The Technical Review Panel (TRP) of the Global Fund is an independent body of health experts and academics that reviews the technical merits of every application the Global Fund receives.
When the Global Fund’s board of directors meets in November in New Delhi, it will either accept or reject the TRP’s decision on Zimbabwe and other countries. The Global Fund board has never rejected a decision by its TRP but Zimbabwe has a history of troubled relations with the organisation.
Zimbabwe applied for at least US$500 million for HIV/AIDS, malaria and tuberculosis programmes earlier this year.
The country’s relationship with the Global Fund has not been a rosy one. In seven rounds of funding disbursements, Zimbabwe’s applications have been successful in only two.
AIDS activists and health officials had expressed disappointment over the Global Fund’s previous decisions to exclude Zimbabwe, citing the already limited resources available to tackle its health burden.
Zimbabwe’s health minister, David Parirenyatwa, has frequently accused the Geneva-based agency of political bias, which the Global Fund has strongly denied. When the Global Fund declined the country’s round seven grant proposal in 2007, government officials attacked the Fund for making politically motivated decisions.
Zimbabwe is one of the countries hardest hit by the AIDS pandemic, with an estimated prevalence rate of 15.3 percent. The public health system has collapsed over the years due to poor budget allocations, shortages of foreign currency and a massive brain drain.
In Round 8, Zimbabwe’s Country Coordinating Mechanism (CCM) – responsible for drawing up the country’s funding proposals – requested about US$300 million for HIV/AIDS, and US$58 million for its TB programme. The CCM also requested about US$80 million to revive the country’s ailing health sector.
Counting chickens before they hatch?
Jon Liden, Head of communications at the Global Fund, told IRIN/PlusNews that although the TRP had recommended that Zimbabwe be awarded the money, it was "considerably premature" to announce that these applications would be approved.
Liden said the panel had placed Zimbabwe’s proposal in "Category 2". According to Global Fund procedures, this meant the request for funding had been recommended for approval, provided clarifications or adjustments were met within a specified timeframe.
"Yes, the information about Round 8 has leaked out from Zimbabwe due to a decision this time to inform countries in advance of the board decision about whether their applications have been recommended or not," said Liden.
"This was done so that those whose applications were not recommended could quickly turn around a new or improved application for Round 9, which has already opened."
David Parirenyatwa, who is also Chairman of the CCM, has welcomed the TRP’s decision. "We are delighted by this piece of news. We know, yes, the board still has to endorse the decision by the panel [TRP], but we know that’s just a formality," he told IRIN/PlusNews.
"Once the panel says a proposal is technically sound, it is unlikely the board will fail to take the recommendation. Our financial coffers had run dry and this is a welcome relief."
Dr Douglas Gwatidzo, Chairman of Zimbabwe Doctors for Human Rights, agreed with Liden that it might be too early to consider Zimbabwe’s application as granted.
"Should the board approve this application, based on information we have about previous grant disbursements, we will only receive this money in April. We must look at this with an open mind. There is an urgent need of HIV/AIDS funding, so while we wait for the Global Fund we must look elsewhere or otherwise our people will continue to die."
Gwatidzo said the decision to request a grant to strengthen the health system was "very wise" because the performance of all other grants for HIV/AIDS, TB and malaria depended on a fully functional health delivery system.
Of the 1.7 million people living with HIV in Zimbabwe, only 100,000 are accessing treatment free government treatment, but 320,000 people are still in need of antiretroviral drugs.