Managing funds held in trust in the health sector
Title: Fiduciary agent services in the health sector
Commissioned by: Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM); Gavi, the Vaccine Alliance
Financier: Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM); Gavi, the Vaccine Alliance
Country: Democratic Republic of the Congo
Lead executing agency: Ministère de la Santé Publique (Ministry of Public Health)
Overall term: 2014 to 2019
In large parts of the Democratic Republic of the Congo the population is exposed to considerable health risks. Apart from shortcomings in the fight against widespread infectious diseases, such as AIDS, malaria and tuberculosis, access to vaccinations against life-threatening diseases such as hepatitis B, yellow fever and meningitis is still inadequate.
In 2009, in the wake of the country’s health financing reform, a business unit was set up within the Ministry of Public Health to coordinate and implement external financing more effectively. The biggest international donors that channel their funding through this business unit include the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) and Gavi, the Vaccine Alliance. They have commissioned GIZ International Services as Fiduciary Agent.
The Congolese Ministry of Public Health uses the funds provided by the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) and Gavi, the Vaccine Alliance, transparently and in compliance with regulations.
As Fiduciary Agent, GIZ cooperates directly with the Ministry of Public Health and the health authorities in all of the country's 26 provinces. GIZ has its own personnel in the decentralised health authorities of 14 provinces.
The project focuses on capacity development at the Ministry of Public Health in the fields of financial, procurement and organisational management. GIZ countersigns the accounts of the Ministry of Public Health and reports to GFATM and Gavi on a regular basis about expenditure, procurement processes and any irregularities.
GIZ has produced procedural handbooks on financial, payment and procurement management in line with GFATM and Gavi rules and national regulations. They are consistently applied by the Ministry of Public Health in all of the country's 26 provinces. As a result, transparent and efficient administrative processes have been introduced, thus considerably decreasing the Ministry of Public Health's ineligible costs. At the same time, spending and hence the number of project activities implemented by the Ministry of Public Health have increased.
GIZ has introduced effective control and monitoring mechanisms that significantly minimise the financial risks borne by Gavi and GFATM. As a result of support from GIZ, both donors receive financial status reports on schedule from the Ministry of Public Health.
In cooperation with the other international donors in the health sector, GIZ has drawn up a plan to build skills and capacity in the field of financial and procurement management at the Ministry of Public Health. There have been continual and measurable improvements to financial management at the Ministry of Public Health in the administration in Kinshasa and in the 26 provinces.