Zambia has lately been in the news, with revelations from the Global Fund's Office of the Inspector General (OIG) citing significant financial and management control weaknesses, misappropriation and fraud, resulting in losses of millions of dollars. All of the four principal recipients (PRs) – designated to receive and then disburse Global Fund grants to sub-recipients and programme implementers – were found wanting. (See GFO 132, at www.aidspan.org/gfo.)
For civil society organizations in Zambia, this was not unexpected. For a long time we questioned the way that the Global Fund was being run in Zambia. Although it is promoted as the best funding mechanism to effectively deal with the three diseases, according to insiders at the country level, out of all the multilaterals, the Global Fund is the most vulnerable to abuse. In the case of Zambia, local NGOs had identified the following issues that needed to be addressed:
1. CONFLICTS OF INTEREST: The Global Fund in Zambia is dogged by conflicts of interest. Take for example, the intersecting roles of the National AIDS Council, the country coordinating mechanism (CCM) and the Government of the Republic of Zambia. First, the CCM is supposed to be an independent entity. In Zambia, it is housed at the National AIDS Council, which in turn is a quasi-governmental body, as well as a sub-recipient of the Global Fund. Its location may seem minor, but the very fact that the CCM does not have a secretariat and has to depend on the resources of a sub-recipient, which is itself controlled by the government, limits its independence.
Related to this is the fact that members of the CCM have remained unchanged since its inception, making it almost impossible to be critical of the way things are going. When I visited the local fund agent (LFA) in September this year, and asked to whom I could address my concerns, I was told that I could address them to the Director-General of the National AIDS Council. As mentioned above, the National AIDS Council – as sub-recipient and partly a government body – should not be running the Global Fund show in Zambia. The Director-General is a Zambian government employee, and cannot, by virtue of being a civil servant, be impartial.
2. PROBLEMS IN DISBURSING FUNDS: In August this year, I went on one of my Global Fund advocacy tours in Japan. While there, I met a number of top government officials, including former Prime Minister Shinzo Abe. At one of the meetings with officials from the Ministry of Foreign Affairs and Japanese civil society, a Japanese NGO working in Zambia narrated how it had followed procedure by applying for project funding from a PR, the Zambian National AIDS Network (ZNAN – not to be confused with the National AIDS Council). She said that although the application was approved, it took eleven months for the funds to be disbursed. There were murmurs of disapproval and many wondered why there should be such a delay.
The resource mobilisation officer from the Global Fund in Geneva, who was present at the meeting, said he could not understand why that would be the case, because the Global Fund was designed to be efficient while ensuring that funds were properly accounted for. I later told him that I had heard similar complaints from other organisations. Some had experienced delays of three to four months, but when the funds finally were released by ZNAN, ZNAN expected the organisations to report as if they had received the funds on schedule.
3. LACK OF GLOBAL FUND PRESENCE AT COUNTRY LEVEL: The lack of physical presence of the Global Fund at the country, or at least regional, level should be revisited. And so should the role of the LFA, the entity hired by the Global Fund in a country to "oversee, verify and report on the progress on the grants and make recommendations for future funding". In Zambia, it seemed to have slept through the mess.
My conclusion is that in its current form, the Global Fund in Zambia is doing more harm than good. Figures can be quoted about how much has been achieved, but imagine what could have been achieved if money had not been stolen (as has been alleged by the OIG). There are many places in rural Zambia where many patients still cannot access treatment, and yet we have millions of dollars going into the pockets of a few individuals. I have always known that criticising the Global Fund was going where angels fear to tread: activists in Western countries, who keep campaigning so hard, feel that even a mild criticism is playing into the hands of donor governments that are already unwilling to put money into a fund that they cannot control.
But with more and more Western NGOs working in our countries, we can no longer hide the Global Fund's deficiencies. When I point out these weaknesses, it is not because I do not like the Global Fund. I do. I am its ambassador and have advocated for its replenishment even when I have been unwell. But I simply feel that what is going on in Zambia should not be allowed to continue. In Zambia, the entire CCM should quit and new people should be appointed. Then we should change all of the PRs. I suggest that even though the Global Fund should be country-owned and locally-driven, a foreign entity needs to be involved to ensure effective oversight.
Winstone Zulu (email@example.com) is a TB/HIV activist in Zambia. He has lived with HIV for 20 years and has worked with several civil society organisations in Zambia, including the Network of Zambian People Living with HIV/AIDS and TB Alert. He is currently a board member of the Museum of AIDS based in South Africa and a tireless advocate for the Global Fund. This article was reproduced, with minor changes, from www.aids-freeworld.org, with permission of the author.