16 July 2019
The Democratic Republic of Congo (DRC) is a challenging operating environment characterized by poor infrastructure, recurring armed conflicts and repeated Ebola outbreaks. Despite this, Global Fund-supported programs have achieved impact in the country, with significant progress made in reducing the burden of the three diseases. A Long-Lasting Insecticidal Nets mass campaign and expanded community case management have contributed to a decrease in malaria mortality. HIV-related deaths halved between 2012 and 2017, and new infections fell by 25% over the same period. For tuberculosis, treatment success rates improved from 77% in 2013 to 87% in 2018.
The previous OIG audit in 2016 identified various deficiencies regarding programmatic oversight, delivery of quality health services, internal financial controls, and mechanisms to trace health commodities to health facility level. Since then, the Secretariat has put in place enhanced safeguards to improve program implementation and oversight, supply chain management and financial controls. Pervasive stock-outs of HIV test kits remain, however, and there is insufficient stock of malaria commodities at health facilities. Reported numbers people living with HIV under ARV treatment are inaccurate, making it difficult to determine and monitor numbers lost to follow-up. Finally, financial management in DRC remains inadequate, due to limited controls in place at the Ministry of Health, an absence of quality assurance over the work of the Fiscal Agent, and limited Secretariat oversight.
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