COMMENTARY
In the early days of the Global Fund for Aids, Tuberculosis and Malaria (GFATM) I did everything I could to get the decision makes to pay attention to the issue of tgransparency, accounting and accountability. The war was lost as soon as the decision was made that the GFATM would adopt many of the ways of the United Nations which, while sometimes doing some very good things and c ourageously, most of the time is one of the world's worst managers of financial resources with almost zero capacity for competent financial accounting and reporting.

In the first letter below the case is made that doing accounting is going to make the program much more difficult ... while I try to make the point in the second letter that accounting needs to be at the core of the program, but very easy accounting that then becaomes accessible to everyone ... true 'open-book' accounting.

My attempts to get transparencyu and easy to use accounting and accountability lasted a long time ... some progress was made ... but eventually my efforts came to nothing. I was able to 'connect the dots' to show programs funded by GFATM were delivering benefit to the higher ups in the health sector of various countries, but convincing myself that the programs were delivering benefit to needy beneficiaries was more difficult. If the programs were using the money well, this would have been really easy to do.
Peter Burgess

[af-aids] Re: HIV/AIDS Programs Drain Funds From Programs Aimed at Malaria (2)

To: 'AF-AIDS'
Subject: [af-aids] Re: HIV/AIDS Programs Drain Funds From Programs Aimed at Malaria (2)
From: af-aids@healthdev.net
Date: Tue, 12 Nov 2002 06:27:52 +0200
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Re: HIV/AIDS Programs Drain Funds From Programs Aimed at Malaria (2)
1. Caroline Blair
2. Peter Burgess
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1. Caroline Blair

I would like to respond to the message regarding how the US Govt should stop funding the Global Fund. There are several points I would like to make:

1. The fund has not received 'billions' - in fact, it is under-funded

2. The first grants have only just been approved and distribution of funds is recent (and thus activities starting up)

3. [Can] … changing behaviour and putting health systems in place be done in such a short period of time (less than six months?). If so, why do even rich countries continue to have such serious problems with HIV/AIDS (see stats in places like Washington DC) and other public health problems (Syphilis etc).

4. How many years of concerted effort did it take to get the anti-smoking campaign working and although it has made tremendous strides, why do people continue to start smoking (an example of how human behaviour takes time and money to change). How may dollars have been spent on anti-smoking campaigns?

Having lived and worked in Africa for over 14 years, I will be the first to admit that accountability and systems are required. However, sometimes putting these into place causes delays, particularly in societies where literacy is low, poverty is high, and infrastructure is poor. Does this mean we give up? No. It just means the job is harder.

A trade-off between tough accountability standards and quick delivery of programs is always required and achieving the balance is not easy. On the one hand, you want to make sure services (and drugs) get to the people that need them. On the other hand, you don't want to strangle timeliness with layers and layers of bureaucracy.

… in some countries [even] access to even simple infrastructure is a constant challenge. I lived in one country where we had 3 hours of electricity a day in the capital city at some times of the year. This means no computers to do your work, no internet/e-mail, phones fail etc.

Finally, why do people think that people with huge responsibilities like the Director of the Global Fund have to live like Peace Corps volunteers or Missionaries? Running a large and complex relief and development organization takes education, experience and skills that would pay a VERY high price in the Private Sector. Someone like the Director of the Global Fund may very well be able to earn a much higher salary outside the UN. On the one hand, we want professionalism, accountability and experience,and on the other hand, we want these highly skilled people to work for peanuts.

Most of us in this business have been volunteers or worked for low wages with very little security. However, we all move on in life and need to support families and have personal security (like medical insurance, pension and benefits). If you pay peanuts, you get monkeys. Or you get a multi-millionaire, and few of us who are technicians in public health fit that prescription.

Regards

Caroline Blair E-mail: cb229@georgetown.edu

2. Peter Burgess

Dear Colleagues

I think Mia has highlighted an important issue - exactly what is the GFATM doing with the resources that it has been given?

The fact that there is little or no accounting and accountability is a real problem ... and it is really shocking that basic accounting and reporting is not taking place. The idea that some heavy-weight accounting firms should be paid big fees to study the lack of accounting is pretty silly ... when what is wanted is very basic.

What is needed is a database that has the information in it about money deployed and results achieved - not too big a demand I would say. The database should be secure so that the information cannot be changed without proper authentication. The database should be easily accessible by anyone so that it is truly 'open book' accounting and truly transparent.

This is not about WORDS ... this is about simple and powerful action. It is about something that can be done well and quickly by people who know what they are doing and will take for ever if it is left to people who do not know these aspects of management

Sincerely Peter Burgess ATCnet Email: profitinafrica@aol.com

AF-AIDS is the regional forum on HIV/AIDS in Africa, moderated by the Health & Development Networks Moderation Team (HDN, www.hdnet.org) with technical support from Health Systems Trust (HST) on behalf of the AF-AIDS Policy and Steering Committee (HST, HDN & SAfAIDS) The views expressed in this forum do not necessarily reflect those of HDN, HST or SAfAIDS.