Global Fund, a key international financier of health programs, has placed Management and Development for Health (MDH), a major implementer of donor-funded health programs in Tanzania, under scrutiny.
This follows a Global Fund investigation that concluded “MDH engaged in fraudulent practices by failing to disclose key conflicts of interest involving a senior executive and closely linked organizations.”
MDH, in its defence, has denied any wrongdoing, stating that no conflict existed and that any perceived ties did not affect the selection process.
In the Global Fund’s report, released on June 3, 2025, the fund’s Office of the Inspector General (OIG) found that MDH did not disclose “actual, apparent, or potential conflicts of interest” between an executive manager and two organisations—referred to as Sub-recipient A and Partner A—that had personal and professional ties to the executive and spouse.
The Fund’s Secretariat is expected to decide on MDH’s role in ongoing grant implementation by August 31, 2025.
The Global Fund to Fight AIDS, Tuberculosis and Malaria is one of the world’s largest multilateral health financiers, investing more than USD 50 billion since its inception in 2002 to support disease response efforts in over 100 countries, including Tanzania.
Its funding model relies heavily on trust, accountability, and transparency among grant recipients.
Report details
The report reveals that the executive’s spouse sat on the board of Sub-recipient A and held an executive position at Partner A. The report further says the executive had previously worked as a consultant for both organisations, and was later listed as a “Partner Scientist” in a research proposal submitted by Partner A while MDH was implementing a Global Fund grant.
Despite these overlapping ties, MDH failed to disclose the relationships to the Global Fund during the selection process of the Sub-recipient. According to the OIG, this omission violated the Fund’s strict Code of Conduct, which mandates full transparency in matters that could compromise fair and accountable use of funds.
“The cumulative nature of these relationships created an actual, apparent or potential conflict of interest,” the OIG stated. “MDH was obligated—but failed—to declare them, despite being bound by a Framework Agreement signed on November 10, 2023.”
The report further states that MDH “knowingly or recklessly misled the Global Fund” to avoid scrutiny that might have resulted in restrictions on the award of contracts.
Global Fund’s investigators concluded that MDH had “knowledge of the numerous ties” and determined that its failure to declare them amounted to fraudulent practice by omission.
What’s happening at MDH?
Following the report’s release, MDH announced on June 13 that its Board of Directors held an emergency meeting and requested its CEO Dr. David Masambe Sando to step down for a full review.
Mr. Damasco Peter Mwakipokile was appointed Acting CEO, and an internal and external review of MDH’s systems and governance was launched. MDH assured the public that services would continue uninterrupted and reiterated its commitment to transparency.
Dr. Sando confirmed his departure via Instagram, expressing gratitude for his time at MDH, saying:” Dear friends and colleagues, I wanted to personally share with you that I am stepping down from my position as CEO of MDH.”
The Global Fund, a major multilateral health financier, relies on trust and transparency from its grant recipients, like MDH in Tanzania. The Fund’s Ethics Office also recommended standardizing conflict of interest definitions across policies to prevent future incidents.
