The Global Fund has approved three grants for Zimbabwe over a two-year period: US$79 million for HIV/AIDS; US$63 million for malaria and US$27 million for tuberculosis.
The Geneva-based organisation said these grants could be extended up to five years, depending on the performance and results of the approved grants during the first two years. Zimbabwe had applied for about US$500 million for the three diseases, and also to help resuscitate the country’s ailing health sector.
Last week the country’s funding proposal hung in the balance after the government failed to meet the deadline of Thursday 6 November to return over US$7 million to the Fund. Some of the money was held by the Reserve Bank of Zimbabwe (RBZ) but was distributed "erratically and only partially", which had affected the implementation of programmes, the Fund said.
Michel Kazatchkine, executive director of the Fund, had warned that no future grants would be awarded until the remaining US$7.3 million had been transferred to commercial banks by the due date.
Although the RBZ eventually paid the outstanding amount on Friday 7 November, the Global Fund had warned it would not approve any new grants for Zimbabwe until it had received assurance that its money would be safe.
Jon Liden, the Fund’s head of communications, told IRIN/PlusNews that although the board had approved Zimbabwe’s application, no grant agreement would be signed until the funding body had made sure that the money would reach the intended beneficiaries.
"Approving the grants is just the first step. Now, negotiations about a grant agreement will begin, and the Global Fund has made it clear that no grant agreement will be signed with Zimbabwe until we can guarantee that the money going to the recipients of these grants can reach them without delay or diversion," said Liden.
"For the new grants, it normally takes six to twelve months between Board approval and grant signing, but it may take longer unless we can quickly find satisfactory ways of channelling the money in a safe way, as well as making sure all the recipients of the grants are of high quality."
Zimbabwe’s HIV/AIDS community welcomed news of the grant, but there was concern that the conditions imposed by the Global Fund, however justified, would further delay grants to beneficiaries who were often in dire need as a result of the worsening national health and HIV/AIDS crises.
The Harare and Parirenyatwa hospitals, Zimbabwe’s largest health institutions, recently shut down when staff downed tools in protest against poor salaries and working conditions. The health professionals argued that the hospitals had become "death traps" because there were no drugs or medicines, and essential life-saving medical equipment did not work.
Dr Douglas Gwatidzo, chairman of Zimbabwe Doctors for Human Rights (ZADHR) told IRIN/PlusNews that the approval of the Global Fund grant was a "welcome relief" because the country’s health resources were running low, but he feared the money might take "forever" to reach the people who needed it.
"The conditions put in place by the Global Fund are understandable after the conduct of the Reserve Bank of Zimbabwe; clearly there is a strong element of mistrust," he commented.
HIV/AIDS activist Sebastian Chinhaire, a member of the Zimbabwe National Network of People Living with HIV/AIDS (ZNNP), said the delay in the grant signing could mean death for many HIV-positive people.
"As we speak, the government-run antiretroviral (ARV) drugs programme that supports at least a 100,000 people is struggling to keep afloat. Recently, the opportunistic infections clinics at Harare and Parirenyatwa hospitals closed down because there were shortages of drugs."
While Zimbabwe puts its house in order with the Global Fund, reduced donor funding means at least 100,000 people in state-funded ARV programmes face an uncertain future; on top of this, a further estimated 320,000 HIV-positive people are in urgent need of the life-prolonging drugs.