Partnership with Aidspan to improve accountability of Health Donor Funds through SAI audits

AFROSAI-E and Aidspan are working together with the Global Fund Secretariat and Office of the Inspector General (OIG) to increase the number of SAIs involved in the Global Fund audits and increase the audit scope to include compliance and programmatic audits.

Our partnership with Aidspan continues as we start the second phase of an ongoing Aidspan project entitled Supreme Audit Institutions audit Global Fund Grants in Sub-Saharan Africa – Phase 2, running from August 2020 to January 2022. The project is focused on building the capacity of our member-SAIs to audit Global Fund grants and health programmes in their countries.

Why should the SAIs be involved in the audit of these grants

Involving SAIs, who already have the mandate, legal power, and knowledge of the local context, can improve accountability, sustainability, and country ownership of the grants. SAIs have an added advantage of reporting their findings to Parliament, which increases visibility and can compel hearings and remedial measures where needed. SAIs are also better placed to track the implementation of audit recommendations.

In addition, SAIs can transfer the acquired knowledge and skills to the audit of health programmes in general, including those funded by other bilateral and multilateral donors such as the Gavi Alliance and the World Bank.

AFROSAI-E member states are the biggest beneficiaries of Global Fund investments

Of our 26 AFROSAI-E member states, 25 states have received more than $24 billion from the Global Fund since 2003, as they bear a huge burden of the three diseases and often have weak health systems. Only Seychelles does not receive any Global Fund financing. This amount represents half of Global Fund’s investments thus far ($48 billion).

Government institutions have received more than two-thirds of this funding ($17 billion) (Figure 1 below). These include the Ministry of Health (including the three disease programmes), the Ministry of Finance (and its equivalents), and independent government institutions such as the National AIDS Commission or Control Councils.

Despite most of these funds going to government institutions, only ten SAIs audit them within their countries: Botswana, Eritrea, Ethiopia, Ghana, Kenya, Lesotho, Rwanda, Tanzania, Uganda, and Zimbabwe. The Global Fund relies on private audit firms to monitor grant funding in the remaining countries.

Figure 1: Global Fund disbursements to governmental institutions in AFROSAI-E member states since 2003 total US$17billion, which makes up 71% of Global Fund Sub-Saharan investment.

Outcomes of the first phase of this initiative

AFROSAI-E and Aidspan collaborated to implement the first phase of the project between December 2018 and March 2020. During this phase, we trained six SAIs to conduct financial, compliance, and programmatic audits of Global Fund grants. At the time of the training, three of the SAIs (Ghana, Kenya and Rwanda) were already auditing Global Fund grants. The other three SAIs (Liberia, Malawi and Sierra Leone) were not.

Since then, these SAIs have initiated special audits of Global Fund grants while others have incorporated programmatic aspects in the audit of Global Fund grants and other health-related audits.

AFROSAI-E and Aidspan new partnership to include more SAIs

AFROSAI-E and Aidspan will continue to work with these six SAIs and will reach out to five more SAIs in second phase of the project. For SAIs that already audit Global Fund grants, we will strengthen their existing financial audits and empower them to perform compliance and programmatic audits of these grants. For SAIs currently not auditing Global Fund grants, we will first provide them with detailed information on the Global Fund systems and processes, audit requirements, and then strengthen their capacity to audit Global Fund grants. We will also provide information on how Global Fund grants are implemented in their countries and link the SAI members with relevant in-country stakeholders.

In line with our initiatives to build SAI capacity to perform disaster audits, we issued a Research Paper on SAI resilience to disaster situations, which led to a Pocket Guide on audit considerations in response to disasters. We will also support the SAIs in preparing for audits of COVID-19-related funds within their countries in this second phase.

Overall, AFROSAI-E and Aidspan, with the support of the Global Fund, will provide technical support to the SAIs as they plan, execute and report on these audits. Under this project, we will also help them explore new sources of funding while leveraging existing ones to support the execution of these audits.

Aidspan, a Kenyan-based international non-governmental organisation, monitors the transparency and effectiveness of the Global Fund to Fight AIDS, Tuberculosis, and Malaria (herein the Global Fund). The Global Fund is an international financing institution based in Geneva, Switzerland, that supports HIV, TB, and malaria programmes and helps strengthen health systems in more than 100 countries in sub-Saharan Africa, the Middle East and North Africa, Latin America and the Caribbean, Eastern Europe and the Asia Pacific. It channels its investments to governmental and non-governmental institutions in these countries.

For more details on this partnership, please contact Edmond Shoko at [email protected] and Syson Laing at [email protected]