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2020-12-31-accounts

TROPICAL HEALTH AND EDUCATION TRUST

REPORT AND FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 DECEMBER 2020

CHARITY No. 1113101

COMPANY No. 05708871

TROPICAL HEALTH AND EDUCATION TRUST

(A company limited by guarantee)

REPORT AND FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST DECEMBER 2020

CONTENTS
Page
Reference and Administrative Details 2
Trustees’ Report 3
Independent Auditor’s Report 13
Statement of Financial Activities 16
Balance Sheet 17
Statement of Cash Flows 18
Notes to the Financial Statements 19

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TROPICAL HEALTH AND EDUCATION TRUST (A company limited by guarantee)

REFERENCE AND ADMINISTRATIVE DETAILS FOR THE YEAR ENDED 31ST DECEMBER 2020

Trustees: Dr. Anne Austen
Ms. Roda Ali Ahmed (appointed 1 January 2021)
Dr Jemima Dennis-Antwi (appointed 1 January 2021)
Ms. Janice Barber
Dr Titilola Banjoko
Professor Ged Byrne
Ms. Claire Hammond
Chair: Professor Judith Ellis OBE
Professor Irene Leigh
Mr Mike McKirdy
Mr Hugh Risebrow
Mr Jonty Roland
Dr David Alexander (resigned 31 December 2020)
Ms Frances Day-Stirk (resigned 31 December 2020)
Chief Executive: Mr Ben Simms
Company Secretary: Ms Jacqueline Mutibwa
Registered Office: 1 St Andrews Place
Regent’s Park
London
NW1 4LE
Independent Auditor: Haysmacintyre LLP
Chartered Accountants
10 Queen Street Place
London
EC4R 1AG
Charity Registration No: 1113101
Registered Company No: 05708871

2

TROPICAL HEALTH AND EDUCATION TRUST (A company limited by guarantee)

TRUSTEES’ REPORT FOR THE YEAR ENDED 31ST DECEMBER 2020

The Trustees, who are also the Directors of the company for the purposes of the Companies Act, present their Annual Report, which is also the Directors’ report for purposes of the Companies Act, together with the audited Financial Statements of the company for the year ended 31 December 2020.

The financial statements comply with current statutory requirements, the requirements of the charity’s governing document and in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice (Charities SORP (FRS 102)).

The name of the charity is Tropical Health and Education Trust; it is also known as THET.

The following trustees have acted during the year:

Dr David Alexander (Resigned 31[st] December2020) Ms Frances Day-Stirk (Resigned 31[st] December 2020) Dr. Anne Austen

Ms Janice Barber Dr Titilola Banjoko Ms Claire Hammond Professor Judith Ellis OBE Professor Irene Leigh Mr Mike McKirdy Mr Jonty Roland

Chief Executive: Mr Ben Simms Company Secretary: Ms Jacqueline Mutibwa

Introduction from the Chair of Trustees

For THET, 2020 has been a year characterised by fast-paced response and resilience. The year began with great positivity as THET embarked on implementing the UK Partnerships for Health Systems programme, on contract to the Department for International Development. With this and other successes, the charity expanded its in-country presence to 10 countries and set about expanding its UK team. Then, in March, the COVID-19 pandemic took hold. This has affected every aspect of activity. The charity has excelled in working with the Health Partnership community to respond to these challenges, as this report makes clear.

From adversity often comes innovation, and this is true of the THET team in 2020. Cancellation of overseas travel, and imposed home working, far from supressing activity or negatively impacting on team working and communication, has led to technological innovation. One fantastic example of this has been the development of Pulse, our new online platform which now forms the central hub of the Health Partnership community, allowing partnerships to share learning, attend events and form working groups. Another has been the equality in connection and communication that homeworking has brought about, providing an equal opportunity for all THET staff to meet virtually, with no requirement for travel or funding. Never has the team felt closer together.

We also feel closer to our global partners, through online conferences and webinars that have reached and supported every corner of the world. The THET conference in October attracted over 450 online delegates with speakers from over 20 countries, and a COVID conference in April was attended by over 250 people. The value of THET’s partnership model, based around sharing for mutual benefit, has never been clearer.

