Mismanagement May Cost Kenya Key Health Funds

The review board for the Global Fund to Fight AIDS, Tuberculosis, and Malaria has recommended Kenya's bids for hundreds of millions of dollars under the latest round of funding be rejected.  Monitoring ratings produced by the Global Fund rank Kenya near the bottom globally in properly managing Fund grants.

The government has requested a total of $650-million from the Fund.  The $270-million requested to fight malaria has been rejected outright for this round of funding.  The $50-million sought for tackling tuberculosis could still be awarded if the proposal is satisfactorily revised.

The government has the opportunity to appeal the rejection of the $300-million sought specifically for HIV/AIDS programs and is sending a high-level delegation to push for the funds to still be awarded.

Last year, the Fund similarly rejected the nation's funding proposals, costing Kenya a potential of nearly $470-million for fighting the three deadly diseases.

The Kenyan government's failure to secure recent grants from the Fund may be influenced by its poor record of handling such procurements in the past.

A November 2008 analysis of Global Fund evaluative marks compiled by the Nairobi-based Global Fund watchdog group Aidspan placed Kenya 110th out of 114-ranked nations in terms of its overall grant management.

Key players have suggested the nation's bloated Cabinet, created to appease both sides of the power-sharing government, has only further dropped donor confidence in Kenya's grant performance.

In 2008 the nation's health ministry was split into the Public Health Ministry and the Medical Services Ministry.  Infighting between the two ministries has reportedly led to significant overlap in mandates and major battles over health funds.

Kenya's coordinating committee to the Global Fund is headed by a top official at the Medical Services Ministry. But it was the minister for the Public Health Ministry and her team which was sent as a delegation to the Fund's summit in Ethiopia.

When contacted, the secretariat for the coordinating committee said she could not comment on the latest funding round decisions, as the team was not represented at the summit. In addition, VOA has been told the senior Kenyan technical advisor on the Global Fund was excluded from the delegation because he works under the Finance Ministry.

A recent public spat between NGOs tasked with distributing HIV/AIDS treatments could also give insight into Kenya's difficult relations with donors.  In October, local organizations accused Care Kenya, a recipient of a $4.7-million grant from the Global Fund, of refusing to quickly release the money.  The group of local NGOs warned that if the money was not soon allocated, the Fund might refuse to donate more dollars in the current round of funding.

But Care fired back, saying that less than half of the 58 groups set to receive the Global Fund money had yet been able to meet the Fund's accounting criteria for the funds already given them.

The U.S. President's Emergency Plan for AIDS Relief program, known as PEPFAR, is Kenya's largest provider of HIV/AIDS assistance, taking some of the pressure off of the Kenyan delegation sent to appeal the Global Fund's decision.

But the head of a Kenyan HIV/AIDS advocacy group, James Kamau, says without the Global Fund money thousands of Kenyans will be left without treatment options. "We need to appeal to the Global Fund on humanitarian grounds, for at least the component of ARVs to continue, because as it were right now, we have only had 300,000 people on ARVs, but those who require ARVs at the end of the day are 600,000," he says.

The Geneva-based Global Fund was established in 2002 after world leaders agreed to its creation during the 2001 G8 summit.