Of the funds given for Round 2 more than three years ago, over US$57 million (Ksh 3.6 billion) is yet to be spend in the phase 2 of the round. Of these, US$ 17 million is supposed to buy antiretroviral drugs, with the rest going to strengthening structures and reporting systems. The Global Fund has warned that this money will be returned and future funding stopped if it is not used by the end of November.

What is then ailing Round 2? It is emerging that of the 29 NGOs given the money, some have been an unable to spend it within the required time-frame, while others were just briefcase outfits, with no capacity at all on how to implement the beautiful programmes they had detailed in their proposals.

In the past, Global Fund has raised questions about expenditures whose accounting is not satisfactory or delays in submitting reports for some of the expenditures already made.

This has resulted in the Fund refusing to fund HIV/AIDS programme in the subsequent rounds until money for round 2 is used and properly accounted for. It is only in round 7 that the Fund decided to approve funding after the government promised to look into the issue of absorption capacity.

At the Special ICC-HIV/AIDS meeting held on 3rd March 2008 at the National Aids Control Council (NACC) boardroom, the members expressed fears that the absorption of Global Fund round 2 was very poor, calling on the stakeholders to address the serious capacity absorption issues.

Problems with this round, which was the first funding Kenya got from the Global Fund, started when the Fund changed its parameters from requiring countries to report on how much money had been spend, to reporting outputs- that is what money had done.

Hence, like other countries, Kenya was expected to report the number of people put on ARV treatment or those trained and not just stating the number of drugs bought or training materials developed. 

The other requirement was to properly account for money used, after it emerged that several NGOs and Ministry of Health had used funds on questionable things and could not provide satisfactory accounting. In addition to this, some organizations which have been receiving money from the National Aids Control Council have been unable to utilize it with the efficiency required.

These factors sent the country into a spin, and they have remained its main source of misery.

It is not clear why the government has not acted expeditiously on the reasons for the low absorption even after Global Fund (GF) pinpointed specific areas that needed action such as dual-tracking and community and health systems strengthening.

“There were outstanding Phase 2 reporting issues that needed to be tackled before applying for additional GF funding as well as addressing taxation issues to pave way for absorption of GF funds already in the Country,” says the minutes of the Special ICC-HIV/AIDS meeting of 3rd March 2008.

Those present at the meeting were worried that implementation of Round 7 had not even commenced and yet progress of each Round triggered the next. “Incapacity to absorb funds could be a factor of priority setting,” they proposed.

A section of the members wondered if “funds for implementers with poor absorption capacity could be transferred to those with high rate of funds absorption.” But this is likely to be a tall order as many NGOs will not agree their lifeline to be cut or tampered with.

But Prof Alloys Orago, NACC’s Director, insists this has to happen if the civil society is to be assured of future funding. 

“Together with the civil society, we have come up with a working formula on how to use the round 2 money. This includes taking funds from organizations with low absorption capacity to those with high abilities,” says Dr Orago.

“Other funds will be redistributed to organizations with proven abilities, but which were never funded in the first place,” he adds.

The Council is further going to put in place a raft of strict requirements to ensure what happened in round 2 is not repeated. Starting this month all NGOs using Global Fund money are to be monitored on a monthly basis.

At team from NACC will have to prove the registration and in collaboration with the provincial administration, the physical location of any NGOs before funding any such organizations. On government bureaucracy in releasing the money, the Council is now going to deal directly with an officer at the Treasury, who is to coordinate all matters relating to the Fund.

In addition to this, ICC for HIV/AIDS members recommend that the government fast-track Global Fund Round 2 budget for ARVs to expedite the use of the pending funds.

Although these members acknowledge the serious challenges facing round 2, they said the country cannot afford fail to apply for Global Fund Round 8.

“Even with the existing bottlenecks, Kenya could still apply for GF Round 8 but with a comprehensive explanation of the bottlenecks and proposed measures to address them annexed to the Proposal,” recommends the Special ICC-HIV/AIDS meeting.

Prof Orago disclosed that a task force to look into how to go about Round 8 has already been set-up. It is going to focus on three areas that the proposal is to address. The first issue the proposal is to address is Gender Mainstreaming into HIV/AIDS programming.

Funds for this arm are to look into correlation between HIV/AIDS and sexual violence in a more detailed way. The second area will be seeking funds to strengthen the health system; while the third area is to focus on strengthening communities to respond better when offering home-based care services.