US embassy cable - 05COLOMBO1261

UNCLAS COLOMBO 001261 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: EAID, KHIV, TBIO, CE, COSI 
SUBJECT: POST RECOMMENDATIONS ON GLOBAL FUND PHASE 2 RENEWALS 
 
REF: SECSTATE 129571 
 
1.  Following is post review on the overall grant for Sri Lanka 
under the Global Fund.  Due to limited time available for 
responses, this cable will provide general comments on the 
performance of the Global Fund for Tuberculosis and Malaria 
collectively, based on post discussion with key stakeholders to 
the project. 
 
Sri Lanka/South East Asia 
 
2.  The implementation of the Global Fund in Sri Lanka for 
Tuberculosis and Malaria has reported encouraging results, 
although there is room for improvement in terms of the 
operational aspects and structure of the Country Coordinating 
Mechanisms (CCM). Some NGO's representing the CCM are of the 
view that the government tends to dominate proceedings at the 
CCM with NGO's not given due consideration as per the mandate of 
the Global Fund.  The frequent participation of the current 
Minister of Health at CCM meetings does not create a conducive 
environment for productive discussion and active participation 
by all representatives. The venue of CCM meetings in recent 
times are within the Ministry of Health (MOH) and not a neutral 
venue.  This also serves to heighten government ownership of the 
program.  According to World Banks sources, Sri Lanka's health 
sector services are largely provided by the government, unlike 
other countries in the region.  Therefore, government direction 
is to be expected in health sector programs. 
 
3.  According to the principal recipient for NGOs, a sub- 
recipient for the TB program has not been suitable in terms of 
capacity and financial accountability.  The CCM approved payment 
to the sub-recipient is based on an independent assessment. 
However, questions remain on the financial veracity of the sub- 
recipient.  Suggestions have been tabled at a recent CCM meeting 
for financial audits of funding to recipients that demonstrate 
lack of a framework thus far for financial accountability within 
the existing CCM structure in the country.  The TB program of 
the MOH has brought positive results in terms of number of 
detections, treatment and public awareness campaigns, according 
to the principal recipient for the NGO sector. 
 
4.  A key issue raised by NGOs pertains to procurement.  There 
is heavy political pressure on contracts and the principal NGO 
recipient to award contracts to suppliers with political 
affiliation.  According to the principal recipient, the 
government has expressed keen interest in handling all 
procurement for the program. 
 
5.  The Secretary to the MOH (who chairs the CCM) states that 
although some difficulties have been experienced, there have 
been no major issues hindering the progress of the programs. 
Funding disbursement is a major constraint for development in 
the country, given inefficiencies in the government bureaucracy. 
Funding disbursement is also an issue for the global fund, 
though not at the same unproductive level.  The Secretary 
recommends certain changes and improvements to the CCM such as a 
permanent secretariat, a constitution and reduction of CCM 
membership, as he believes the present number is too large and 
unwieldy. 
 
6.  Comment: The structure of the CCM needs to be reviewed in 
terms of the responsibility of all members towards achieving 
Global Fund goals.  Currently, there does not seem to be an 
equal partnership between government, NGOs, civil society and 
private sector, with the government dominating CCM proceedings. 
Private Sector participation appears to be nominal.  Mechanisms 
to ensure transparency and financial accountability need to be 
applied to the CCM in order to select qualified and competent 
recipients and ensure funds are utilized appropriately.  The 
government's role in procurement should be examined, as 
widespread corruption reportedly prevails in government 
purchases.  Funding could be continued at current levels as 
there is widespread consensus that the Global Fund can play an 
important role in combating the spread of malaria, tuberculosis 
and HIV/Aids in Sri Lanka if all stakeholders participate 
equally in the program and necessary accounting systems are 
incorporated into the CCM. 
 
7.  These comments are a summary of the overall performance of 
Global Fund in Sri Lanka.  Post will be happy to provide any 
clarifications on requests concerning specific aspects of the 
Global Fund in Sri Lanka. Embassy contact is Richard Merrin 
(MerrinRC@state.gov). 
 
LUNSTEAD