Cambodia is eligible to receive Global Fund aid

A health official checks a blood sample during an HIV screening in Kandal province in 2016. Cambodia met its co-financing requirement to obtain $55.4 million from the Global Fund for HIV and TB. Tang Chhin Sothy/AFP
A health official checks a blood sample during an HIV screening in Kandal province in 2016. Cambodia met its co-financing requirement to obtain $55.4 million from the Global Fund for HIV and TB. Tang Chhin Sothy/AFP

Cambodia has met a co-financing requirement to be eligible for millions of dollars from the Global Fund for HIV and TB, following through on a new “incentive” requiring it to increase its own contribution in order to continue receiving funds.

Ibon Villelabeitia, with the Global Fund in Switzerland, said on Wednesday that Cambodia’s HIV and TB allocations for the next three years are $41.6 million and $13.8 million respectively.

“As expressed in the Global Fund allocation letter, a minimum additional investment of $6.9 million from domestic resources in the HIV/TB program or related health systems strengthening during 2018-20, was required to access the full co-financing incentive of the allocation,” Villelabeitia wrote in an email.

Cambodia’s financing requirement for HIV was $5.19 million and $1.7 million for TB.

“The government has committed to increase their contribution to the HIV and TB programs by US$8.9m ($5.2m for HIV and $3.7m for TB),” she wrote. “This exceeds the requirements for accessing the co-financing incentive of the new allocation.”

However, Ly Penh Sun, director of the Ministry of Health’s National Centre for HIV/AIDS, Dermatology and STDS (NCHADS), claimed Cambodia had received $1 million less than the Fund pledged, and that even with the extra million, the funding is still not enough.

“The coverage of the current grant is not sufficient; [it’s] not 100 percent,” he said, adding that, for example, coverage for preventive services for key populations, such as entertainment workers, was only at 80 percent.

However, coverage for treatment is at 100 percent and will be covered with the government’s co-financing contribution of $4.5 million, Penh Sun said. The government has also put forward a little over $1 million for contracted staff, but only for 2018, and how long the government will be able to afford the contractors remains to be seen.

Penh Sun said officials were asking the Global Fund if it could slightly increase its grant.

Tia Phalla, vice chair of the National AIDS Authority, said he believed the government will be “forced to prioritise” and deploy more resources to high-burden areas.

Cambodia will also have a different approach to outreach this year. Rather than spending more on identifying new cases, officials will put the bulk of funding into programs to keep known patients virally suppressed.

Phalla said it would be a challenge to test this new framework and to secure funding for the next five years, as decreases in future Global Fund grants are expected.