The charity also moved to implement a fast access COVID grants programme; the Lives on the Line: Health Worker Action Fund, which was established to help protect the lives of health workers in Low and Middle-Income Countries.

Activity in 2020 has not only been focused upon COVID and this has ensured that THET as an organisation continues to be well governed and a good place to work. Implications of the Black Lives Matter campaign in relation to THET staff and partnership working have been considered, work on Safeguarding has continued, and in September the Gender Equality and Social Inclusion toolkit was published allowing consideration of how partnerships consider and address gender issues.

3

TROPICAL HEALTH AND EDUCATION TRUST (A company limited by guarantee)

TRUSTEES’ REPORT FOR THE YEAR ENDED 31ST DECEMBER 2020

The charity has continued to benefit from not only the dedicated commitment of staff across the world, high calibre Trustees and Honorary Advisors, and our Patron, Lord Nigel Crisp but also from our Founder, Sir Eldryd Parry, who this year celebrated his 90th birthday with a video call attended by over 60 global well-wishers.

Everyone’s loyalty and passion has been vital in ensuring THET continues to attract funding in this difficult year. It is a testimony to the positive UK and global impact of partnership activity, that in 2020 THET has secured ongoing funding from the Fleming Fund for work on anti-microbial stewardship. We have also continued our extremely rewarding partnerships with Health Education England, Johnson & Johnson, the Bill & Melinda Gates Foundation and Novartis.

Towards the end of the year, the clouds that would define THET’s experience in 2021 were gathering. In November, THET joined with others to oppose the merger of Department for International Development (DFID) with the Foreign and Commonwealth Office. We looked anxiously at the planned reductions in UK Aid and in April 2021, our worst fears had been realised, with a cut of over £48m of funding for the Health Partnership approach, including the cancellation of our main programme, the UK Partnerships for Health Systems. Careful contingency planning, the diversification of our funding partners in recent years, and a very generous donation from the Fraxinus Trust means that the charity will survive and flourish in 2021 and beyond, but the loss of funding for global health activity across our partners in the UK health community is a devastating blow, significantly reducing our ability to fulfil our vision of ensuring everyone, everywhere, has access to quality Universal Health Coverage.

In 2020, the coronavirus pandemic tested THET and the Health Partnership approach, and we rose to the challenge. In 2021 this approach was further tested by the coup in Myanmar and cuts to UK Aid. But as the UK and LMIC health services respond to and plan a recovery from the COVID -19 pandemic, the need for THET’s partnership approach has never been so great. This, together with careful planning, gives an underlying confidence in the future contribution the charity can make to advancing quality healthcare. An important goal for us in 2021 is to identify my successor as Chair of Trustees and to start the process of developing a new Strategy Plan to be applied from 2022 onwards.

OBJECTIVES AND ACTIVITIES

Established in December 1988, THET has been training and educating health workers overseas now for 30 years. We work closely with governments and diverse partners in over 30 countries, implementing programmes directly, awarding grants to our partners across the UK health community, and by undertaking policy work. In 2020, 1,421 health workers were trained directly as a result of our activities.

At the heart of our work is the Health Partnership approach. Health Partnerships are a model for improving health and health services based on ideas of co-development between actors and health institutions from different countries. The partnerships are long-term and are based on principles of reciprocal learning, recognising the mutual benefit for countries overseas, and for us here in the UK.

This report outlines our main achievements in 2020 and states our strategic priorities for 2021. In producing this report, THET’s Board of Trustees can confirm that they have complied with the duty outlined in the Charities Act 2011 to have due regard to Charity Commission guidance on public benefit.

This report is structured around our Key Performance Indicators (KPIs) which we have developed to measure our progress in implementing THET’s Strategic Plan 2016-2021. Staff and partners reported progress against a set of quantitative targets and qualitative measures, on a quarterly basis for five Enabling Goals, and every six months on three Impact Goals.

Our dedicated Monitoring & Evaluation team gather regular reports from our programmes teams and grantees. In addition, we commissioned studies to investigate effectiveness, such as value for money, and we developed case studies on project and partnership impact.

