Samuel Muniu                                                                                                                     

18 March 2021 – Aidspan, the independent observer of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, plays a critical role in influencing the Global Fund’s transparency and effectiveness in its response to the three diseases and resilient and sustainable systems for health (RSSH). We are strategically positioned as a credible source of information to countries on Global Fund policies and processes, thereby enabling them to access and utilize grants effectively to fight the three diseases and strengthen the health systems within which services are delivered.

Aidspan provides information and critical analyses on country-level experiences

It is crucial to understand country-level experiences and context that impact the implementation of programs to fight HIV, TB, and malaria in order to be able to identify the barriers to access and provide user-friendly and welcoming services for these three diseases. As an organization, we seek to understand the experiences and challenges countries faces while fighting disease, particularly those supported by the Global Fund. We document these country experiences, challenges, and best practices and share them with our stakeholders, including the Global Fund. For illustrative purposes, we documented the strategies that state implementers of Global Fund grants to Malawi, Sierra Leone, and Uganda adopted to improve their absorption of funds.  

Aidspan makes information available through its flagship publication, the three-weekly newsletter the Global Fund Observer (GFO) produced in English and French as the Observateur du Fonds Mondial (OFM). The organization also publishes in-depth reports on its website (www.aidspan.org). Aidspan plays a critical role in guiding countries on Global Fund processes. In most cases, these processes are not straightforward, and their guidelines and publications contain a lot of jargon. Through our guides (see our Beginner’s Guide to the Global Fund) and newsletter articles, we show countries how to navigate the Global Fund processes smoothly.

Aidspan also convenes roundtables to bring together stakeholders involved in the fight against the three diseases and RSSH to learn from each other. For instance, in 2018, Aidspan organized a roundtable that brought together representatives of the Global Fund in-country structures, including Country Coordinating Mechanisms (CCMs), State and non-State implementers and civil society from seven African countries to discuss how to strengthen their countries’ data systems. The roundtable participants appreciated the importance of maximising their use of data to improve Global Fund grant implementation efficiency.

Aidspan helps countries to better understand Global Fund processes to enable them to successfully request funding to reduce domestic health budget gaps

Limited financial resources are one of the barriers to delivering HIV, TB, and malaria services in Africa. To ensure African countries access additional resources to fund their health programs, Aidspan convenes regional workshops to improve national-level capacity to develop targeted funding requests to the Global Fund. For instance, in February 2020, together with the Global Fund’s Africa Constituency Bureau Aidspan co-organized a regional workshop in Benin where seven African countries (Congo Brazzaville, Gambia, Guinea, Ivory Coast, Liberia, Mali, Senegal, and Sierra Leone) were trained on prioritization of RSSH components. Also, the countries were taken through on how to use Global Fund tools to draft country funding requests on RSSH. These countries came out of the workshop in a better position to develop a successful funding request to attracts funding to strengthen the health systems that support these countries to respond to the challenges of HIV, TB, and malaria.

We also advocate for increased domestic health financing in Africa, through asking African governments to allocate more finance to tackle the three diseases through their medium-term expenditure frameworks or other national budgets. We provide critical analyses and commentaries on domestic financing to help build the case on the need for increased investment in health in Africa. For instance, through our article on ‘increase in domestic health financing in Africa will be hard amid COVID-19‘, we raised the dual challenge that Africa faces of mitigating a pandemic in an already economically strained environment with existing fragile health systems but at the same time having to reduce expenditure in other sectors, as well as from critical disease spending itself, to reallocate funds to healthcare for COVID-19.   

Rooting for a transparent and accountable use of available resources to fight HIV, TB and Malaria

As an organization, we are at the forefront of ensuring that recipients of donor funds, including African governments, are transparent and accountable to the public in the use of these global funds to fight diseases and build resilient and sustainable health systems. Specifically, we strive to ensure that Global Fund-supported programs to fight HIV, TB, and malaria use accountable resources and there are programmatic outcomes to show for it.

For Aidspan to achieve this, we provide capacity strengthening to Supreme Audit Institutions (SAIs) in sub-Saharan Africa to audit Global Fund grants. SAIs are public institutions that are constitutionally mandated to audit the use of public resources. Generally, only a few SAIs in sub-Saharan Africa audit Global Fund grants in their countries despite government institutions managing a huge proportion of these grants. Instead, private audit firms audit most of these grants. In 2019, we collaborated with the umbrella organizations of African SAIs (AFROSAI-E and CREFIAF) and other stakeholders to train eight SAIs on conducting financial and programmatic audits of Global Fund grants. We also organized a roundtable where the eight SAIs exchanged their experiences and shared best practices.

From the training and the roundtable, we improved the capacity of SAIs to understand their client base and how to align financial use with program outputs and outcomes. In this way, the eight SAIs are better positioned to advise whether Global Fund-supported programs to fight the three diseases are either on target or off track to achieve their intended purpose. Also, SAIs report audit findings to the public through their elected representatives in the legislature in English-speaking African countries, while audit queries are subjected to a judicial process in the French-speaking African countries. This increases the transparency and accountability of these funds.

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