Office of the Inspector General

Audit of Global Fund Multicountry Grants

14 February 2019

Multicountry grants are designed to accelerate the end of the HIV, TB and malaria epidemics and to strengthen health systems by tackling regional bottlenecks and cross-border issues. They have the potential to achieve impact particularly where bottlenecks cannot be resolved by a single country application. The Global Fund Board adopted a refined allocation methodology for the 2017-2019 funding cycle to increase the impact, simplicity, flexibility and predictability of multicountry investments, and approved funding to be directed towards multicountry approaches targeting priorities deemed strategically critical.

To date, multicountry grants have facilitated regional coordination and an integrated approach towards issues such as malaria elimination, tuberculosis in miners and ex-miners, access to services for refugees, migrants and mobile populations, human rights and gender barriers to accessing HIV services. Multicountry grants have, however, faced challenges in their implementation; 71% of the multicountry/regional grants selected for review by the OIG performed below expectation at the last progress update in December 2017. The malaria program in the Greater Mekong Sub-region faces particular challenges.

While the Secretariat has streamlined some multicountry grant processes (such as grant applications), grant implementation arrangements could be further optimized. Equally, the lack of effective governance for one of the two main multicountry governance arrangements (Regional Organizations) has resulted in ad-hoc management of important processes. Issues relating to risk management and also grant monitoring need to be addressed.

One particular challenge faced by multicountry grants is the inability of current regional data systems to provide quality and timely programmatic data on the three diseases, while another relates to the alignment of various country reporting standards to ensure regional data is available.

Overall, multicountry grant processes, systems and resource allocation have not yet been adequately tailored to cater for their specificities and complexities.

  • Global Fund Multicountry Grants (GF-OIG-19-003 - 14 February 2019)
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For more information:

Dougal Thomson
Mobile: + 41 (0)79 717 6694


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.

The Global Fund believes that every dollar counts and has zero tolerance for fraud, corruption and waste. Through its whistle-blowing channels, the Office of the Inspector General encourages all to speak out to report fraud, abuse and human rights violations that prevent Global Fund resources from reaching those who need them.