The current conflict in Syria has severely affected implementation of Global Fund grants in that country. Adjustments have been made and one grant has been reprogrammed to achieve the desired results, according to Fabien Lefrancois, a spokesman for the United Nations Development Programme (UNDP), the principal recipient (PR) for the grants.

To date, Syria has received two Global Fund grants, a Round 6 TB grant worth $7.4 million, and a Round 10 HIV grant worth $1.7 million.

The conflict, which has lasted for over a year, has displaced more than 2.5 million people within Syria. Nearly one million people have fled to neighbouring countries. Road and air services within the country are either not available or dangerous. Air shipments have been diverted to Beirut airport and are then transferred by road to Damascus.

The result is more paperwork for the PR, UNDP, and more time required to clear goods through Customs.

In addition, communication services – including landlines, mobile phones and the Internet – have been disrupted, and banks are operating under international sanctions. Finally, the UN Department of Safety and Security has imposed restrictions on the movement of all UN staff within the country.

“In view of these challenges, we have set up plans to mitigate disruptions and to ensure services continue to be delivered,” Lefrancois said. “For instance, displaced patients have been referred to the health facilities nearest to their temporary residence or shelter to ensure they receive treatment. Courier mail has been used to transfer the samples of TB patients and to distribute medication to regional stores.”

“Due to the current unrest, the country coordinating mechanism has asked the Global Fund to re-programme the HIV grant to include the provision of antiretroviral treatment (ART) for close to 150 HIV patients and the provision of laboratory reagents to monitor the effects of treatment,” Mr Lefrancois said.

In addition to the two current grants, Syria is in line to receive a TB grant under the Transitional Funding Mechanism of up to $2 million. Global Fund spokesman Andrew Hurst told GFO that the grant is being negotiated but has not yet been signed. UNDP will be the PR.

Mr Hurst said that the Global Fund does not have a specific policy on how to implement grants in conflict situations. “Our general policies, however, provide flexibility which allows reprogramming of grants on a case by case basis like we have done in Syria,” he said.

Editor’s Note: We have not been able to obtain comments for this article from civil society organisations in Syria, likely because of the current disruptions. If anyone reading this article can respond directly from experience in Syria, we would like to hear from them.