Headline Achievements in 2020

The year began with optimism as we moved to implement the £28m Foreign, Commonwealth and Development Office (FCDO)-funded UK Partnerships for Health Systems (UKPHS) programme. THET had signed the contract in December 2019 and extensive dialogue with overseas Ministries of Health and partners were underway when, in March, it became clear that this would be a year like no other. International travel for NHS staff volunteering in our antimicrobial stewardship programme was cancelled on 2nd March, and a travel ban for all staff and partnerships soon followed.

4

TROPICAL HEALTH AND EDUCATION TRUST

(A company limited by guarantee)

TRUSTEES’ REPORT FOR THE YEAR ENDED 31ST DECEMBER 2020

The impact of COVID-19 can be seen throughout this report as the charity worked effectively to both respond to the challenges of the pandemic and pivot our approach to take account of this travel ban. The result has been a significant delay in the award of grants to Health Partnerships. However, in many other respects, this period has been positive as THET has innovated to respond to the pandemic.

Highlights of our response to COVID-19

Training health workers around the world

Championing excellence through Health Partnerships

Strengthening our in-country programmes presence

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TROPICAL HEALTH AND EDUCATION TRUST

(A company limited by guarantee)

TRUSTEES’ REPORT FOR THE YEAR ENDED 31ST DECEMBER 2020

Maintaining momentum in a challenging environment

Our people-centred organisation

Our Performance Against Our Strategy

1. IMPACT GOAL 1

Redouble our efforts to train and support health workers.

In 2020, our work through our country programme presences in ten countries continued, and through our grants streams we awarded 40 grants to UK Health Partnerships in 12 countries. Taken together, these provided training opportunities to a total of 1,421 health workers in Africa and Asia. Of these 523 were women and 710 were men (with no gender data for 188). Examples include:

2. IMPACT GOAL 2

Partner with national governments to strengthen health systems.

In 2020, THET engaged meaningfully in eight health system strengthening initiatives, reflecting our strengthened position in-country. Examples of this work include:

3. IMPACT GOAL 3

Champion the contribution health workers are making to the development of our societies.

THET continues to actively position itself as an essential partner to the UK health community, speaking to the distinctive space we occupy at the interface between the UK health system and those of low and middle-income countries (LMICs).

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TROPICAL HEALTH AND EDUCATION TRUST

(A company limited by guarantee)

TRUSTEES’ REPORT FOR THE YEAR ENDED 31ST DECEMBER 2020

4. ENABLING GOAL 1

Forge strong country bonds to increase programme quality.

Across all our work, there is evidence that our in-country presence is strengthening our ability to understand and partner with institutions and Ministries of Health in those countries. A key focus in 2020 has been the development of clear standards for quality to further drive and measure improvements.

Examples of work include:

5. ENABLING GOAL 2

Champion the health partnership approach positioning THET as an essential partner to NHS, academic and private sector institutions in the UK.

The year has been characterised by new initiatives and partnerships that have strengthened our position as a partner of choice for NHS and academic institutions in the UK operating internationally. Highlights include:

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TROPICAL HEALTH AND EDUCATION TRUST

(A company limited by guarantee)

TRUSTEES’ REPORT FOR THE YEAR ENDED 31ST DECEMBER 2020

6. ENABLING GOAL 3

Ensuring security through diverse funding sources.

We were pleased that our long-standing partnerships with the UK’s Foreign, Commonwealth and Development Office continued through 2020 and that we were able to grow our partnership with Health Education England. THET continues to make efforts to diversify its income sources, both through new grants and earned income efforts, with this characterised in particular by the following programmes of work: the BBC Radio 4 Appeal which was supported by Dame Julie Walters and focused on our programme of work in Somaliland, the Health Worker Action Fund which saw an unprecedented level of restricted giving from corporate partners and individual donors, an FCDO Myanmar UK Health Partnerships contract and a new Johnson & Johnson supported programme focused on Saving Mothers at Birth in Myanmar.

