The lack of capacity of sub-recipients is a long-standing problem in Guinea.
In September 2015, the Global Fund signed a $62.7 million HIV grant with Guinea. When the Guinea country coordinating mechanism submitted the concept note for the HIV grant in August 2014, the SRs had not yet been identified. The CCM oversight committee started consultations to select them at the end of September 2015. “The CCM, in cooperation with the principal recipients, will evaluate the Round 10 SRs and, if necessary, select additional applicants through call of expression of interest,” a member of the CCM told Aidspan.
The CCM would like to work with SRs from a Round 10 HIV grant that have a proven track record in financial and program management. The oversight committee will use the Global Fund’s capacity assessment tool to evaluate the capacity of the SRs. This tool covers monitoring and evaluation, financial management and financial systems, governance and program management, and procurement and supply management. The SRs that meet all the requirements will be selected. The evaluation will also identify what needs to be improved. “A plan to build capacities based on the gaps identified during the evaluation will be developed and implemented,” the CCM member said. “We’ll use the technical assistance budget in the concept note. Other TA opportunities will be explored using providers listed by the Global Fund.”
“Based on our experience in the previous rounds,” a representative of one of the PRs told Aidspan, “we can say that there are two types of SRs: those who emanate from international NGOs, who have good skills; and those who are from local civil society and who can’t comply with all the expectations of the Global Fund to implement a grant. Several activities were included in the Round 10 grant to support local NGOs, but today we’re not seeing the benefits of this investment.”
Large investments were made during the Round 10 grant to strengthen community systems. Funds were provided through 50 local NGOs for activities related to behavior change communication, promoting HIV testing and providing support. In addition, the NGOs received training on management, good governance, project development, and resource mobilization. Five national networks also received equipment and organizational support, as well as financial support to help them provide HIV services to the community. As well, associations of people living with HIV benefited from income generating activities to support their financial autonomy.
In spite of these efforts, challenges remain. “We lost qualified staff during the Ebola outbreak and we lack sustainable financial resources to keep skilled staff,” a representative of an SR explained to Aidspan. The Ebola outbreak left the health system in shambles. Frontline workers were particularly affected.
The performance of the SRs is not the only challenge. A civil society representative on the CCM told Aidspan he is concerned about the performance of one of the PRs, SE/CNLS (Secrétariat Exécutif du Comité National de Lutte Contre le SIDA). “During the rounds, and in spite of corrective actions,” he said, “there were issues concerning the financial management capacities of the PR. Financial management will be even more important under the new funding model. The oversight committee of the CCM is aware of the problem and plans to enhance its support to the PR.”
Dual track financing
For its NFM grant, the CCM has opted for dual track financing – i.e. one government PR and one civil society PR – not only because the Global Fund prefers dual track, but also in an effort to improve Guinea’s ability to absorb and successfully implement the grant. Having two PRs will also improve monitoring of the SRs.
The two PRs have been selected: SE/CNLS on the government side, and Population Services International for the civil society portion.
In spite of these efforts, numerous challenges remain. A civil society activist involved in Global Fund activities told Aidspan that “even though the CCM is working really hard to get the grant off the ground, we are still preoccupied by the electoral process [i.e. the presidential election] which could cause the security situation to deteriorate.”
Tensions around the election could indeed slow down the implementation of the grant.