Ugandan activists including The International Community of Women Living with HIV Eastern African held a press conference to call for immediate bold corrective action in the management and control of Global Fund grants by the Ugandan government. This follows a new audit of Global Fund grants in Uganda that found millions in unspent funds; massive public sector stockouts of life-saving HIV medicines; ineffective Ministry of Health leadership, management and oversight; and lack of government accountability.
The audit report noted that only 46% of funds disbursed to the Ministry of Finance between January 2013 and June 2015 had been spent.
This routine audit of Uganda’s grants focused on whether: the national supply chain delivers quality medicines in a timely manner; accurate data are available to support decision making; and whether internal controls result in economic, efficient and effective use of Global Fund funding. Unfortunately on all fronts, the audit showed Uganda’s grant performance was poor.
And the civil society is not convinced that the corrective actions being proposed are substantial enough to trigger the changes that are urgently required.
In 2005, Uganda’s reputation was put at stake because of a major Global Fund scandal. The fund ended up suspending all grants amid reports that money was being stolen with impunity. A judicial inquiry was set up and some people were jailed for stealing fund money. Grants were restored after governance reforms but subsequent reviews continue to raise worrying queries.
According to the activists, numerous independent analyses show that even accounting for the depreciation of the shilling, if medicines had been purchased at internationally benchmarked prices, there should have been more than enough funding to prevent drug stock outs. Recently, both the European Union Observer Mission as well as the Commonwealth Observer Mission to Uganda’s 2016 Elections independently highlighted massive state spending of public sector resources to fund campaign activities.
“We are concerned that diversion of national resources for electioneering deprived the Treasury of the resources needed for procurement of life-saving medicines,” said Lillan Mworeko, Executive Director, ICWEA. “This must never happen again, government must immediately complete a transparent and detailed gap analysis, in partnership with civil society, and allocate sufficient funding in the FY2016/17 budget to close the funding gap.” In addition, multiple supply chain weaknesses such as theft commodities were reported.
This is a crisis,” said Joshua Wamboga, Executive Director of UNASO. “In almost all cases the problems that the audit found have been known to the Ministry of Health for years—but no effort has been made to resolve them. Meanwhile, Ugandans with HIV are suffering entirely preventable stock outs of medicines. These failures are completely untenable—there is no committed leadership, no action, no accountability, and no sign that government is taking these problems seriously.”
Recommendations
The CSOs gave a number of recommendations including dissolving the Global Fund Focal Coordination Office in the Ministry of Health, and immediately handing over authority to TASO (The AIDS Support Organization) for completion.
They also recommend that Ministry of Health should no longer be the main implementer of Global Fund grants in the public sector; the Country Coordinating Mechanism (CCM) should work with the Ministry of Finance, Planning and Economic Development (MoFPED) to find an alternative implementer with a proven track record of successful grant implementation and performance.
Read full statement here: http://www.icwea.org/wp-content/uploads/downloads/2016/03/Press-Statement-on-the-audit-of-Global-Fund-grants-in-Uganda.pdf