7. ENABLING GOAL 4

We continued to develop our People Strategy during 2020 that will ensure THET continues to recruit, retain and support staff who are working in an extremely challenging environment. Operationally, this has been a challenging year, with a heavy agenda associated with COVID-19, an office move, and many elements related to the pandemic including working from home. This has been a period through which we have strived to ensure staff well-being continues to be a priority, during the unprecedented year resulting from a global pandemic. This has not stopped us progressing our work on Safeguarding and on Gender Equality and Social Inclusion in particular. THET has revised its policies in both areas but also developed Toolkits for our partners which are available online. This is enabling us to have structured conversations both internally and externally about the vital importance of safeguarding and advancing GESI across all our activities.

8. ENABLING GOAL 5

Transparency and accuracy through robust evidence gathering.

THET continues to embed robust Monitoring and Evaluation systems in our grants and programmes work, including monitoring visits, learning and reflection, continuous improvement, and evidence generation to support our work throughout the year. This enabled us to report successfully to Trustees and a range of donors, achieving an ‘A’ rating, for example, in our final assessment from DFID.

KEY LESSONS LEARNT – CHALLENGES IN 2020

In November, THET was a signatory to the letter co-ordinated by BOND, opposing the UK Government’s move to reduce UK Aid from 0.7% to 0.5%. This move, which follows the merger of DFID and the FCO in September, was a sobering reminder of the unpredictable environment we are operating in. We ended the year with great concern about the nature and focus of UK Aid which will be fundamentally altered with fresh legislation, not least because of the charity’s success in securing such funding in recent months.

Volatility continued to define many of the countries we are working in, including conflict in Ethiopia, riots in Uganda and the recent elections in Myanmar, all of which are impacting on our ability to pursue our charitable mission by reducing the ability to travel and deliver training in-person.

Managing organisational growth effectively continued to be a priority throughout 2020. At the heart of this challenge rests our finance, HR and operations functions. We have successfully recruited to these roles in 2020 and this has underpinned our progress in improving our systems.

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TROPICAL HEALTH AND EDUCATION TRUST (A company limited by guarantee)

TRUSTEES’ REPORT FOR THE YEAR ENDED 31ST DECEMBER 2020

Structure, Governance and Management

THET is a registered charity (registration number 1113101) and is constituted as a company registered in England and Wales and limited by guarantee (registration number 05708871). Its objects and powers are set out in its Memorandum and Articles of Association, which is the charity’s governing document.

Trustees

The Directors of THET are the Trustees, collectively known as The Board of Trustees (The Board). The Board, THET’s governing body, comprises a minimum of 3 and a maximum of 12 Trustees. Trustees serve an initial term of three years that can be extended for up to a maximum of three years. The trustees are also members of the company. New Trustees are appointed by ordinary resolution at the general meeting. Members of the Board have guaranteed the liabilities of the company up to £1 each.

Trustees are appointed following open advertising in specialist publications or on specialist websites and following a rigorous interview process. All new Trustees are provided with a structured induction programme.

The Board of Trustees has created four specialist sub-committees to assist it with its work: the Finance, Risk and Governance Committee (FRGC), the Programmes Quality Committee, the Remuneration Committee (RemCo) and the External Engagement Committee. Each committee includes members of the Board and may include additional members appointed for their specialist knowledge.

The Finance, Risk and Governance Committee (FRGC), THET’s audit committee, chaired by the Treasurer, meets as necessary with the external auditors, both with and without the presence of management. The FRGC reviews the external auditor’s management letter and monitors implementation of actions required as a result. The FRGC also has responsibility to advise the Board on whether the audit, risk management and control processes within THET are effective. The Remuneration Committee monitors THET’s policy on remuneration and benefits for its staff and reports annually to the Board.

The Remuneration Committee meets annually and is chaired by Hugh Risebrow. Salaries are set after consideration of the cost of living, the financial position of the charity, and roles and responsibilities after taking into account the contracts being handled by THET.

THET’s Trustees are responsible for everything that THET does. However, to ensure that THET is managed efficiently and effectively, the Trustees have delegated a range of day-to-day decision-making powers to the Senior Management Team. Trustees have also established appropriate controls and reporting mechanisms to ensure that the Senior Management Team operates within the scope of the powers delegated to it. The delegation policy is updated on an ongoing basis and is formally reviewed and approved by Trustees. The last review was in June 2016, with the next review planned for 2022. The members of the Senior Management Team are not directors for the purposes of company law.

