Global Fund Grants in the Republic of Namibia
02 August 2023
Namibia is classified as an upper-middle-income country and invests significantly in the fight against HIV, tuberculosis (TB) and malaria. Global Fund grants are strategically positioned and relevant to the country's needs. Since 2004, the Global Fund has disbursed US$372 million to Namibia. It is one of the few countries in the world that have achieved the 90-90-90 UNAIDS targets, with reported achievement of 92-99-93 in 2023. The country is also among the five countries in Africa currently in the malaria pre-elimination phase and has witnessed a decrease in TB incidence and mortality rates.
To ensure this progress is sustained, community intervention needs improvement. Limited availability of community health workers (CHWs) is impacting delivery of interventions for the three diseases. To help address this, the Government approved a Social Contracting Policy in March 2023. This policy will enable the Government to contract civil society organizations (CSOs) to provide essential health services in line with government priorities including the hiring of CHWs. Despite these challenges, the adequacy and effectiveness of the community-based interventions are rated as effective due to the significant progress made and the country’s programmatic outcome in the fight against the three diseases.
Despite the progress made, Global Fund-supported programs in the country face challenges including low fund absorption and non-achievement of some of the previous grant objectives. The country is also experiencing delays in achieving the objectives of the current grant, which ends in December 2023. Gaps in the Country Coordinating Mechanism (CCM) and in the Principal Recipient’s oversight contributed to grant implementation challenges. Suboptimal reporting structures, inadequate supervision and capacity gaps have impacted the Principal Recipient’s effectiveness. The adequacy and effectiveness of the implementation and oversight arrangements of the Global Fund supported programs – to ensure the achievement of grant objectives – are rated partially effective.
There is a need to enhance the design and compliance of financial management and procurement processes to safeguard grant funds. Shortcomings in financial management and reporting are impacting the reliability of reported information. Non-compliance with procurement processes is also impacting the transparency and competitiveness of procurements. The adequacy and effectiveness of the financial controls and in-country assurance mechanisms in safeguarding Global Fund resources are rated as needing significant improvement.