ISLAMABAD: The Global Fund, a Geneva-based international financing and partnership organization, has expressed dissatisfaction over the utilization of its grants in Pakistan to fight tuberculosis, AIDS and malaria and decided to invoke special measures to ensure “accountable use” of the funds.
The organization mobilizes and invests more than $4 billion a year to support programs run by local experts in more than 100 countries including Pakistan.
It has disbursed over $600 million to Pakistan since 2002, and its next grant cycle will allocate nearly $300 million to fight the three diseases.
The Fund has now invoked its Additional Safeguard Policy (ASP) for Pakistan with “immediate effect” after expressing discontent over the performance of Common Management Unit that helps utilize the funds.
“We are not satisfied with the role and performance of the Common Management Unit and do not see the strength of leadership necessary at this level to balance the centrifugal forces of devolution and to enable provinces to build stronger and more effective programs,” The Global Fund wrote to Prime Minister Imran Khan’s special adviser on health, Dr. Faisal Sultan, earlier this month.
The Fund can invoke the ASP whenever “existing systems to ensure accountable use of Global Fund financing suggest that Global Fund monies could be placed in jeopardy without the use of additional measures.”
The Fund said it had observed a worrying epidemiological trend over the past couple of years in Pakistan in its response to tuberculosis and HIV, where TB case notifications stagnate or even decrease and the HIV incidence largely remains unmitigated and on the rise.
“We feel that notably our public sector principal recipients have not yet found an adequate way to transform domestic and external funding into a convincing approach to overcome those challenges,” the Global Fund said in the letter, a copy of which is available with Arab News.
The Fund said that it would revoke the ASP after the fulfilment of eight conditions in Pakistan, including evidence that provincial programs were performing adequately and that programmatic and fiduciary risks were controlled.
It added that it would review the status of these conditions annually.
Dr. Malik Mohammad Safi, director-general health at the Ministry of National Health Services, declined to comment on the development, saying: “We are currently in the process of sending some projects to The Global Fund, so we aren’t in a position to comment on the letter.”
Opposition parties and public health specialists have raised questions over the government’s capacity to manage these funds and grants.
“The Global Fund has taken this decision due to fraud, corruption and non-transparency [in the utilization of funds] in Pakistan,” Marriyum Aurangzeb, a spokesperson for the opposition Pakistan Muslim League-Nawaz party, told Arab News.
Dr. Khalid Mahmood, a public health specialist at the Rawalpindi Institute of Urology, urged the government to ensure transparency in the utilization of grants by ensuring internal and external audits of the funds.
“Our public health departments are poor in record keeping like number of patients and utilization of funds, forcing donors like the Global Fund to question lack of transparency,” Mahmood told Arab News.
He said that malaria and TB were deadly diseases and quite rampant in the country, especially in poor and rural areas, adding that massive awareness campaigns were required to bring them under control.
“If, God forbid, we lose grants from The Global Fund, we won’t be in a position to fight the spread of these diseases within our limited resources,” he warned.