There has been no specific restriction imposed by the charity’s governing document on the operation of the Trust. Trustees are authorised by the charity’s governing document to invest any money of the Charity not immediately required for its function in appropriate, legal investments provided that any necessary consents are first obtained.

Annual trustee activity

A typical year for a trustee includes the following:

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TROPICAL HEALTH AND EDUCATION TRUST (A company limited by guarantee)

TRUSTEES’ REPORT FOR THE YEAR ENDED 31ST DECEMBER 2020

Risk assessment

The Trustees keep strategic and operational risks under quarterly review at the Finance, Risk and Governance meetings, and the full Board of Trustees meetings. This involves an assessment of probability and potential impact, and a discussion of mitigating actions prepared by THET’s Senior Management Team. The areas of risk reflect the fact that THET’s staff and volunteers operate across many different jurisdictions, meaning that controls around finance and the movement of people are especially important. The risks also examine the extent to which THET is able to evidence the impact of its work and demonstrate Value for Money to its wide range of supporters, both individual and institutional. Finally, the risks look at the charity’s ability to generate financial support for its distinctive model of Health Partnership working. In terms of its general affairs, THET operates prudent policies in all its financial operations, with any significant expenditure requiring approval by Trustees. THET also makes arrangements for appropriate insurance cover and other protection where this is appropriate in its activities at home and overseas.

There are a wide range of mitigations in place. In relation to demonstrating impact, for example, THET makes regular use of external evaluations of its work. In relation to income, THET is able to closely track its conversations with donors allowing it to closely track the success of its efforts to grow and diversify its income. In 2020, the main improvements resulting from Trustee discussions around risk were in relation to the financial and operational processes. This has seen a tightening of procedures around our oversight of financial transactions in particular and led to an expansion in the size of the Finance and Operations Team at THET.

Our approach to fundraising activities

The charity raises funds from institutional donors including Trusts and Foundations, and Government Institutions in the UK and internationally. We have developed an Ethical Fundraising Policy to guide decisions on solicitation and acceptance of funds.

The charity undertakes bi-yearly fundraising campaigns which reach a small number of patrons and supporters who have consented to receive the campaigns. Beyond this the trustees are pleased to receive unsolicited gifts and legacies from patrons and supporters who generously support our work. THET does not currently actively fundraise from the public, run legacy campaigns, or undertake similar fundraising activities in its own right. No complaints have been received from funders or beneficiaries in respect of fundraising activities undertaken by the charity.

Grant-making policies

THET issues grants to Health Partnerships delivering projects in keeping with its mission. Grants are selected following a fair and transparent process whereby applicants are provided with template forms and guidelines that state the purpose of the funds, eligibility criteria and a timeline for submission and selection.

Once awarded, and when contracts are signed, grants are managed in line with the Grants Management System, which sets out checks and controls to ensure that funds are being used for the purpose stated in the application. Financial and narrative reports are submitted at contracted intervals to show levels of spend and activity against plan and, where necessary, to explain exceptional variances. Milestones are set during the inception phase of each grant and progress is measured against these.

Other risk management processes include checks and controls on adequate financial management and verification of the legal protection and safety of those involved in the project. Information is gathered through reports and meetings and through spot checks on receipts and other documentation.

Financial Review:

Key highlights from the 2020 Accounts are:

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TROPICAL HEALTH AND EDUCATION TRUST

(A company limited by guarantee)

TRUSTEES’ REPORT FOR THE YEAR ENDED 31ST DECEMBER 2020

The principal funding sources in 2020 were government bodies, including the Foreign, Commonwealth and Development Office; public bodies, including Health Education England; corporate entities, such as Johnson & Johnson; and Trusts and Foundations, such as the Bill & Melinda Gates Foundation. This funding is used for various project activities as specified in the donor agreements. For specific details of these projects please refer to Note 17 of the accounts.

Charitable funds

The funds held by THET are in interest-bearing accounts managed by the Charities Aid Foundation from which they can be withdrawn as needed. The Trust is able to meet all its obligation and commitments within its present cash flow and assets.

THET does not hold assets except as detailed in the accounts. The salaries of project staff are derived mainly from grants. THET operates in collaboration with other charitable bodies to pursue its objectives.

