Government’s failure to show full commitment to exhausting allocated grant from the Global Fund has resulted with a 50 per cent slash of the next allocation covering the period 2019 to 2021, informed sources have revealed. Government’s P320 million (US$ 32 million) allocation has now been reduced to P170 m (US $17 million); a move that has left close observers fuming at Government’s failure to show commitment to speedy project implementation. The funds were to be used by the National Aids Coordinating Agency (NACA) in the TB/HIV campaign (US $ 26 million) and for Anti-Malaria campaign (US $ 5 million). So far with less than a year before the end of the funding period only a paltry amount – way below 50 per cent – has been used; hence the signal by Global Fund that it will be cutting its funding to Botswana. Unused money will be returned to Global Fund. What is considered to be implementation on the Government side primarily deals with equipment acquisition which then means that the real programmes are yet to get underway. Because of the poor implementation record of previous grants from Global Fund and with a repeat of disinterest seemingly underway, leading organisations that offer grants are said to be reading a lot from this.“There is an emerging concern from international funders that Botswana is communicating a picture that it does not need any assistance. This is despite the shortage of medication in hospitals and the many challenges that the sector faces,” said one informed observer. He blamed the lackadaisical attitude of Government employees for their failure to use funds that are readily available which could help in saving some of the state resources for use in its many other priorities. “It looks like it is simply business as usual with Government and for an average person it will appear like all is okay. This is definitely a big deal. They are given money for free for which they will not even pay interest or anything; yet they are simply comfortable in seeing it being returned without being spend,” he charged. Blamed for this is the tendency by some government officials to pick the easy way – they shun the rigorous process that has to be followed to access the allocated Global Fund money, which includes following appropriate procurement procedures and ultimately accounting for every Thebe used. To avoid this, sources say, officials choose to use Government funds due to the available short-cuts of securing them. Compared with the civil society principal recipient – the African Comprehensive HIV/AIDS Partnership (ACHAP) – whose performance has been well over 70 per cent, Government implementation has come under serious scrutiny.This development comes at a time when Government is in the process of rolling out HIV treat all campaign – where individuals found HIV positive are immediately put on treatment without waiting for one to have his CD4 count reach a certain level. It is expected that this would add extra burden to the already overstretched Government fiscal.
Growing health budget
Government’s spending on health is often beaten only by the education budget. According to the 2015/16 budget allocation, some P5, 9 billion was set aside for the health sector with P5, 7 billion as recurrent estimates and P203, 8 million development estimates.In the 2016/17 financial year a whopping P6.48 billion was requested and approved with P5.74 billion as recurrent budget, and over P741.8 million as the development budget
The National Aids Coordinator Agency’s National Coordinator, Richard Matlhare, answered questions from The Patriot on Sunday as follows:
There has been a concern that Botswana is not taking full advantage of the grants availed to it particularly from the Global Fund which often results with allocated funds being returned. Kindly respond to this.
A: Since inception of the Global fund in 2002, Botswana has benefited through four grants. The first grant (round 2) was for HIV – The grant was terminated not because the money was not used, but due to incomplete reporting. The work had been done and funds spent, but some Implementing organisations lacked capacity to report, hence the country did not meet the targets and reporting deadlines. The second grant (Round 5) was for TB – A 5-year grant was implemented and finished on time. Currently there are 2 grants (one for Malaria and the other for TB/HIV - The malaria grant is finishing in September 2018 and the TB/HIV in December 2018. Implementation is on track and it would be too early to say that funds had not been used as we have details of our expenditure levels and commitments so far and the projected spending in the remaining 12 months.
It is said due to the under-spending of the current allocation a letter of intent for the period 2019 to 2022, Global Fund has announced that it will cut down allocation to Botswana by almost 50 per cent. Are you aware of this?
A: I am not aware of such a letter, unless you provide me with a copy which I shall be glad to respond to. Like I said earlier, the current grants are still active. Of course the 2019 to 2022 allocation is lower based on the allocation criteria; and the 2023 to 2025 would even be lower. The 2026 to 2028 allocation would be even much lower and it would be the last grant to receive from the Global Fund. This is not attributable to non-spending but to the fact that Botswana is classified as an Upper Middle Income country and it is expected that at some years to come we should transition from the Global Fund support. So Botswana is going towards a transition phase, as this support is not forever. Countries graduate at different stages based on their economic status and disease burden.
The TB/HIV allocation for 2015-18 has allegedly not been used to the level expected with only a few months before the funding period expires. What is the current performance in the use of this grant?
A: The absorption rate stands at 55%. With twelve more months to go, we have pegged our expenditure projections to 88% for June 2018. There are two major projects namely: procurement of some specialised medical equipment, already at an advance stage of procurement (we can show you our procurement schedule) and a TB/HIV Prevalence survey that is scheduled to start in January and finish in August 2018 (again we can show how the survey details and expected expenditure). These two would take most of the funds while the remaining 12% would just be salaries for the staff and their severance benefits. Such detail has also been authenticated by an independent accounting firm called Grant Management Solutions which was commissioned by PEPFAR in August this year (2017) to review our performance . Their report among others indicates that: “Government should be able to implement all the activities before the end of the grant period in December 2018,” and that “there is Potential for funding shortfall which will result from the survey expenditure next year (2018).”
The issue of poor use of Global Funds grants is common with Botswana and the country is now seemingly getting a reputation of being aloof – not showing that it needs international support. Your comment to this?
A: This is misrepresentation. Botswana needs donor support and there is great need to fight this perception. Media Houses should like yourselves’ should at times visit us to understand where and how we operate and get first hand details from us as a source.
Any other comment?
A: There has never been any official communication from Global Fund in any form to the effect that reduction of funding is due to non-utilisation of grants as there has never been a time where the money allocated to Botswana was returned to the Global Fund – unless you give us evidence to that effect. What we know is that the Global Fund had allocated Botswana an additional USD 17 million for the 2017 - 2019 Funding Cycles. The funding to any country is based on two key parameters; Country economic status and the disease burden within the country. The Global Fund covers three disease areas being TB, HIV and Malaria.
Global Fund 2017 Eligibility Rating
Country Income Category Disease Component Disease Burden Eligibility
•Botswana UMI HIV Extreme Yes
• Botswana UMI TB Severe Yes
•Botswana UMI Malaria Moderate Transition(2016)e*
e* Botswana’s malaria component moved to transition in 2016 as Botswana was classified as an Upper-Middle Income country and Botswana’s malaria disease burden classification changed from ‘High’ in the 2015 Eligibility List to ‘Moderate’ in the 2016 Eligibility List. Botswana’s malaria component continues to have Moderate’ disease burden classification and will therefore be eligible for a final allocation of Transition Funding. Legend: UMI-Upper-Middle Income
The global fund to fight aids, tuberculosis and malaria, often called the global fund, was created in 2002 as an innovative financing mechanism that seeks to rapidly raise and disburse funding for programs that reduce the impact of hiv/aids, tuberculosis and malaria in low- and middle-income countries. The global fund is structured as a partnership between developed countries, developing countries, the private sector, civil society and affected communities. Unlike many other donors, the global fund has adopted a model that provides funding to country governments and in-country stakeholders based solely on proposals and implementation plans designed by the countries themselves. As a result of its new approach, and its ability to raise funds, the global fund has rapidly become one of the most significant aid mechanisms. It now provides 20% of global funding for hiv/aids, and 66% of the funding for tuberculosis and malaria. [cgdev.org]