The Global Fund has threatened to suspend or reduce health grants to Cambodia totalling more than $100 million if the Ministry of Health, the National Center for HIV/AIDS, Dermatology and STD (NCHADS) and NGO umbrella group MEDiCAM fail to meet a 30-day deadline to return funds identified as “misused” by a Global Fund probe.

In a letter sent to Health Minister Mam Bun Heng on December 9 and obtained yesterday by the Post, the Global Fund says that if $472,841 is not refunded within 30 days of that date, the fund may not proceed with, suspend or reduce grants totalling $106 million. The bulk of funds to be returned – $410,712 requested from the Health Ministry – relates to improper commissions received by senior officials at the National Malaria Center from international mosquito net suppliers between 2006 and 2012.

“Please note that the Ministry of Health, NCHADS and MEDiCAM have all been set the same deadline and must return the funds to the Global Fund within the next 30 days. I would like to emphasise the urgency of this request,” Mark Eldon-Edington, Global Fund division head for grant management, wrote.

Grants that could be affected come January 9 – the end of the 30-day deadline – include an HIV/AIDS grant worth $57 million, malaria-related grants worth about $28 million and a “Health Systems Strengthening Grant” worth almost $21 million.

Health NGOs yesterday said moves to suspend or reduce those grants could seriously affect programs addressing malaria and HIV/AIDS in the Kingdom. But despite the Global Fund’s tough words, the Health Ministry does not appear to be rushing to meet the deadline.

A senior ministry official who did not wish to be identified told the Post yesterday that although he had not seen the letter, he was not worried about the Global Fund’s threats and that the ministry should not be responsible for paying back the requested funds.

“We have to find the real person who spent the money to pay them. We do not need to pay them back, but it does not mean we [should] keep quiet. We have to investigate the case to find the real person who was involved with it,” he said.

“It does not matter [if the Global Fund cuts grants]; we have other organisations to help. Do not blame the government, because it did not know everything.”

He referred further questions to Health Minister Mam Bun Heng, who could not be reached for comment.

NCHADS director Mean Chhivun could not be reached for comment, while MEDiCAM executive director Sin Somuny said he did “not have time” to answer questions. CNM director Char Meng Chuor could also not be reached.

Tim Vora, executive director at the HIV/AIDS Coordinating Committee (HACC), said Cambodia relied on the Global Fund to provide funding for HIV/AIDS sufferers.

“I think it will really affect it, because [the government] is buying the medicine with Global Fund money. So over 50,000 people living with HIV/AIDS using [anti-retroviral drugs] … will be impacted if they cut the funding. Who will support to buy the medicine for all those people?” he said.

“I think the Global Fund should not do that. They should find [another] mechanism to deal with the government and not just cut the funding, because it does not affect those who committed the [corrupt] acts, it affects those who are living with HIV/AIDS.”

Im Sarun, country director at Partners for Development (PFD), an NGO that works on Global Fund-funded projects for malaria prevention and control, said the floated cuts to malaria programs could have a significant effect.

“To me it would have a lot of effect … [there would] really be an impact and as a key player in the malaria area, PFD is really worried about this,” he said.

“The national program is the backbone, and when it cannot run, there could be a lot of impact on beneficiaries,” he said.

Seth Faison, communications director at the Geneva-based fund, said yesterday that the organisation was always cautious when suspending grants.

“We are always careful not to put lives at risk. When it is necessary to suspend or reduce grants, we work hard to find alternatives that provide a continuation of service for those affected,” he said in an email.

In the December 9 letter, the Global Fund asked Bun Heng to contact the directors of NCHADS and MEDiCAM to “ensure an update on the progress of the refund” was provided by December 16.

Faison did not respond yesterday as to whether any update had been received, nor did he say whether any of the institutions involved had made any commitment to reimbursing the funds.

The Global Fund has said that in its “estimation”, improper payments of $410,712 to the CNM by suppliers forced the fund to overpay for nets by that amount, which is why they are asking for the full sum to be returned.

The fund has asked NCHADS to return $41,404 related to the alleged manipulation of procurements by a senior official, while MEDiCAM allegedly charged the fund $20,725 for two staff positions in 2009 that were never filled.