Catholic Relief Services, the principal recipient (PR) of Global Fund grants for malaria management in Niger, will expand its slate of services responding to the malaria epidemic, with testing and first-line medication.
The expansion is envisioned under an $18.1-million (EUR 13.5 million) grant extension approved by the Global Fund board in August 2013. The extension was allocated under the transitional funding mechanism that prevents gaps in grant disbursement in countries as the new funding model is rolled-out in place of the previous rounds-based approach.
The order for long-lasting impregnated nets (LLINs) and malaria rapid diagnostic tests (mRDTs) has been finalized, with the first lot of nets expected to arrive between May and June, William Rastetter, the country representative for CRS in Niger, told Aidspan. The order for artemisinin-based combination therapies (ACT) is still under process.
The funds will support the purchase of some 1.65 million LLIN, to be distributed around the Tillabery region in southwestern Niger. The region includes the capital, Niamey, and is the most densely populated region in the arid, malaria-endemic nation. Distribution and associated costs for another nearly 1.2 million nets – which will be purchased separately by the Niger government – for the Dosso region, also in the southwest, is also forecast.
Malaria remains a leading cause of death in Niger, with 3,000 deaths reported from some 2.6 million cases in 2012, according to an August 2013 article in the Lancet.
As PR, CRS has provided LLIN and other outreach services in Niger since 2008; the grant extension marks an expansion into testing and distribution of first-line medication for the organization.
In addition to the LLIN, 4.75 million mRDTs and 1.45 million doses of ACT will be procured. Distribution will be coordinated jointly by CRS and the country's National Malaria Program.
Niger's grant portfolio has undergone a massive restructuring since 2011 after some major weaknesses in procurement procedures emerged during routine verification. Allegations of financial irregularities led to an investigation by the office of the Inspector General (OIG). No report has been issued by the OIG, Rastetter said, but enhanced accountability measures and more stringent fiduciary controls have been applied in order to ensure "good stewardship of [Global Fund] resources".
CRS hopes to conclude its malaria procurement to coincide with the onset of Niger's rainy season, expected in June. However, the order for ACTs is still in process and has been complicated by perceived conflicts in requirements.
Niger's government advocates the use of a particular product because it is familiar to facility-level clinicians, and worries that training on the use of a different product would delay its distribution. Niger was one of eight countries enrolled in the AMFm pilot, which included the introduction of a specific, Global Fund-approved ACT medication for a different PR identified with a green leaf on the packaging. With the end of the pilot in 2012, the product may no longer be available.