Concerns about Malawi financial management outweighed by burden of need
Despite continued concerns about Malawi’s ability to absorb grant funds, the country will receive an additional $37 million in incentive funding to support its HIV program, bringing the total allocation under the new funding model for this central African nation for all three diseases and health systems strengthening to more than $611 million.
The decision to release the additional funds was attributed by UNAIDS chief Michel Sidibe to the country’s leadership in committing to ambitious targets to reduce its disease burden. Malawi has a 10.6% general prevalence rate of HIV and an estimated 500,000 people on ARVs.
Speaking on 13 June at the African Union summit in Johannesburg, Sidibe hailed Malawi’s evolution from being a follower to a leader in the fight against HIV.
“Malawi was the first country to introduce Option B+, putting HIV-positive pregnant women automatically on treatment,” Sidibe said during a session attended by President Arthur Peter Mutharika. “You were also the first to sign the 90-90-90 treatment target to help end the AIDS epidemic by 2030. Mr. President Sir, we are very impressed with the risks that you are ready to undertake. Now we have been able to work with Global Fund to release $611 million.”
If Malawi continues on its trajectory, Sidibe predicted that no babies would be born infected with HIV by the end of 2015.
“We have managed to reduce the new HIV infection rate by 65%. I am glad that we are just one point away from achieving zero percent mother-to-child transmission of HIV,” Mutharika said in response “We just need to remain focused; with more commitment and resources we will achieve this in no time.”
Despite being a low-income country, with a per capita GNI of $750, Malawi has committed to purchasing $8.5 million in ARV and other commodities through 2017. This will represent a first-ever pledge by the government to pay for its own HIV therapies and is a supplement to Malawi’s commitment to double its willingness-to-pay contribution from $30 million to $60 million across all three disease components.
The meeting in South Africa followed a high-level visit by Global Fund officials to Malawi in May to assess the country’s readiness and ability to move beyond a financial mismanagement crisis within the National AIDS Commission and an NGO managed by the first lady that required repayment of several million dollars in misappropriated funds.
In late May, the Grant Approvals Committee (GAC) decided that Malawi’s HIV concept note should proceed to grant-making with an upper ceiling of about $444 million: allocation funding worth $296 million and an above-allocation request of $148 million. The final budget could be less, depending on what happens during grant-making. The grant-making stage is expected to start by 1 July, and the grant will run through December 2017.