Global Fund frustrates Uganda’s plans to strengthen health information infrastructures

On 20 March 2017, the Uganda country coordinating mechanism (CCM) submitted a funding request to The Global Fund to Fight AIDS, Tuberculosis and Malaria containing three components: TB/HIV, malaria and RSSH (resilient and sustainable systems for health). The CCM also submitted a proposed program split for its 2017-2019 allocation. According the Global Fund Observer, however, the fund secretariat turned down the proposed program split. In so doing, the Secretariat effectively told Uganda that it could not use a portion of its allocation for a stand-alone RSSH component.

The Global Fund is committed to funding the development of sustainable infrastructures as outlined in its recent information note which affirms that it:

has always recognized that strong health systems that integrate robust community responses are needed to end HIV, TB and malaria as threats to public health. Therefore, the Global Fund has prioritized investments in building resilient and sustainable systems for health (RSSH) as a core aspect of its work, as highlighted in the new Global Fund Strategy 2017-2022 “Investing to End Epidemics.” This focus on RSSH aims to continue strengthening and expanding the capacity of systems to address health issues in a sustainable, equitable and effective manner, including for the three diseases. By strengthening systems for health, it is also expected that they will be prepared for and able to cope with any potential future shocks.

According to an in-depth study of this case conducted by Aidspan’s Global Fund Observer bureaucracy has got in the way of good intentions.  It put the question

How can the Fund, on the one hand, encourage countries to divert funds from their HIV, TB and malaria allocations in order to come up with enough money for a stand-alone cross-cutting RSSH component – and then, on the other hand, criticize countries for “weakening” their response to the diseases in the process? Where else can a country come up with money for an RSSH component except by taking it from the HIV, TB and malaria components?

To which the Global Fund replied

We do not encourage countries to divert funds from HIV, TB and malaria allocations; we encourage countries to do so only where it makes sense. In this instance in Uganda, the proposed RSSH element did not have a clear link to how the expected systems would benefit the disease component. More important, it would have reduced funding for essential treatment, where essential treatment is urgent and significant. Funding for RSSH should never get in the way of procuring or acquiring indispensable commodities such as ARVs or mosquito nets.