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HEALTH PORTFOLIO COMMITTEE
25 February 2003
UN GLOBAL FUND: BRIEFING
Chairperson: Mr L Ngculu (ANC)
Documents handed out
UN Global Fund monies allocated to HIV/Aids, TB and Malaria have not yet appeared in the country's treasury. According to the Minister of Health, the Global Fund allocated monies to South Africa which would undergo certain processes before it was disbursed to various governmental, NGO and private sector interests whose proposals were approved. The Minister clarified that contrary to misconceptions the government had not received any money from the Fund for Kwazulu Natal. The committee expressed concern that so far developed countries had not been forthcoming in the fulfilment of their pledges.
The Chair informed the committee that the issue of the global fund and the alleged money donated to the KZN to fund HIV/Aids projects had been a prominent feature in the news. The Committee debated the issue in the past without arriving at a conclusive resolution. It was in this light that it became necessary to invite the Minister to address the Committee in effect to clarify the position as regards the UN Global Fund.
Briefing by Minister of Health
The Minister, Ms Tshabalala Msimang commenced her address to the committee by giving a brief background to the UN Global Fund (the Fund) on HIV/Aids, TB and Malaria. She explained that the idea of a global fund was mooted out of the need to create an independent public/private funded entity to mobilise both national and international resources to help combat HIV/Aids, TB and Malaria. The idea arose due to the burning need to arrest the debilitating effects of the HIV/Aids pandemic in the face of dwindling health resources and the dilapidated health infrastructure which had given way to an unacceptable situation of inadequate health care. The concept which was developed by the G-8 countries in Okinawa Japan was adopted in Zambia Lusaka during the AU summit and that it was unanimously endorsed during the UN Assembly. The World Bank is the custodian of the Fund and that its mandate was to invest the funds and dispense it to the various implementing authorities.
The Minister outlined the objectives of the establishment of the Fund and noted that the foremost of them was to balance the need for prevention, care and treatment of the three ailments namely HIV/Aids, TB and Malaria. The other objective is to increase capacity to fight the said three ailments. The Fund is merely a financial instrument whose mandate was to mobilise resources and not an implementing agency. The Fund pursued a balanced approach in terms of the variant needs of different regions and that it had an independent review process that approved the disbursement of funds to its constituencies.
The Minister explained the criterion that a proposal for funding must meet noting that it focussed on best practices and that it must increase coverage for an effective intervention in prevention and treatment of the three targeted ailments. The proposal must complement and enrich regional programs in which case it must focus on projects that link resources in a clear partnership between NGOs, the government and private sector concerns. The proposal must include mechanisms to promote and build on existing partnerships in this regard whilst seeking to work in conjunction with existing infrastructure. In which case, the Minster stressed, Country, Co-ordinating Mechanisms (CCM) became the central focus for the implementation of these programs. The Fund only considers non-cc-ordinating proposals from countries without functional government or those in a state of civil strife.
On the question of eligibility, the Minister explained that the overriding consideration was the burden of the three mentioned ailments that is HIV/Aids, TB and Malaria. She pointed out that developed countries wanted to base eligibility on poverty but this was objected to by developing countries. Application forms for the funds were available on the Fund's web-site and that applications were accepted in any of the six UN languages. The Technical Review Panel (TRP) made decisions on who qualified for funding. She observed that although developing countries expressed their opinion on the composition of the Panel, the body was independent and its activities are transparent, predicted upon technical, systematic and programmatic process.
The Minister outlined the four broad categories of proposals - namely:
-those that were recommended with no or minor modifications and that this regime was dealt with only by the Chairperson or Co-Chair
-those that call for further clarification within at most the space of six months -should such clarification be called for
-those that were not recommended in their present form but are strongly advised to re-submit but that such must wait for the second round of proposal
-the last regime was that which was not recommended for funding at all
The Minister noted that two proposals submitted by South Africa had been approved and funding had been allocated to them. The proposals were for love life, National Association of People with Aids (NAPWA) and that of KZN. Turning to the controversy of Funds allegedly allocated to the KZN the Minister explained that no single cent of the amount allocated had been disbursed to the country as yet. There were many other processes that would have to be gone into before the beneficiaries were finally put into funds.
The Minister clarified that the Fund was not a primary source of funding but that the applicant must demonstrate sustainability of the programs it purposed to roll out since funding from the fund covers a period of only two years. The government had pledged the sum of two million US dollars hoping that developed countries would honour their pledge in this regard. The Minster concluded that the key challenge really was how to establish and maintain the necessary infrastructure to manage the approved funding.
Ms Kalyan (DP) wanted to be updated on the status of the KZN application.
The Minister explained that KZN had flouted the laid down procedure by tendering an application directly to the Fund instead of channelling the same through the Country Co-ordination Mechanisms (CCM), which was the authorised country co-ordinating unit. The proposal was rejected. KZN had since re-submitted its proposal through the CCM as required and it had been approved for funding save that no monies have been disbursed yet.
