Monitoring and administration subsidies provided by Gavi and the Global Fund
Title: Trust agency services in the Democratic Republic of Congo
Commissioned by: The Global Fund to Fight AIDS, Tuberculosis and Malaria and Gavi, the Vaccine Alliance
Country: Democratic Republic of the Congo
Lead executing agency: Ministry of Health
Overall term: 2014 to 2019
People living in the Democratic Republic of the Congo are exposed to major health risks in many areas of the country. In addition to deficits in the fight against widespread infectious diseases such as AIDS, malaria and tuberculosis, access to vaccinations against deadly diseases such as hepatitis B, yellow fever and meningitis is not guaranteed. In the course of health financing reforms in the Congo, a structure was set up within the Ministry of Health in 2009 to improve the coordination and implementation of third-party financing, the Cellule d'Appui et de Gestion Financière (CAGF).
The Congolese Ministry of Health uses subsidies from the Global Fund and the Vaccine Alliance Gavi appropriately, transparently and in compliance with the rules.
The International Services business area within the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH has been acting as a trust agency for Gavi and the Global Fund since December 2014. The Congolese Ministry of Health receives technical support to achieve various goals. One aim of the project is to ensure transparency and compliance with donor requirements and international standards in the administration of Gavi and Global Fund financing. In 2018, this funding amounted to more than 50 million dollars. In addition, the project is enhancing the Ministry of Health’s capacities in the areas of finances, procurement, accounting, reporting and organisational management. In the capital city, Kinshasa, the project supports the Ministry of Health as it implements centrally controlled administration processes. It also works with health authorities in the country’s 26 provinces. In 14 provinces, chief accountants and treasurers have a permanent presence to administer funds in decentralised provincial health departments (DPS).
Work focuses on quality assurance through effective control mechanisms. Payments’ eligibility for funding is also checked and documented properly. CAGF is supported with the precise and timely keeping of financial records for all transactions. The project ensures that contractual deadlines of the funding programme are adhered to and guarantees regular reporting to Gavi and the Global Fund. It also strengthens the financial capacity of the Ministry. All these measures aim to reduce expenditure that is not eligible for funding and, over the long term, to ensure that CAGF is able to administer the funds received efficiently and independently without any irregularities.
- Procedural handbooks have been developed for financial, payment and procurement management. These follow the recommendations of the Global Fund and Gavi, and correspond to national regulations.
- The Ministry of Health uses the procedure nationally and in the 26 provinces. In this way, it has succeeded in implementing transparent and efficient administrative processes that have significantly reduced the non-eligible costs of the Ministry of Health.
- The Ministry of Health has increased its expenditure and thus the number of project activities performed.
- Financed activities primarily relate to the Global Fund’s malaria, tuberculosis and HIV projects and Gavi’s vaccine project. The focus of the latter includes the effective management and transportation of vaccines and the development of a strategy to improve the quality of vaccination data.
- Effective control and monitoring mechanisms have been created. These significantly reduce financial risks in the administration of Gavi and Global Fund subsidies. At the same time, CAGF has developed its capacities.
- Checklists for justifying expenditure, a risk register and an instrument for monitoring decentralised provincial health departments have been developed. A cooperation system between GIZ and CAGF has been established. Both donors receive financial reports from the Ministry of Health.
- Together with international donors in the health care field, a plan has been created to develop the Ministry of Health’s capacities and human resources in financial and procurement management. Continuous improvement of the Ministry of Health’s financial management can be demonstrated in the administration in Kinshasa and the 26 provinces.