The classification of Namibia as a middle-income country continues to haunt the country as the Global Fund has drastically reduced its funding for the next three years.
The Global Fund is an international financing organisation which provides additional resources for the fight against HIV-AIDS, tuberculosis and malaria in the world, including Namibia.
According to Sandi Tjaronda, executive director of the Namibia Network of AIDS Service Organisations (Nanaso), which is one of the recipient NGOs in the country, the Global Fund has allocated US$37 106 905 (N$450 million) to the country for the next three years - covering the period from 1 January 2018 to 31 December 2020.
This is a significant decrease from the estimated US$100 million (N$1,4 billion) that the Global Fund used to allocate to programmes in the country, and it has thus affected the fight against the diseases.
There are two projects which are being funded by the Global Fund under the Ministry of Health and Social Services and Nanaso.
The two projects are split into three key focus components - HIV-AIDS; malaria and tuberculosis prevention; treatment, care and support programmes.
The director of the Global Fund programme's management unit, Sarah Mwilima told The Namibian this week that Namibia has continuously been subjected to a reduction in external financial aid because it is now classified as a middle-income country.
"The Global Fund is reducing its financial support to Namibia to help other less fortunate countries with bigger public health challenges," she noted.
Mwilima said although some programmes would be affected by the cuts, Namibia has made progress in utilising the money from the fund by renovating clinics and health centres in six regions.
She said progress on the renovations and erecting pre-fabricated structures are being monitored to ensure the timely completion of quality work, while progress reports are being compiled and shared with the fund's senior management.
Mwilima said Namibia will be eligible to apply for more funding after 2020, depending on how the country meets the targets set under the disbursed grant. The ministry is also ensuring a strong donor bond with local development partners that are still assisting the country, such as the President's Emergency Plan for AIDS Relief (Pepfar), Centres for Disease Control and Prevention (CDC), and the European Union. Nanaso comprises national networks of AIDS Service Organisations (ASOs).
They deal with training and teaching communities about HIV-AIDS, running distribution centres, and bridging the gap between local and national communities.
Tjaronda said the decrease in funding is a huge blow to community-led health services in the country.
Nanaso had to cut down the programmes funded by the Global Fund to only four.
"Out of the 10 organisations that are programmed under Nanaso as recipients of the Global Fund grant, only two were retained due to the reduced funding," he stated. The two retained programmes are under Society for Family Health (SFH), and Positive Vibes. Two new programmes were, however, added. These are Cohena, which deals with tuberculosis, and an entity under the Walvis Bay Corridor Group, which provides health services to truck drivers and sex workers. Tjaronda added that the drastic cut in funding would also result in job losses for staff members, and compromise the stability of the organisations.
If the Global Fund were to completely withdraw from funding projects in Namibia, this would have a devastating impact on the programmes. "Namibia is currently experiencing a technical recession, and the withdrawal would negatively impact on the gains achieved so far in attaining HIV epidemic control, and the country's ability to reach set targets," he said. Tjaronda, however, said "as a country, we should look for innovative options to support community-led programmes, and build resilient and sustainable systems across all sectors". The Namibian asked Mwilima about the N$14,85 million the Global Fund wanted to recover from Namibia in 2012, after the funds were not properly accounted for. "Most sub-recipients of funding from the Global Fund have paid the money back. Out of 21 sub-recipients who owed funds to the Ministry of Health and Social Services, 20 had repaid the money, leaving only one NGO, Cestas," she said. Cestas, an Italian NGO, has an outstanding balance of N$1 105 795, and are currently being pursued through the Namibian Police's international crime unit.