By Jia Ping
China’s Ministry of Health and Center for Disease Control have run into serious trouble over funding.
The Global Fund to Fight AIDS, Tuberculosis and Malaria suspended hundreds of millions of dollars in aid to China in May, reportedly due to insufficient participation by civil society organizations in program implementation, inadequate financial management and possible misuse of grant funds.
While news reports say Beijing has reached a preliminary agreement with the Global Fund and is expected to improve its programs, there are future lessons for international donors, the Chinese government and non-government organizations over how they should work together.
In 2009, China applied for the six-year $500-million Round Continuation Channel AIDS program from the Global Fund. After it received approval, the Chinese government made an ambitious attempt to integrate its own state-sponsored programs, the Global Fund program, and other international aid programs into one consolidated effort against the disease.
The total value would have been as much as $2.2 billion dollars over six years – an enormous figure, even though more money does not necessarily mean better performance. Nor does a higher concentration of management mean safer implementation.
There were other fundamental problems.
It appears the Global Fund’s technical review panel considered more the quality of the proposal, rather than the burden of the disease, when it approved China’s plan.
Meanwhile, China’s AIDS non-government organizations were not part of the proposal writing process. And, as they competed with one another for representative seats on the country’s governance body for Global Fund programs, the actual issue of governance of the programs seems to have been ignored.
With this lack of attention, the governance body’s top-down management model soon proved an impossible mission.
So what can be learned?
First, global donors should pay greater attention to governance issues in both the Chinese government and civil society.
Second, the Global Fund needs to take greater responsibility in monitoring grant money – though the Chinese government should feel a strong sense of responsibility and obligation for the welfare of the people. As such, the Chinese government must improve its standard of public health governance and the transparency of management.
Third, as Global Fund Executive Director Michel Kazatchkine pointed out recently, government restrictions are the main barrier still preventing civil society from contributing to a national response to HIV and AIDS. The Chinese government should build a more supportive social environment for civil society and can benefit from the experience of other countries. Meaningful engagement of NGOs should amount to more than just handing them some money and allowing them to attend some meetings.
The overall aim of such an internationally funded program should be to translate global policy into local action with an open mind and attention given to the concerns of local people.
China needs to shoulder more responsibility when dealing with challenges that have international dimensions like AIDS and HIV, as investing in public health is equivalent to investing in its own future.
Editor’s note: Jia Ping is a China-based associate fellow with Asia Society. He is also the founder and CEO of the China Global Fund Watch Initiative, an independent watchdog organization in Beijing.