The Global Fund to Fight AIDS, Tuberculosis and Malaria was formed in 2001 for the purpose of setting up an innovative approach to providing finance to combat the three diseases that kill more than six million people worldwide every year.
Since its inception, the Fund has committed US$11.3 billion to 136 countries, about half of which has been disbursed. Funding to beneficiary countries is based on performance, and failure to meet targets can lead to delays, suspension, discontinuation or termination of grants.
These are some of the countries that have fallen foul of the Fund's strict accounting procedures.
Pakistan - In 2002, the Fund discontinued support for Pakistan's malaria projects because of weak project implementation, slow procurement of health products, poor data quality, and slow spending of project funds; according to reports, only 15 percent of insecticide treated nets were distributed during the specified grant period.
Ukraine - In 2004, the Global Fund temporarily withdrew grants worth $92 million to the Ukraine, citing "management issues". The grants were reinstated One and a half months later, when a new principal recipient, the International HIV/AIDS Alliance, was put in place.
Myanmar - In 2005, the global Fund discontinued grants worth $98.4 million after the government imposed temporary restrictions on travel and new procedures for reviewing the procurement of medical and other supplies. The Fund said at the time that the restrictions "prevented implementation of performance-based and time-bound programs in the country".
Senegal - In 2005, the Fund cut malaria grants worth $7.1 million over systemic issues that resulted in poor performance. The Fund later approved a grant proposal for malaria projects submitted in Round 4.
South Africa - In 2005, the Global Fund Board stopped funding for an HIV prevention programme. The Board decided that the grant, implemented by an NGO named loveLife, had failed to "sufficiently address weaknesses in its implementation".
Uganda - In 2005, the Global Fund temporarily suspended all five of its grants after a review by PricewaterhouseCoopers of one of the grants revealed evidence of "serious mismanagement" by the Project Management Unit in the Ministry of Health. The grants were worth a total of $201 million over two years, of which $45.4 million had already been disbursed. The health minister and his two deputies lost their positions and are on trial with several other government officials for charges relating to the misuse of Global Fund money.
Chad - In 2006, the Global Fund suspended its support after an audit uncovered evidence of misuse of funds and a lack of satisfactory capacity in the principal recipient and sub-recipients to manage the Fund's resources. The suspension was lifted in 2007 after a series of investigations and commitments from stakeholders to put better systems in place.
Nigeria - In 2006, the Fund decided to discontinue its Round 1 support for Nigeria's HIV/AIDS programmes, but awarded other HIV/AIDS grants in Round 5.
Kenya - In 2008, the Global Fund's Technical Review Panel (TRP) recommended that the Board reject Kenya's application for $300 million in Round 8. The government has not made public the reasons for rejection, but national media report that mismanagement and the misappropriation of money are the likely causes. The Minister of Health has put together a task force to trace and account for all money disbursed to Kenya by the Global Fund, and has called for suspension of the application in Round 9 until management glitches are ironed out. The government has experienced difficulties with its Global Fund proposals in the past: in 2003, $37 million was delayed after claims of corruption in the National AIDS Control Council.
Zimbabwe - In 2008, the Global Fund accused Zimbabwe of misusing $7.3 million of a $12.3 million grant, and asked for the money to be returned. In October, the TRP recommended that Zimbabwe receive some $500 million from Round 8. If the Board approves the money, it will be only the third time the country's proposal has been accepted - the government has frequently accused the Geneva-based agency of political bias in its approval of grants, which the Global Fund denies.
Several other countries, including Namibia, Tanzania and Togo, have also had proposals for funding rejected in the past. Countries can appeal a grant decision when a proposal has been rejected in two consecutive rounds.
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