Reserves Policy

The Board of Trustees has established a General Reserves Policy which continues to protect our programme work from risk of disruption at short notice due to a lack of funds. The Policy also provides parameters for future strategic plans and contributes towards decision-making. It determines an appropriate target level for general reserves, taking into account the following factors:

This approach provides a target base level of general reserves for good governance; to cover 3 months organisational closure cost and the costs incurred by cessation of programme and grant activity. The basis of determining the target reserves level is kept under review and is adjusted to reflect funded activity, and thus organisational size, taking into account actual and perceptions of risk. The minimum target level of reserves in 2020 was set at £250k. Reserves were £227,572 at 31 December 2020, but have been brought above this minimum level at the signing date of the accounts.

Arrangements for monitoring and reviewing the reserves policy

The reserves policy is, as a minimum, subject to annual review by Trustees, with the next review scheduled for 2022. In addition, the Trustees monitor THET’s performance against the budget throughout the year and consider the need for a reconsideration of reserves, dependent upon changes in activity and organisational structure.

General Reserves (Unrestricted)

General reserves are not restricted to or designated for a particular purpose. General reserves are £227,572 (2019 - £203,915) at the end of December 2020. A detailed review of the level of unrestricted reserves was conducted in 2021.

Restricted Funds

These funds are tied to particular purposes, as specified by the donor or as identified at the time of a public appeal. At 31 December 2020, unspent restricted funds were £1,453,525 (2019 - £1,566,495).

Total funds

At 31 December 2020, total funds were £1,681,097, with £14,503 of this relating to fixed assets.

11

TROPICAL HEALTH AND EDUCATION TRUST

(A company limited by guarantee)

TRUSTEES’ REPORT FOR THE YEAR ENDED 31ST DECEMBER 2020

Future plans

The drastic reduction in funding from FCDO for 2021 does raise questions about the scale of the charity’s future work. We will not be able to replace £48m of funding that we have lost. However, the steady diversification of our funding partners in recent years is producing considerable dividends, and this is expressed in the considerable expansion of our policy, learning and communications work. The THET conferences and policy papers place THET at the heart of global health and Health Partnerships debate and allow us to continue to play a role as a constructive partner to the World Health Organization and to the UK Government in particular. Our increased country presence allows us to continue to contribute meaningfully to our partner institutions and Governments overseas: our work to provide care for people with non-communicable disease in Ethiopia will continue with a new 3-year partnership with Novartis for example. We also continue to work very effectively with our partners at the Department of Health and Social Care (DHSC) and the Commonwealth Pharmacy Association (CPA) to address the ‘silent pandemic’ of growing antimicrobial resistance. We enter 2021 with considerable momentum. The second half of 2021 will allow the charity to take stock of its contribution though the development of a new strategic plan, replacing the one developed in 2016, and the recruitment of a new Chair of Trustees, replacing Professor Judith Ellis who has served for six years. The qualities of agility and innovation that have defined the charity in response to COVID-19, the coup in Myanmar, and the cuts to UK Aid will be crucial to this, as the charity navigates the challenges of operating in a world defined by its volatility, uncertainty, complexity and ambiguity.

Impact of COVID-19

During 2020 and since the year end the COVID-19 pandemic has created additional challenges for the charity. THET has however been able to continue operations remotely, with limited disruption, although some projects have been delayed and onsite monitoring visits have not been possible in all cases. The impact of COVID-19 on THET has therefore been restricted.

Trustees' responsibilities

Company law requires the Trustees to prepare accounts for each financial year which give a true and fair view of the state of affairs of the charity and of the surplus or deficit of the charity for that period. In preparing these accounts, the Trustees are required to:

The Trustees are responsible for keeping proper accounting records which disclose with reasonable accuracy at any time the financial position of the charity and to enable them to ensure that the accounts comply with the Companies Act 2006 and with Accounting and Reporting by Charities: Statement of Recommended Practice (Charities SORP (FRS 102)). They are also responsible for safeguarding the assets of the charity and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

Each of the Trustees confirm that:

Approved by the Board of Trustees on 1 July 2021 and signed on its behalf by

Professor Judith Ellis Chair of Trustees

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TROPICAL HEALTH AND EDUCATION TRUST

(A company limited by guarantee)

INDEPENDENT AUDITOR’S REPORT TO THE MEMBERS OF TROPICAL HEALTH AND EDUCATION TRUST FOR THE YEAR ENDED 31ST DECEMBER 2020

Opinion

We have audited the financial statements of Tropical Health and Education Trust for the year ended 31 December 2020 which comprise the Statement of Financial Activities, Balance Sheet, Statement of Cash Flows, and notes to the financial statements, including a summary of significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice).

