19 July 2017
South Africa is a leader in the fight against HIV and tuberculosis and building resilient and sustainable systems for health. South Africa has the largest number of people living with HIV and the world’s largest HIV treatment program. South Africa’s government strongly supports the HIV response, and is by far the largest investor in national HIV programs, providing around 80 percent of funding. South Africa has made great progress against HIV, and has dramatically improved the nation’s overall life expectancy in recent years. In addition, South Africa is at the forefront of innovative approaches to preventing infection, recognizing the critically important role of focusing on adolescent girls and young women, who are disproportionately affected by HIV.
South Africa also has the sixth-highest number of people diagnosed with TB in the world, and the government provides more than 90 percent of funding for TB programs.
The Global Fund’s support for the response to HIV and TB, while considerable, represents a fraction of what is being invested by South Africa’s government. In that context, the Global Fund’s support for South Africa is focused on prevention. We provide catalytic investments in critically important areas, and support innovation to increase impact. Many programs in South Africa that are supported by the Global Fund are new and require strong leadership and effective coordination. As in all new interventions, changes are made as lessons are learned.
It is vital to support innovative programs to protect key and vulnerable populations, especially adolescent girls and young women. We are constantly learning and adapting. We will continue supporting innovative programs, while taking calculated risks.
The Office of the Inspector General (OIG) conducts independent audits and investigations to complement the active risk management and controls put in place by the Secretariat with oversight by the Board of the Global Fund. The audit report on grants to South Africa did not identify any misuse of funds or fraud. The audit, conducted nine months into the implementation of the current grant cycle, identified implementation challenges and highlighted internal control arrangements that could provide assurance on financial risks. It is early, in the start-up period of a complex and innovative program, to draw conclusions. Yet the country team is already working with partners to address coordination and governance as well as programmatic assurance challenges.
As the OIG indicated in its response to concerns raised by the Audit & Finance Committee, the country team is actively engaged in program oversight, making improvements and supporting corrective actions that are being led by the CCM. Many of the issues identified in the audit are inherent to a program of this nature, and were proactively identified by the country team, which took mitigating actions including catch-up plans and revisiting the monitoring mechanisms to ensure that they remain effective with regard to new program interventions and innovative approaches. The country team is also particularly focused on supporting interventions that address the disproportionate risks to adolescent girls and young women.
The Global Fund is constantly strengthening measures to increase value for money, and improve effectiveness.
Interim Executive Director