25 August 2017
Despite extremely challenging circumstances, Guinea has made significant progress against AIDS, TB and malaria. Increasing the number of HIV patients on antiretroviral treatment, and reducing malaria prevalence by distributing millions of mosquito nets, including more than 8 million in 2016, Guinea is strengthening many features of its health system, with support from the Global Fund.
Guinea highlights the challenges of addressing new threats to global health security, as witnessed in the Ebola outbreak in 2014. Guinea has weak institutional structures, poor infrastructure and the lowest health care workforce ratio among 49 countries prioritized by WHO.
The Global Fund is committed to strengthening health systems where they are needed most, supported by efforts to improve value for money, through strict financial, procurement and supply controls, with mechanisms specifically suited to high-risk countries so that health investments reach the people most in need, despite all obstacles.
The audit of the Office of the Inspector General into Global Fund grants in Guinea did not identify any ineligible expenses. It recognizes that mitigation measures instituted by the Global Fund have addressed risks and achieved good programmatic results, especially under the malaria grant. The audit also identifies inefficiencies in the supply chain management and limitations in implementation of the HIV grant, which are directly linked to Guinea’s significant systemic challenges, including an overall weak health system, limited operational capacity of the National Committee for the Control of AIDS and the limited number of partners to support the HIV program.
The Global Fund provides a significant portion of the financial resources available for Guinea’s response to HIV, TB and malaria. In collaboration with partners and donors, the Global Fund is supporting Guinea to address systemic challenges and improve decision-making, strengthening essential pillars of the health system, including upgrading its health management information system for better quality of data and its supply chain management. The Global Fund is conducting an audit to determine the actual number of people on HIV treatment after Ebola, which will allow more precise quantification and cascading of health products, thereby lowering the risk of expiries and stock outs. A recent mapping of hotspots of key populations may facilitate better target prevention programs.
The Office of the Inspector General is a central part of ensuring that our investments are made in the most effective and efficient way to meet our mission of ending the epidemics. The Global Fund is already working with partners in Guinea to address weaknesses identified in the audit. We are grateful for the suggestions to achieve the greatest impact.
Interim Executive Director