03 May 2019
Resilient and sustainable systems for health (RSSH) are crucial in ensuring that people have access to effective and efficient services, and are essential for ending the HIV, TB and malaria epidemics. The Global Fund has invested approximately US$5.8 billion for health system strengthening activities since 2014, reaffirming its commitment to building resilient and sustainable systems for health by elevating RSSH to a strategic objective in its 2017-2022 Strategy. This audit covered the Secretariat’s management and monitoring of all RSSH activities, and analyzed progress on financial management and supply chain strengthening components of RSSH sub-objectives.
The Global Fund’s structures, systems, processes and skill sets are primarily designed to deliver disease programs, rather than RSSH activities. The Secretariat’s monitoring framework to routinely assess grant performance is unsuited to RSSH activities, and sustainability measures are not consistently considered in RSSH activities.
Progress has been achieved in strengthening the financial management capabilities of implementers. The Secretariat has also instituted measures to mitigate the unique risks usually faced by RSSH activities at country level, although these are not being consistently implemented.