Ms Baloyi (ANC) inquired about the criteria that would be used to disburse the funds to various provinces during implementation of the projects.
The Minister replied that provinces and various NGOs had presented their budgets for funding through this program. The Department was working on a strategic plan as a country on how to disburse the funds to various beneficiaries.
Ms Kalyan asked who was the primary recipient for country
The Minister replied that stakeholders had appointed SANAC to be the primary recipient for the country
Dr. Cachalia (ANC) asked if there were business plans to ensure the optimal utilisation of the funds
The Minister clarified that no funds had been received to enable interest groups to draw business plans yet but pointed out that it was the responsibility of all stakeholders to work extra hard to ensure that all funds were put to optimal use. The critical question of capacity building would ultimately fall on the kind of people that would be employed to implement the health care programmes on the ground.
Ms Dudley (ACDP) asked how the CCM functions.
The Minister explained that CCM's responsibility was to monitor where money went but that it would principally be informed by the global fund's guidelines and of course the over-sight role of the committee must always kick in.
Ms Rajbally (MF) lamented that the past record for the NGOs sector in donor fund management had left a lot to be desired and wondered whether there were mechanism in place to monitor their activities.
The Minister concurred that indeed NGO's sector had been wanting in sound management practices and pointed to situations when the Department had to sent people to help them put their house in order. The Department would continue to send people to help them render a proper account.
Ms Dudley asked where a successful proposal could be obtained.
The Minister reiterated that the Fund's activities were transparent and that all materials regarding its operations including successful proposals could be found on the Fund's web-site.
Ms Kalyan inquired on the composition of SANAC.
The Minister replied that SANAC represents all sectors of society and that the Chair was the Deputy President while she was the Co-Chair.
Dr. Gous (NNP) asked who represented the country on the global fund and its principal agent in South Africa.
The Minister reiterated that South Africa fell under the east and southern Africa region whose current representative on the Board of the Fund was from Uganda and that the Fund's agent in the county was the CCM.
Dr. Gous made reference to the fact that KZN's application was allowed to go that far which he felt clearly showed that there was something lacking in the structures of government co-ordination and networking.
The Minister insisted that KZN was well aware and knew the correct procedures yet it ignored the Department's advice and went ahead to submit its proposals. She added that all the other provinces had followed the laid down procedure to no fault and there had been no negative incident whatever.
Ms Malumise (ANC) lamented that the final product of a solid proposal seemed to undergo a cumbersome process and wondered how long it took to put together a successful proposal.
The Minister concurred that indeed getting together a successful proposal was an enormous effort and that was why various stakeholder took a long time to put together their proposals. She added that the Department had now established a secretariat and that things were moving a little bit fast than in the past.
Dr. Jassat (ANC) asked how much of the pledges that were made by developed countries had been honoured so far.
The Minister noted that Koffi Annan pledged 10 billion USD per annum and hoped to mobilise this from mostly developed countries but that so far these countries have pledged 2.2 billion USD out of which the money that has been made available is 724 million.
Dr. Jassat wondered if given the lukewarm manner by which countries were responding to their pledges the whole idea would lapse and fall by the wayside.
The Minister admitted that it was difficult to decipher what individual governments decided but hoped that all parties would strife to deliver on their pledges.
Dr. Luthuli respectively concurred with concerns expressed by Dr. Jassat that the Fund did not appear to be in good shape and that signs were that it may not last long to benefit a concerted multi-sectoral approach in fighting the HIV/Aids pandemic.
The Minister explained that the Fund only mobilised countries to put faith in their own capacities and not to be the primary sources of funding to arrest the devastation that had been caused by the targeted ailments. She, however, noted that stakeholders would rely on donor goodwill to honour their pledges and that the fact that the process had kicked off is a good sign that those who pledged meant well.
Ms Kalyan said that one of the requirement for Funding was that the recipient must be apolitical and wondered how this requirement would be enforced.
The Chair clarified that the Minister had not made any reference to the recipients being apolitical but that all she said was that these applications would be strengthened at the political level. The Chair, however, associated with members concerns and stated that the key question was to ensure that the pledges had been honoured.
Ms Malumise thanked the Minister for her in-depth presentation terming it an all important exercise which had gone into clarifying the position that not even a cent of the Global Fund had landed on the country's soil.
The Chair concurred that the presentation had given a holistic picture with regard to the activities of the UN Global Fund and that once for all the critical question of Country Co-ordination Mechanisms had been clarified. He added that the process in terms of applications had come out very clearly noting that some sections of society thrive on working on perceptions rather than concrete facts. He pointed out that the information the Minister had outlined would go along way to dispel suspicion on the subject last year.
Meeting was adjourned.