03 October 2014
Auditors from the Office of the Inspector General found that financial risks in Guinea-Bissau have been managed well by the Global Fund and that the safeguards in place are generally effective. On the other hand, stock management of health products, grant performance data and Local Fund Agent oversight need improving. The Global Fund has already taken steps to address these issues.
The Global Fund’s grants to Guinea-Bissau were the first to be audited by the Office of the Inspector General using a new tailored approach that looks specifically at the controls in place to safeguard future Global Fund investments and to ensure that grants have the greatest impact.
The Global Fund has implemented effective mechanisms to control the significant financial risks in Guinea-Bissau, including a zero-cash policy and a dedicated fiscal agent for the HIV grant. As a result, grant recipients have adequate financial controls in place. The auditors found no major stock-outs of essential medicines but concluded that stock management at health facilities was unsatisfactory. This is largely due to a lack of training and inventory tools.
The audit highlighted that poor infrastructure, limited supervision and under-qualified staff at health centers in Guinea-Bissau have resulted in unreliable performance data, particularly on the malaria and tuberculosis grants. To mitigate this, the Global Fund has committed to reviewing how the performance-based approach can be tailored for countries with significant data quality challenges.
Guinea-Bissau is a tough environment for the Global Fund. It is one of the world’s poorest nations and ranks 177 out of 187 in UNDP’s 2014 human development index. Despite this difficult context, the Global Fund Country team has tried to balance considerable operational risks with the provision of reliable and safe services for those in need.
There are currently three active Global Fund grants in Guinea-Bissau: an HIV grant managed by the National Secretariat to Fight AIDS (SNLS), a tuberculosis grant and a malaria grant, both managed by the United Nations Development Programme (UNDP). A total of US$ 68 million has been disbursed to Guinea-Bissau to date, of which US$ 22 million was paid out in 2013. There are currently over 6000 people on antiretroviral therapy, over 7000 new smear-positive tuberculosis cases have been detected and treated and more than 1 million bed nets have been distributed to date.
The Office of the Inspector General works to ensure that the Global Fund invests the world’s money in the most effective way possible in the fight against AIDS, tuberculosis and malaria. Through audits, investigations, oversight and consultancy work, it makes objective and transparent recommendations to promote good practice, reduce risk and condemn abuse.
Established in 2005, the Office of the Inspector General is an independent yet integral part of the Global Fund. It is accountable to the Board through its Audit and Ethics Committee and serves the interests of all Global Fund stakeholders. Its work conforms to the International Standards for the Professional Practice of Internal Auditing and the Uniform Guidelines for Investigations of the Conference of International Investigators.
The Office of the Inspector General believes that every dollar counts and has zero tolerance for fraud, corruption and waste. Through its whistle-blowing channels, the Office of the Inspector General encourages all to come forward to point out any irregularities that prevent Global Fund resources from reaching those who need them.