Dar es Salaam. Global health financier, Global Fund (GF), has embarked on a move to trace a Sh2.77 billion fund for delivery of antimalarial drugs that are believed to been over-supplied in Tanzanian health facilities, if records are anything to go by.
GF, the country’s leading funder of HIV, tuberculosis and malaria programmes, says in its latest report posted on its website (https://www.theglobalfund.org/) that it would recover the funding it committed for antimalarial drugs in Tanzania if it fails to trace the whereabouts of the drugs.
A series of weaknesses in data management in supply chain operations have been cited as reasons for loss of the drugs. There are also fears the drugs may have been diverted to parallel markets.
The organization’s Office of the Inspector General (OIG) carried out an investigation in Tanzania and revealed a significant discrepancy of 4 million GF-funded blisters worth more than $1.2 million in between 2016 and 2017.
The OIG audit report indicates that consumption of antimalarial blisters was estimated to be 15 million in accordance with the inventory records by the Medical Stores Department (MSD), says GF in its report.
The investigation found that this was 40 percent higher than the dispensed antimalarial drugs (11 million blisters) as per the District Health Information System (DHIS2) for the same period.
When contacted to explain the data discrepancies, the MSD Director Mr Lauren Bwanakunu referred The Citizen to the Ministry of Health for clarification, saying it was responsible for malaria programme financing.
The ministry’s Permanent Secretary Dr Zainabu Chaula told The Citizen when reached for coment that the inconsistencies had been sorted out.
“That discrepancy is no more, it has been worked out,” she said. However, she did not explain in details how the matter had been resolved.
The report of investigation found that critical data flaws continue to negatively impact the Global Fund’s malaria grant in Tanzania.
In an interview with The Citizen, Global fund’s communication official, Mr Ernest Waititu said the fund is yet to establish if the drugs could be recovered as planned.
“At this point, Global Fund is seeking to trace the delivery of ACTs. As such, we are yet to establish whether there is a recoverable amount,” said Mr Waititu.
However, he noted, the fund would continue seeking ways of working with Tanzania to end Aids, tuberculosis and malaria.
Possible explanations for the discrepancy include unreported expiries by facilities, under-reporting of malaria treatments in DHIS II, or potential drug leakages.
“Understaffing at government health facilities is also a likely contributor to reporting errors,” the 2018 audit report by the OIG asserted.
Global Fund grants to Tanzania are largely commoditised, with 73 percent of funds in the current grant cycle allocated to procure and distribute health products. Principal Recipient is the Ministry of Finance and Planning.
Commodities are directly delivered from the warehouses of the central Medical Stores Department (MSD), the central agency responsible for procurement and distribution of drugs in Tanzania, to the health facilities.
The Inspector General (OIG) reported that Global fund has invested approximately $1.9 billion (Sh4.3tr) in Tanzania since 2002.
In its 2018 audit report the OIG indicated that “Tanzania Mainland is one of the most important countries in the Global Fund portfolio, representing almost 6 percent of total allocation for the 2017-2019.”
Global Fund grant funding is allocated separately between Tanzania mainland and Zanzibar.
At the time of the 2018 audit, there were five active Global Fund grants in Tanzania Mainland, all ending on December 31, 2017.
Through the ministry of Finance and Planning, Global fund signed a grant worth over $126.71 million that started from May 2016 to December 2017.
GF grants by 2020
A total of 19 grants from the fund of which $2.51 billion was signed and $2.2 billion have been disbursed.
For malaria, there were five grants with a signed amount of $756.78 million, and a total of $647.99 million set to be disbursed.
Other funds goes to the fight against HIV/AIDS, Tuberculosis, and resilient and sustainable systems for health (RSSH) investments.