Sindh govt objects to performance of anti-HIV organisations

ISLAMABAD: International donor agency Global Fund has agreed to conduct a ‘clinical audit’ and ‘third-party evaluation’ of around $44 million it provided to a private organization in Pakistan for the prevention of HIV among People Who Inject Drugs (PWID) during the last 10 years after health authorities in Sindh expressed serious reservations over the performance of private organizations working for HIV prevention, officials said on Tuesday.

“On Sindh Sindh government’s concerns and request, the Global Fund has hired a Dutch firm Mainline last month to conduct a rapid assessment and response study of the performance of two of its grant recipients in Pakistan including Nai Zindagi Trust (NZT) and Bridge Consultant Foundation (BCF) in Sindh which received millions of US dollars from the Global Fund for HIV Prevention and Control in the province”, Dr. Ershad Kazmi, Additional Director of the Communicable Disease Control (CDC) Sindh told The News.

The Global Fund to fight AIDS, Tuberculosis and Malaria is an international donor which has invested US$697 million in Pakistan since 2003 and is the country’s biggest donor for HIV/AIDS and TB. Dr. Ershad Kazmi said Global Fund has provided over $44 million to a private organization Nai Zindagi Trust for control and prevention of HIV among people who inject drugs but unfortunately, the prevalence of HIV among drugs users is alarmingly increasing and now its stands at 38.4 percent in the country.

“In 2005, only 10.8 per cent of injectable drug users were infected with HIV but now around 38.4 per cent of injectable drug users are HIV positive in the country, especially in Sindh province. Our main concern in this regard is that despite the provision of unlimited resources, which amount to millions of dollars for the last 11 years, the new infections, HIV prevalence and deaths among PWIDs are constantly increasing with no impact and value for the money”, Dr. Ershad Kazmi maintained.

According to him, the performance of the principal and sub recipients of the Global Fund grants including Nai Zindagi Trust and the Bridge Consultant Foundation (BSF) was never checked in the last one decade by anybody including the provincial government as well as the donor agency.

“A few weeks backs, the directorate of CDC HIV/AIDS Sindh wrote to the Global Fund Country Team in Geneva and conveyed serious concerns of the provincial government about the manner in which the Global Fund PWID (People Who Inject Drugs) Grant was being managed”, he informed and added that on Sindh health authorities’ request, the Global Fund agreed to conduct the audit and third-party evaluation of the performance of both the organizations.

But to the surprise of the Sindh health authorities, the audit firm hired by the Global Fund for third-party evaluation and audit Mainline is also the partner of Nai Zindagi Trust, Dr. Ershad Kazmi claimed and questioned how could an organization conduct audit and evaluate performance of its own partner? “We have also conveyed our concern in this regard to the Global Fund in Geneva and asked to ensure an impartial probe and audit as people of Sindh are suffering due to mismanagement and lack of transparency in the use of global funds”, he added.

As far as performance of Bridge Consultant Foundation is concerned, which is the sub-recipient of the Global Fund grant, Dr. Ershad Kazmi said it lacks trained and qualified experts and due to its poor performance, no impact on the front of HIV prevention and control was seen in the province. “For instance, they have hired the services of a pathologist Dr. Rafiq Khanani for the training of people in HIV Prevention and Control, although he has no experience in this regard”.

Dr. Kazmi maintained that he had brought the entire situation into the notice of Sindh health minister Dr. Azra Pechuho and on her directives, his directorate had contacted the Global Fund to probe into the matter and rectify the issues in the area of HIV control and prevention. “But since we have raised this issue and started questioning the performances of these private organizations, they have started negative propaganda against me and my team. Unverified claims of new HIV outbreaks are being circulated through social and local media but we are not scared of these tactics”, he informed.

Officials in the Common Management Unit (CMU) which deals with HIV, TB and Malaria in the National Health Services, Regulations and Coordination (NHS,R&C) said they were also closely monitoring the situation and collecting the data to ask for similar audits and third-party evaluations at other provinces and federally controlled areas including Islamabad, AJK and Gilgit-Baltistan.