Office of the Inspector General

Grant Implementation in Western and Central Africa

31 May 2019

Western and Central Africa (WCA) is critically important for the Global Fund. Since 2002, the organization has invested US$6.9bn in the region, with US$1.1 billion invested in Resilient and Sustainable Systems for Health since 2014, and US$10m provided annually in technical assistance.

WCA is a challenging operating environment characterized by high fragility and instability, weak health systems, limited fiscal space, low health financing and a significant funding gap. Despite this, significant progress has been made in reducing mortality from malaria (-37% since 2010) and HIV (-27% since 2010). WCA is however lagging behind in the fight against tuberculosis, with a 5% increase in TB deaths in the same period.

At the request of the Executive Director, the Office of the Inspector General conducted an advisory review on grant implementation in Western and Central Africa, to gain a better understanding of potential implementation barriers and to identify opportunities to enhance program performance.

The review found that balancing risk mitigation measures with simple, flexible processes that can be tailored to specific country contexts is a critical enabler to successful program implementation. Multiple implementation arrangements in place across WCA are dragging down performance, and barriers to accessing health services are contributing to the lagging performance on HIV and TB. In order to overcome current challenges and improve performance in the WCA region, the advisory review provided various recommendations related to Global Fund internal processes, implementation arrangements, technical assistance, and access to health.

  • Grant implementation in Western and Central Africa (WCA) Overcoming barriers and enhancing performance in a challenging region
    (GF-OIG-19-013 - May 2019)
    download in English | Français
  • Secretariat Action Plan
    download in English | Français

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.

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