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GFO Issue 398



Ministry of Health, Republic of South Sudan

Article Type:

Article Number: 5

ABSTRACT In issue 397, Aidspan published an article relating to the selection process for the Principal Recipent for South Sudan’s malaria grant. We now publish the Ministry of Health’s response to the article.


In the Global Fund Observer issue #397, Aidspan published an article on the issues surrounding the selection of a new Principal Recipient (PR) for the malaria grant (The South Sudan Malaria Grant implementation has yet to start several months into this Global Fund program cycle). The following response has been received from the Ministry of Health (MOH) in the Republic of South Sudan.

Response from the Ministry of Health

Dear Aidspan team

Greetings from Juba!

The Ministry of Health of the Republic of South Sudan first extends its appreciation to Aidspan for its interest in shedding light on the situation of South Sudan’s partnership with the Global Fund.

I would like to take this opportunity to make a few points to further explain and clarify the position of the Ministry of Health regarding the current stalemate the Global Fund Secretariat on the selection of a second UN Agency as Principle Recipient for the Malaria Grant in South Sudan

South Sudan is a young republic trying to build its institutions, health system, infrastructure and capacity after decades of civil war. It is therefore important to note that the decisions made today will help shape our trajectory for decades to come. Thus, we really insist on the need to promote the principle of country ownership, capacity building, efficiency and value-for-money with the Global Fund and other partners’ investments.

South Sudan has been under additional Safeguard Policy ever since it was part of Sudan, it never had the opportunity to choose the Principal Recipients of the Global Fund grants, and therefore both the United Nations Development Programme (UNDP) and Population Services International (PSI) were selected as transitional PRs by the Global Fund Secretariat. We have worked with the different teams with the MOH as a sub-recipient (SR) for all the grants. But over the years, it is only UNDP in 2018 that finally accepted to align itself with the concept of being a transitional PR with the capacity and commitment to building the capacity of the National Entity/MOH for a future transfer of the PR role.

We are also under a zero-cash policy that has always affected the ability to effectively implement and absorb the funds, especially under NFM1 before the Challenging Operating Environment (COE) Policy and flexibilities were approved by the Global Fund Board. Moreover, we are conscious of our limited envelope compared to the funding gaps and therefore we considered the need to find innovative ways to be efficient and maximize the impact with fewer resources. So we proposed an approach that ensures efficiency and demonstrates value for money: keep one PR initially appointed by the Global Fund. This will not only save money from the grant but will also save some of the time and energy the MOH currently devotes to compliance with the different procedures and processes as required by the Global Fund for the multiple PRs. We do a lot of the work on the ground for the grant implementation, rightly so, for malaria which is endemic in South Sudan. This is our country and we are determined to continue serving our people to the best of our ability

With the above emphasis on the need to consolidate and ensure efficiency, the Global Fund Country Team and the Secretariat are bent on having two PRs for reasons that we do not comprehend. The Global Fund dual-track financing did not aim to have two UN agencies as PRs in COE countries. It aimed at having a Civil Society Organization (CSO) alongside governments as PRs. If the spirit of that policy was applied to South Sudan, then CSOs, the government or other entities will be the PRs alongside the UN organizations. But, we are reasonable and are not even asking for that. We are just asking to have a single PR, committed to capacity building so that after about 20 years of investment in our country, the MOH and other local CSOs such as the NGO forum, the Network of AIDS Service Organizations in South Sudan (NASOSS) or the Civil Society Alliance can become a PR or at least co-PR. Is it too much if we are asking for this now after nearly two decades? We do not believe so!

Instead, the Global Fund Secretariat is insisting on imposing another PR on us (the United Nations’ Children’s Fund/UNICEF), disregarding the analysis and request of the Country Coordinating Mechanism (CCM). The Secretariat has spent six months trying to choose a PR after a restricted tender. The lack of transparency and length of time taken in the process brewed suspicions. By the time the Global Fund Country Team got back to us, the current Malaria Grant Cycle had already started. The existing PR was then exceptionally allowed to continue implementing life-saving activities but the substantive work that is needed on the grants is being delayed.

As a government entity in charge of the Health Sector, we already work with UNICEF: it was a sub-recipient under the HIV grant (NFM1 and NFM2) and currently implements the Essential Health Services project funded by the World Bank. We will not discuss here UNICEF performance on those two projects. But, the information is available for those who are interested.

Our proposed compromise is this: keep the existing PR because of efficiency and commitment for capacity building; have UNICEF selected as an SR in this cycle and, if it performs well and demonstrates a commitment to capacity building, then it can be also recommended for the consideration of the consolidation approach and the Global Fund can select UNICEF instead of UNDP to be the sole PR for all the grants for the next grant cycle.

In conclusion, it is equally important to emphasize that the MOH is committed to strengthening partnership, coordination and capacity building with the establishment of a Project Management Unit (PMU) that will be strengthened so that we can gradually take over Grant responsibilities from the next cycle at least as a co-PR with either UN agency. This strategic direction shows the importance of having one PR which will help the Ministry to streamline the work on the ground, and adequately invest in capacity building with the necessary structures and systems, comply with processes and procedures as required by the Global Fund to remove its zero-cash policy and allow the MOH to eventually become a PR.


Dr. Kediende Chong
Director General for International Health and Coordination
Ministry of Health
Republic of South Sudan

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