Global Fund grant faces uncertainty

Malawi risks failing to unlock $437.9 million (about K766 billion) from the Global Fund after a row over selection of a community Principal Recipient (PR) stalled communication of a key decision, The Nation has established.

In a letter dated September 15 2026 that we have seen, 12 Country Coordinating Mechanism (CCM) members accuse the CCM Secretariat of delaying to communicate a decision made on August 18 to change the Community PR from World Vision International (WVI) to ActionAid Malawi (AAM).

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The signatories of the letter are Ishmael Phiri, Dan Nthara, Memory Kamwendo, Grace Maonga, Dunker Kamba, Zikani Nyirenda, Agnes Benedicto, Litchapa Moffat, Jayne Chimwala, Treza Mphwatiwa, Tiwonge Gondwe and Stanley Kasawala.

The money, under Grant Cycle 8 (GC8), is critical for Malawi’s health sector, which is facing severe financing constraints worsened by external support withdrawals and shrinking fiscal space on the back of subdued domestic revenue collection and rising public debt.

The grant would cover HIV, TB, malaria and health system strengthening from July 1 2027 to June 30 2030, according to various communications we have seen.

According to the CCM members’ letter, the August 18 decisional meeting at Ministry of Finance, Economic Planning and Decentralisation headquarters overturned a PR Selection Committee recommendation to retain World Vision and endorsed ActionAid Malawi instead.

“When the report was presented to the CCM for consideration… seven CCM members present endorsed ActionAid Malawi as Community PR, while five endorsed WVI. ActionAid Malawi, therefore, received the higher number of endorsements,” reads the letter in part.

The CCM also resolved not to use the Grant Ready Funding Request pathway, under which existing PRs are ordinarily retained unless the CCM formally changes modality.

The members now demand formal communication to the Global Fund by close of business on September 18 (today), warning they will “pursue further appropriate action” if it fails.

“CCM members and the constituencies they represent are entitled to timely and accurate communication regarding decisions taken through CCM processes,” they write.

The impasse comes at a tight moment for Malawi, according to a debrief presentation seen by this paper from the Global Fund Malawi Country Team led by senior fund portfolio manager Marion Gleixner after a September 11 briefing.

The timeline shows Malawi was to submit an updated draft Funding Request for rapid review by September 17 (yesterday), complete adjustments and CCM endorsement by September 22, submit a full grant-ready package by October 5, and file to the Technical Review Panel (TRP) on October 12 for review over November 2-13.

In an email to CCM after that meeting, Gleixner commended progress, but urged quick resolution.

“We commend the significant progress… As work continues toward the submission timeline, we recognise that a number of issues remain to be discussed among stakeholders,” she wrote.

The PR selection process

Selection of PRs for Malawi’s Global Fund health grants follows a highly structured governance process managed by the Malawi Global Fund Coordinating Committee (MGFCC).

Acting as the national CCM, this multi-sectoral body features a diverse composition designed to prevent public sector monopolies.

To satisfy Global Fund rules, the general CCM assembly must maintain at least 40 percent representation from civil society.

This requirement brings together a carefully balanced coalition of public sector ministries, development partners like the United Nations (UN) and civil society organisations (CSOs), including faith-based groups and advocates representing people living with HIV, TB and malaria.

The selection pipeline begins when the MGFCC Secretariat issues a public call for applications. To evaluate these competitive bids, a dedicated PR Selection Committee—comprising balanced government, donor and CSO representatives—is appointed to vet applicants.

They target a strategic blend of public entities such as the Ministry of Health and non-governmental bodies to enforce dual-track financing.

Following this evaluation, the full assembly of CCM members vote to endorse or reject the candidates, as it happened in this case when they picked AAM over WVM.

Once nominated by the CCM member vote, an independent Local Fund Agent (LFA) conducts an exhaustive institutional audit of the candidates’ financial safeguards.

Final approval rests with the Global Fund Secretariat in Geneva, which signs the binding Grant Agreement to trigger performance-based health disbursements nationwide.

What’s at stake

The squabble over the selection process has now left progress in limbo, risking the grant.

The funding at stake—$339.6 million for HIV, $82.2 million for malaria and $16.1 million for TB and Resilient and Sustainable Systems for Health (RSSH)—accounts for over 60 percent of Malawi’s disease programme financing.

International Coalition on Health Financing Advocacy chairperson Maziko Matemba said since 2002, Malawi has accessed $2.8 billion (around K5 trillion) from the Global Fund, where 80 to 90 percent has been dedicated to procurement of drugs for the three infectious diseases of HIV, TB and malaria.

“Currently the cost to the health system for standard first-line adult regimens averages between $60 (around K105 000) to $150 (roughly K263 000) per person annually,” he said.

Malawi’s health sector remains heavily donor-dependent, with domestic health spending at about 10 percent of the national budget, below the Abuja Declaration target of 15 percent and per capita spending far below World Health Organisation recommended levels.

Delays and governance wrangles around Global Fund grants, therefore, pose a strategic risk to continuity of ARV treatment for over one million people, malaria and TB services and community health systems that AAM and WVI serve.

Both AAM and WVI opted not to comment on the matter when contacted yesterday.

Ministry of Health and Sanitation spokesperson Benedicto Mbewe said CCM and the Ministry of Finance, Economic Planning and Decentralisation are better placed to speak, especially because the ministry of Health is also an applicant of the fund like any other organisation.

Secretary to the Treasury Cliff Chiunda, who also chairs CCM, did not respond to our questionnaire yesterday while his vice, Bishop Silent Mtambo, referred us to his chairperson.

MGFCC executive secretary Cuthbert Nyirenda also did not respond to our questions sent yesterday.

But in an earlier email to MCC members, he said it would not be possible to replace the current PR because time was running out.

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