In our opinion, the financial statements:

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the Auditor’s responsibilities for the audit of the financial statements section of our report. We are independent of the Charity in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC’s Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Conclusions relating to going concern

In auditing the financial statements, we have concluded that the trustees’ use of the going concern basis of accounting in the preparation of the financial statements is appropriate.

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the Charitable Company’s ability to continue as a going concern for a period of at least twelve months from when the financial statements are authorised for issue.

Our responsibilities and the responsibilities of the trustees with respect to going concern are described in the relevant sections of this report.

Other information

The trustees are responsible for the other information. The other information comprises the information included in the Trustees’ Report. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon.

In connection with our audit of the financial statements, our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether there is a material misstatement in the financial statements or a material misstatement of the other information. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact. We have nothing to report in this regard.

Opinions on other matters prescribed by the Companies Act 2006

In our opinion, based on the work undertaken in the course of the audit:

Matters on which we are required to report by exception

In the light of the knowledge and understanding of the charitable company and its environment obtained in the course of the audit, we have not identified material misstatements in the Trustees’ Report (which incorporates the directors’ report).

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TROPICAL HEALTH AND EDUCATION TRUST

(A company limited by guarantee)

INDEPENDENT AUDITOR’S REPORT TO THE MEMBERS OF TROPICAL HEALTH AND EDUCATION TRUST FOR THE YEAR ENDED 31ST DECEMBER 2020

We have nothing to report in respect of the following matters in relation to which the Companies Act 2006 requires us to report to you if, in our opinion:

Responsibilities of trustees for the financial statements

As explained more fully in the trustees’ responsibilities statement set out on page 12, the trustees (who are also the directors of the charitable company for the purposes of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error.

In preparing the financial statements, the trustees are responsible for assessing the charitable company’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the charitable company or to cease operations, or have no realistic alternative but to do so.

Auditor’s responsibilities for the audit of the financial statements

Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.

Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.

Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The extent to which our procedures are capable of detecting irregularities, including fraud is detailed below:

Based on our understanding of the charitable company and the sector in which it operates, we identified that the principal risks of non-compliance with laws and regulations related to regulatory requirements of the Charity Commission, and we considered the extent to which non-compliance might have a material effect on the financial statements. We also considered those laws and regulations that have a direct impact on the preparation of the financial statements such as the Charities Act 2011, Companies Act 2006 and payroll taxes.

We evaluated management’s opportunities for fraudulent manipulation of the financial statements (including the risk of override of controls), and determined that the principal risks were related to posting inappropriate journal entries and management bias in certain accounting estimates and judgements such as the income recognition policy applied to grant income. Audit procedures performed by the engagement team included:

14

TROPICAL HEALTH AND EDUCATION TRUST

(A company limited by guarantee)

INDEPENDENT AUDITOR’S REPORT TO THE MEMBERS OF TROPICAL HEALTH AND EDUCATION TRUST FOR THE YEAR ENDED 31ST DECEMBER 2020

A further description of our responsibilities for the audit of the financial statements is located on the Financial Reporting Council’s website at: www.frc.org.uk/auditorsresponsibilities. This description forms part of our auditor’s report.

Use of our report

This report is made solely to the charitable company's members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the charitable company's members those matters we are required to state to them in an Auditor's report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charitable company and the charitable company's members, as a body, for our audit work, for this report, or for the opinions we have formed.

