‘’WE ARE KEEN TO BE MORE FLEXIBLE THAN YOU HAVE REQUESTED’’- GLOBAL FUND BOSS ASSURES HEALTH AND SANITATION MINISTER
Health and Sanitation Minister, Dr. Abu Bakarr Fofanah and Executive Director of the Global Fund, Dr. Mark Dybul
Geneva, May 26, 015 (SLENA) – In 2014, Sierra Leone received from the Global Fund an allocation of US$ 126 million to fight HIV/AIDS, TB, and Malaria. But in order to access the funds the country needed to submit an application in the form of a Concept Note to the Global Fund. The Concept Note would then be reviewed by a special committee of the Global Fund, the Technical Review Panel (TRP). The TRP makes recommendations to the Board of the Global Fund which approves commitments and subsequent disbursements to countries.
The development of the Concept Note is a tedious and multi-stage process that involves among others, mandatory nationwide public consultations. The outbreak of the Ebola Virus Disease (EVD) meant the country could not undertake some of the mandatory activities that would have led to the development of the concept note. This situation led to the postponement of the submission date of the Concept Note four times already since the country learned about the allocation. The risk is that some of the grants meant for life saving treatment (HIV/AIDS and TB) are coming to an end at the end of 2015 and the capacity in country may not absorb the entire $126 million in the remaining period of the allocation period (having lost half of the implementation period). The country risks getting a smaller funding envelope, when the Global Fund makes a decision on the next allocation as the unspent funds form the basis for decision on the next allocation.
The Minister of Health and Sanitation, Dr. Abu Bakarr Fofanah, in putting the country’s case across to the Global Fund, informed the Executive Director, Dr. Mark Dybul that the development of the Concept Note entails a lot of activities some of which are inconsistent with the current laws in the country such as the State of Emergency necessitated by the EVD outbreak, which prohibits large public gatherings.
The Minister further argued that, thousands of HIV/AIDS and TB patients have gone for far too long without treatment. He highlighted the adverse consequences of patients being on protracted period of time without treatment ranging from the development of drug resistance to loss of years of productive life due to premature deaths from curable conditions. The Minister therefore articulated that if funding for HIV/AIDS, TB, and malaria was to be strictly contingent on the successful completion of a process that the country has consistently shown to be unable to accomplish due to exceptional circumstances that it finds itself in, and then more and more people will continue to die.
‘’Sierra Leone and the Global Fund therefore need to work out an innovative modality to quickly access the funds taking into account the need to combine flexibility on one hand and financial risk mitigation on the other. Such an approach, although experimental and implemented for the first time in Sierra Leone, if successful, may well prove to be lifesaving for millions as it can be applied to other countries in similar challenging operating environments” said the Minister.
The Global Fund Executive Director after listening to the Minister reiterated the procedures for accessing Funds from the Global Fund and underscored the compelling manner in which the Minister has put the case for flexibility across. “The Global Fund is now ready to be flexible and we want to be more flexible than you have requested,” the Global Fund Executive Director said. This assurance from the head of the Global Fund means Sierra Leone will not have to submit a concept note but will be able to access the funds by submitting a costed extension, using the existing National Strategic Plans (NSPs). In this regard, the Health Sector Recovery Plan, National HIV/AIDS and TB Strategic Plans will be used for HSS, HIV/AIDS and TB respectively. This breakthrough has lightened the workload for the country significantly. Details on how to operationalize the flexibility will be agreed upon with the Global Fund country team when they come to visit Sierra Leone during the first week of June, 2015.