Nepal’s Country Coordinating Mechanism decides to make the government principal recipient of the Global Fund grants. But challenges remain

‘The Ministry of Health and Population first needs to categorically ensure adequacy and effectiveness of the implementation arrangements to assure effective execution of the activities under the grants.'

NL Today

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Kathmandu: Country Coordinating Mechanism (CCM), a multi-stakeholder national committee to tackle three diseases HIV & AIDS, TB, and Malaria, on Wednesday, decided to make the Ministry of Health and Population (MoHP) the principal recipient of the Global Fund grants. 

Country Coordinating Mechanism (CCM) Nepal was established as a central pillar of The Global Fund grants to Fight AIDS, Tuberculosis, and Malaria architecture to ensure country-driven, coordinated, and multi-sector processes for leveraging and effecting additional resources to reduce morbidity and mortality from HIV, TB, and Malaria.

Wednesday’s decision will come into effect after its endorsement from the Global Fund. The decision has been taken at a time when questions are being raised over the fulfillment of commitments by government agencies.

Principally, activities led by the MoHP seem positive. This is a reason we all supported the idea that the grants should be channeled through the government system, a CCM member said. “The government, however, needs to ensure massive reforms in its working style to ensure the quality of services to intended beneficiaries.”

[Related: Government to become principal recipient of Global Fund grants]

The grant is very much required in the country due to the continuing burden of HIV, tuberculosis, and malaria in the country, he said. “The decision came as a spirit that the government should take a lead in all activities designed to fight HIV & AIDS, TB, and Malaria. It comes with more responsibilities. The government, particularly, the MoHP, should ensure that the previous concerns will be addressed in a credible manner.”

In the beginning, the government was the principal recipient of the grants. Later, UNDP and Save the Children Federation Inc were nominated as the principal recipients following MoHP’s failure to fulfill commitments. 

Of late, the Global Fund has been implementing the programs through Save the Children International, a leading humanitarian organization, as the Principal Recipient (PR) of the grant.

Following the earthquake in 2015, the Additional Safeguard Policy came into effect and the Secretariat nominated the Principal Recipient that year, reads the Global Fund’s report.  “The Ministry of Health and Population, through the national programs for the three diseases, implements the grants as sub-recipients for interventions in the public sector. Other implementers are non-governmental organizations, who mainly implement interventions for key populations.”

The Global Fund’s Grant Regulations 2014 has a provision for the change of principal recipient. 

[Related: Nepal’s newly-appointed Health Minister decides to bring activities supported by Global Fund under the government]

Once the decision is taken unanimously to select the government ministry as the principal recipient of the grants, the government should assure that it will take all measures for the effective implementation of the activities, a high-level ministry official told Nepal Live Today. “The government needs to assure concerned parties that there will be a significant improvement in the areas where the government had failed to deliver in the past.”

Program management is a key area where the government should put more effort to fulfill its obligations, he said. “The procurement issues were recorded as a major stumbling block on the part of the government for the nonfulfillment of some activities. This situation should not be repeated this time.”

Following the decision, it is the responsibility of the CCM and concerned government agencies to produce a convincing plan of project implementation and correspond the reform measures with the Global Fund and other concerned stakeholders, he added. “In fact, the activities under the grant will come under the official channel once it is carried out by the MoHP. The government should also realize the urgency of the grants to lower the disease burden and should act accordingly.”

“Transparency, timely procurement, competitive project management team, and effective monitoring of the activities are the key areas the CCM will closely monitor in the days to come,” the CCM member said.