Malawi has requested The Global Fund to release about K95.2 billion ($207.64 million) of the available $574.3 million (around K245 billion) funding to maintain thousands of people on antiretroviral therapy (ART).
The Country Coordinating Mechanism (CCM) submitted to The Global Fund two concept notes worth $574.3 million covering the period between 2015 and 2017.
CCM head of secretariat Victor Chayamba said yesterday it is a lengthy process and there is no specific date when Malawi should expect a response.
He said: “After the concept note was submitted, an independent technical review panel would be instituted to take over the process. The panel would then present the outcome of the review to the grant approval committee which would then approve the proposal or not.”
These funds will now be channelled through Ministry of Health and two international non-governmental organisations (NGOs)—World Vision and Action Aid—after the National Aids Commission (NAC) was removed as a principle recipient because it did not meet the criteria.
The final concept note, submitted to The Global Fund on January 30 2015 then revised on February 14 2015, indicates that of the $207 million requested for ART, 85 percent will be used to maintain the current 570 000 patients on ART between 2015 and 2017.
States the proposal: “Although Malawi will be heavily donor dependent for the foreseeable future, government is exploring possible alternatives to sustainably contribute to the HIV response.”
Among the alternatives, according to the proposal, are a series of taxes and levies on things such as income, alcohol, phone airtime, tobacco and airlines considered to have potential to contribute more funds to finance the health sector and HIV programmes.
As part of the new funding model requiring Malawi to contribute an additional $21.5 million (roughly K9 billion), which the Ministry of Finance has committed to doing despite failing to fulfil a similar requirement in the past financial years due to what the government described as “reduced donor inflows and high levels of arrears and domestic debt”.
“Malawi expects 2015/16 to be a more normal year and has budgeted $187.9 million for health and HIV, increasing to $190.84 million in 2016/17,” the proposal indicates.
Malawi has also factored in cost implications of the ART guidelines to universal eligibility in 2016—meaning that with its introduction the number of people on ART will have increased from the anticipated 637 000 to 704 000 which will require additional funding ranging from $5.8 million to $301 million.
Of the allocated funding, government plans to use $242 022 for Men who have Sex with Men (MSM) prevention programmes to reduce risky behaviour and create demand for condoms and lubricants which the United States government will provide.
Another vulnerable population, female sex workers, have not been left out in the request for funding as $236 129 will go towards prevention packages such as peer-led risk reduction information, routine testing and counselling and provision of male and female condoms and lubricant.
However, in the January 30 2015 initial proposal, the CCM did not include the specific amount it wanted allocated to these two groups and The Global Fund had to request for further information which has since been provided in the February 14 2015 concept note.
Government also plans to scale up Voluntary Medical Male Circumcision between 2015 and 2020 targeting 10 to 34-year-old males to reduce the female-to-male HIV transmission.