme. The four tiers are effective; partially effective; needs significant improvement; and ineffective.
More than a month has passed since the exchange of letters between the Global Fund and the Venezuelan Network of Positive People (RVG+ in its Spanish acronym) concerning what Venezuelan civil society describe as “a humanitarian crisis.” Very little has happened in the interim, at least not that we can report publicly.
In-country supply chains for many drugs and health products currently face end-to-end challenges, including issues related to forecasting and quantification, storage and inventory management, distribution, quality assurance, and information management and reporting.
At the end of May 2016, the Global Fund formally announced wambo.org, a new online marketplace where implementers of Global Fund grants will be able to check prices and place orders for directly for medicines, other health products and non-health commodities. There are plans to expand the reach of wambo.org even further.
Despite efforts made the Secretariat and despite significant investments – over $800 million in the past few years – there are still major deficiencies in the Nigeria portfolio’s internal controls, affecting procurement and supply chain management, financial management, and program management.