After a delay of about six months, the framework agreement for Global Fund grants to Pakistan is set to be signed the week of 22 February.
Under the new funding model, each country signs a framework agreement which spells out the terms and conditions for all grants to that country. Then, separate grant confirmation forms are signed for each grant for which The Global Fund Board has approved funding.
According to an article in The News International, the Fund provided Pakistan with the text of the framework agreement in August 2015. Various line ministries expressed reservations about clauses related to tax exemptions, money laundering, access to information, and human rights.
GFO understands that The Global Fund agreed to make some changes to the language of these clauses that did not materially alter their substance, but the delays persisted even beyond that.
(The News International alleged that The Global Fund told Pakistan that if the framework agreement was not signed by mid-February, the country would not get any money. GFO has not been able to confirm whether such an ultimatum was made.)
Pakistan’s total allocation for 2014-2016 was $255 million. The Board approved funding in the amount of $41.2 million for two malaria grants in March 2015; and funding in the amount of $138.8 million for two TB grants in June 2015. There is also an HIV grant and a health systems strengthening grant currently in the grant-making stage.
During the delays, existing grants have been extended to ensure that disbursements to Pakistan are not interrupted. The Global Fund believes that there has been no negative impact on services.
The article in The News International quotes the national manager of the AIDS Control Programme, Dr Baseer Achakzai, as saying that “more than 350,000 HIV patients are in dire need of continuity of treatment in Pakistan. It is, therefore, a matter of immense satisfaction that all concerned have arrived at an understanding that the signing of the framework agreement is the need of the day.”
The number of people mentioned by Dr Achakzai as being on HIV treatment is incorrect. There are about 6,300 people in Pakistan currently receiving antiretrovirals, a number that is expected to reach about 12,000 (9% of the estimated 137,000 persons living with HIV) when the HIV grant is fully implemented. The figure of 350,000 may have referred to the number of people currently receiving treatment for TB.
Editor's note: After this issue of GFO was mailed to subscribers, we were informed that the framework agreement was signed on 24 February.