VZCZCXRO7805
RR RUEHMA RUEHPA RUEHTRO
DE RUEHNK #0060/01 0260726
ZNR UUUUU ZZH
R 260726Z JAN 10
FM AMEMBASSY NOUAKCHOTT
TO RUEHC/SECSTATE WASHDC 9056
INFO RUEHZK/ECOWAS COLLECTIVE
RUCNMGH/MAGHREB COLLECTIVE
RUEHAR/AMEMBASSY ACCRA 0242

UNCLAS SECTION 01 OF 02 NOUAKCHOTT 000060 
 
SENSITIVE 
SIPDIS 
 
ACCRA FOR USAID/WA 
 
E.O. 12958: N/A 
TAGS: EAID PGOV SOCI TBIO MR
SUBJECT: MAURITANIA BEGINS TO REFORM TROUBLED GLOBAL FUND 
COUNTRY COORDINATING MECHANISM 
 
REF: 2009 NOUAKCHOTT 577 
 
¶1.  (U)  Summary. After Mauritania's September 2009 
suspension from the Global Fund to fight AIDS, tuberculosis 
and malaria, the Global Fund presented a list of requirements 
to be met by Mauritania before its suspension could be 
lifted, including a reformed Country Coordinating Mechanism 
(CCM), the repayment of USD 1.73 million of misappropriated 
disbursements and a full accounting of an additional USD 2.69 
million of unaccounted funds before March 31, 2010. The USG 
through the Office of the Global AIDS Coordinator, in 
conjunction with Embassy Nouakchott encouragement, agreed to 
finance a technical assistance program to help bring the 
Mauritanian CCM into compliance with international Global 
Fund regulations. The technical assistance team visited 
Mauritania to begin the controversial process of reforming 
the Mauritanian CCM.  The visit of the technical assistance 
team yielded a surprising number of welcome changes to the 
CCM, including a change of headquarters from the Ministry of 
Health to the Ministry of Economy and Development, the 
designation of a senior inspector from the government's 
credible Office of the Inspector General at the head of the 
CCM selection committee, and greater civil society and female 
representation.  While there are many obstacles to be 
addressed in the remaining two technical assistance visits, 
there is widespread agreement among donor partners and GIRM 
and American Embassy officials, that significant progress has 
been made to reform the Mauritanian CCM in line with Global 
Fund standards.  End Summary. 
 
¶2.  (SBU)  The USG's technical assistance program is lead by 
Grant Management Solutions (GMS), an American contractor that 
has previously worked with other suspended Global Fund 
countries.  The GMS team visited Mauritania from January 11 - 
22, 2010 to begin the task of restructuring Mauritania's CCM. 
 The Global Fund previously expressed concerns that the CCM 
was located inside the Mauritanian Ministry of Health and was 
chaired by a senior Ministry of Health official.  The 
Ministry of Health's significant influence over the CCM 
presented a conflict of interest as the Ministry of Health 
was both the administrator of the local oversight committee 
(CCM) and one of the largest recipients of Global Fund 
financing. 
 
¶3.  (SBU)  The GMS team noted that their assistance was 
enthusiastically welcomed by the Minister of Health.  This is 
a positive sign, because it indicates the Ministry of Health 
and by extension the GIRM are open to USG assistance to 
resolve this publicly embarrassing and domestically 
controversial problem.  The Minister of Health expressed to 
the technical assistance team his disappointment with the 
handling of the Global Fund suspension of Mauritania. 
According to the Minister of Health, the GIRM immediately 
repaid USD 1.73 million of fraudulently spent Global Fund 
payments and arrested certain figures charged with 
embezzlement of Global Fund disbursements only to be told by 
the Global Fund headquarters that the GIRM was responsible 
for reimbursing an additional USD 2.5 million of funds which 
were not accounted for in the initial 2009 financial audit. 
It should be noted that the Global Fund clearly put the 
burden upon the Mauritanian government to trace the 
additional USD 2.69 of missing funds when the suspension was 
initially announced in September 2009.  Despite being given 
an extension by the Global Fund to allow for a full 
accounting of all Global Fund disbursements, the GIRM was 
only asked to reimburse the additional USD 2.5 million in 
missing funds after it failed to give a satisfactory 
accounting of all previous disbursements.  The Minister of 
Health has responded to the Global Fund calling for an 
independent audit by a recognized international auditing firm 
to validate the amount of funds that cannot be accurately 
accounted for.  The Mauritanians are not refusing to pay, but 
they have serious doubts that nearly two thirds of the total 
funds could have been misappropriated as suggested by the 
Global Fund. 
 
¶4.  (SBU)  The Mauritanians appointed a senior inspector of 
the Office of the Inspector General to lead the steering 
committee which will help to select the new CCM for 
Mauritania.  This was viewed as a wise choice, because the 
Office of the Inspector General is known as an office that 
does not tolerate corrupt practices.  Under the oversight of 
the Inspector General and with guidance from the GMS team, 
the steering committee undertook the complicated process of 
disassembling the dysfunctional CCM and laying the groundwork 
for the establishment of the new CCM in advance of the March 
31, 2010 Global Fund deadline.  This process was surprisingly 
 
NOUAKCHOTT 00000060  002 OF 002 
 
 
smooth and brought widespread agreement from the members of 
the donor community and steering committee members, which 
included two U.S. Embassy members.  By the end of the GMS 
visit, the steering committee agreed that the newly formed 
CCM will no longer be located in the Ministry of Health, but 
rather in the Ministry of Economy and Development, viewed by 
the Embassy as a positive move.  The steering committee also 
noted that there was a consensus to allow the GIRM to lose 
one seat on the CCM and replace that seat with a member of a 
Mauritanian civil society group.  There was also a consensus 
that 30% of the CCM members will be women. 
 
¶5.  (SBU) Working with civil society also offered challenges 
for the GMS team.  Previously, the civil society members of 
the CCM were also implementing partners.  The GMS team 
stressed that membership on the Board would be incompatible 
with receiving funding through the CCM (indeed, much of the 
misappropriation of funds found by the Global Fund was 
misused by civil society organizations).  Civil society is 
now looking for respected representatives who do not have 
activities directly relate to CCM funding. 
 
¶6.  (SBU)  While far from solving all of Mauritania's 
problems with the Global Fund, the GMS visit was the first 
time, despite previous USG and donor community encouragement, 
that Mauritania made any concrete progress to reform its CCM. 
 The GMS team will return for two more visits in advance of 
the Global Fund's March 31st deadline to be sure the new CCM 
is fully formed, trained and operational.  Their next visit, 
in early February will focus on the difficult task of 
selecting civil society members to participate in the CCM. 
The technical assistance team's final visit in late March 
will be to oversee the CCM membership elections and provide 
training to the elected CCM members to be sure that 
Mauritania is prepared to have a functional and accountable 
CCM overseeing any future Global Fund disbursements.   A 
reformed CCM is not the only obstacle to the lifting of 
Mauritania's Global Fund suspension.  The repayment of the 
missing USD 2.5 million in Global Fund disbursements will 
also have to be rectified between the Global Fund and the 
GIRM in advance of the March 31, 2010 deadline, but the 
recent progress on the CCM reform is a much needed action to 
support Mauritania's efforts to remove its Global Fund 
suspension. 
 
¶7.  (SBU) Although the Global Fund's HIV/AIDS activity in 
Mauritania is relatively modest, the Government is taking 
this problem very seriously both because it puts other Global 
Fund programs at risk but also because it has caused other 
donors who have direct funding relationships to worry about 
the application of their funds.  In this case, the Aziz 
government is holding true to its commitment to seriously 
confront corruption. 
HANKINS