Audit of Grants to Viet Nam
20 August 2018
Viet Nam has made significant progress in tackling HIV, tuberculosis and malaria. The government is progressing towards universal health coverage and towards sustainable domestic financing for health, and has committed to ending the HIV and tuberculosis epidemics and eliminating malaria by 2030. The country is implementing several innovative approaches to disease prevention and treatment, along with mechanisms to improve the sustainability of the health system. Since Viet Nam is now a lower middle-income country, it is expected that donor funding for health will gradually decrease and some donors have already begun reducing their support.
With HIV and tuberculosis treatment currently being integrated into the country’s Health Insurance program, there is a risk that some HIV patients will not be able to access affordable and quality care due to enrolment difficulties, and a risk of increased loss-to-follow-up related to the transition process. To address these risks, the Global Fund Secretariat will work together with Principal Recipients to establish a high level implementation plan which will address risks related to access to care for vulnerable populations and risks related to continuity of the roles of the community in HIV prevention.
Global Fund Grants are well performing and are generally meeting or exceeding expectations. Financial implementation arrangements are effective and have enabled effective absorption of the grants funding in line with the budget. More than 50% of funds available in country are spent at provincial, district and commune levels, and around 76% of these are payments in cash. The OIG did not identify any misuse of funds; however, current assurance arrangements need to be strengthened to mitigate the inherent risks of cash payments.
Financial implementation arrangements are effective and have enabled effective absorption of the grants funding in line with the budget. More than 50% (or US$16 million) of funds available in country are spent at provincial, district and commune levels, and the majority of these are payments in cash. While the OIG did not identify any misuse of funds, the current assurance arrangements need to be strengthened to mitigate the inherent risks of cash payments. There is a need to find alternative, less risky payment methods that would not compromise effective programmatic implementation.