01 December 2015
An Office of the Inspector General (OIG) audit concluded that the Global Fund's oversight and internal controls to mitigate financial and procurement risks are generally effective. However, the OIG found problems with implementation arrangements at the Ministry of Health that could compromise the objective of eliminating malaria in Honduras by 2017. The Global Fund is working with its partners to strengthen controls in the country.
Implementing grants in the Republic of Honduras has been affected by the introduction of a comprehensive health sector reform and significant internal unrest. Honduras has the highest malaria burden in the Central American region with 144,431 suspected cases in 2013 of which 5,364 were confirmed. HIV prevalence for adults between 15-49 years is 0.4% while the number of people living with the virus is estimated at 23,000; tuberculosis prevalence is 74 per 100,000, with fairly low detection rates. Eight grants have been signed with Honduras since 2003 and USD 40 million has been allocated to the country under the Global Fund's new funding model.
The audit reviewed the Global Fund operations from January 2013 to June 2015 and focused on the existing active grants managed by the Cooperative Housing Foundation and the Ministry of Health. It aimed to assess the effectiveness of program implementation arrangements focusing on the current Ministry of Health reform, governance, coordination and oversight mechanisms over Global Fund programs, and the adequacy of the design and operational effectiveness of internal controls in safeguarding Global Fund resources.
Concerning the effectiveness of implementation arrangements, the OIG found that accountabilities within the Ministry of Health were not clearly defined and resources varied between national and regional structures. The Global Fund grant objective is to eliminate Plasmodium falciparum malaria by 2017 but the delays in improving current operational structures could affect this.
Major risks related to governance and financial management are effectively mitigated by the Global Fund secretariat through a number of internal safeguards. However, limited controls over monitoring and evaluation as well as data quality are the result of inadequate risk identification. This means that it is difficult for the Secretariat to know where to prioritise oversight resources. Limited supervision visits, the absence of written procedures, and a predominantly manual data reporting system have contributed to inefficiencies and inconsistencies in data collection.
In order to improve its service delivery, the Global Fund Secretariat has requested each Principal Recipient to map out its implementation arrangements including those with potential sub-recipients. It will also engage with partners to ensure that a National Monitoring and Evaluation Plan is updated by March 2016. In the interim, it will ensure that resources are re-allocated for quarterly monitoring visits to key services.
Audit of Global Fund Grants to Honduras (GF-OIG-15-022 - 1 December 2015)
The Office of the Inspector General safeguards the assets, investments, reputation and sustainability of the Global Fund by ensuring that it takes the right action to defeat AIDS, tuberculosis and malaria. Through audits, investigations and consultancy work, it promotes good practice, reduces risk and reports fully and transparently on abuse.
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