22 November 2017
OIG auditors found that Global Fund grant arrangements in Burkina Faso are well-structured and supported by a well-designed system of community health organizations. This has contributed to reducing significantly the AIDS, tuberculosis and malaria burden in the country. However, although the main grant recipient has functioning governance and control processes in place, it needs to improve its transparency, oversight capacity, program and financial management.
Burkina Faso, with a population of just over 18 million, has the eighth highest malaria disease burden in the world. Since the Global Fund started investing in the country in 2003, the malaria mortality rate has more than halved and the HIV prevalence rate has also decreased significantly.
The OIG found financial risk mitigation processes established by the Global Fund Secretariat are mainly effective. Following an OIG investigation in 2015, the Secretariat put in place measures such as a Fiduciary Agent, a restricted cash policy and strong controls for both health and non-health high value procurements. These measures have contributed to ensuring that program funds are used according to grant objectives.
The Programme d'Appui au Développement Sanitaire du Burkina Faso (PADS), a project management unit established by the Ministry of Health, is one of three Global Fund Principal Recipients. It manages three out of five grants and almost 70% of total Global Fund grant funds. As a result, the effectiveness of PADS has a significant impact on the overall quality of program implementation. The OIG noted some gaps in PADS grant arrangements including:
The involvement of community health organizations and health workers is key to achieving grant objectives in Burkina Faso. The government contributes 75% of health worker salaries, thus ensuring sustainability for the system. However, the OIG found there were significant delays in recruiting the organizations. As a result, the country is still struggling with low rates in retaining people on antiretroviral therapy, HIV testing for infants and detecting tuberculosis cases.
The Secretariat has a comprehensive capacity building plan for PADS to address the weaknesses noted by the audit. The plan will include program management; monitoring and evaluation; financial management; budgeting and governance mechanisms.
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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.
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.
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