Steven Harper (Senior Statutory Auditor) 10 Queen Street Place For and on behalf of Haysmacintyre LLP, Statutory Auditor London EC4R 1AG Date: 8 July 2021

15

TROPICAL HEALTH AND EDUCATION TRUST

(A company limited by guarantee)

STATEMENT OF FINANCIAL ACTIVITIES (INCORPORATING INCOME AND EXPENDITURE ACCOUNT) FOR THE YEAR ENDED 31ST DECEMBER 2020

Unrestricted Restricted Total Total
funds funds 2020 2019
Note £ £ £ £
Income from:
Donations and legacies 4 65,314 - 65,314 63,380
Charitable activities 5 18,551 3,299,136 3,317,687 3,491,525
Investments 6 43 - 43 7,252
Other income 7 67,142 - 67,142 46,578
------------------- -------------------- -------------------- --------------------
Total income 151,050 3,299,136 3,450,186 3,608,735
-------------------- -------------------- -------------------- --------------------
Expenditure on:
Raising Funds 8 42,461 - 42,461 59,671
Charitable activities 10 79,321 3,417,717 3,497,038 3,396,678
-------------------- -------------------- -------------------- --------------------
Total expenditure 121,782 3,417,717 3,539,499 3,456,349
------------------- -------------------- -------------------- --------------------
Net (expenditure)/income 29,268 (118,581) (89,313) 152,386
Transfers between funds 17 (5,611) 5,611 - -
------------------- ------------------- ------------------- -------------------
Net movement in funds 23,657 (112,970) (89,313) 152,386
Reconciliation of funds:
Total funds brought forward 203,915 1,566,495 1,770,410 1,618,024
-------------------- ------------------- -------------------- --------------------
Total funds carried forward 227,572 1,453,525 1,681,097 1,770,410
========== ========= ========== ==========

The Statement of financial activities includes all gains and losses recognised in the year.

A full comparative Statement of Finance Activities is presented in note 23.

The notes on pages 19 to 34 form part of these financial statements.

16

TROPICAL HEALTH AND EDUCATION TRUST

Company number: 05708871

(A company limited by guarantee)

BALANCE SHEET FOR THE YEAR ENDED 31ST DECEMBER 2020

2020 2019
Note £ £ £ £
FIXED ASSETS
Tangible assets 14 14,503 14,495
-------------------- --------------------
14,503 14,495
CURRENT ASSETS
Debtors 15 1,055,571 604,072
Cash at bank and in hand 902,689 1,523,851
----------------- --------------------
1,958,260 2,127,923
CREDITORS: amounts falling
due within one year 16 (291,666) (372,008)
---------------- ---------------------
NET CURRENT ASSETS 1,666,594 1,755,915
-------------------- ---------------------
TOTAL ASSETS LESS CURRENT LIABILITIES 1,681,097 1,770,410
--------------------- ---------------------
TOTAL NET ASSETS 1,681,097 1,770,410
========== ==========
CHARITY FUNDS
Restricted funds 17 1,453,525 1,566,495
Unrestricted funds: 17 227,572 203,915
--------------------- ---------------------
TOTAL FUNDS 1,681,097 1,770,410
========== ==========

The notes on pages 19 to 34 form part of these financial statements.

The financial statements have been prepared in accordance with the provisions applicable to entities subject to the small companies regime.

The financial statements were approved and authorised for issue by The Board of Trustees on 1 July 2021 and were signed below on its behalf by:

……………………………………………….

Professor Judith Ellis Chair of Trustees

17

TROPICAL HEALTH AND EDUCATION TRUST

(A company limited by guarantee)

STATEMENT OF CASH FLOWS FOR THE YEAR ENDED 31ST DECEMBER 2020

2020 2019
Note £ £
Cash flows from operating activities
Net cash used in operating activities 19 (617,646) (246,893)
------------------- -------------------
Cash flows from investing activities
Purchase of tangible fixed assets (3,559) (20,750)
Interest received 43 7,252
------------------- -------------------
Net cash (used) in/provided by investing activities (3,516) (13,498)
------------------ ------------------
Cash flows from financing activities
Repayment of borrowings - 210,887
---------------- ----------------
Net cash provided by financing activities - 210,887
---------------- ----------------
Change in cash and cash equivalents in the year (621,162) (49,504)
Cash and cash equivalents at the beginning of the year 1,523,851 1,573,355
Change in cash and cash equivalents due to exchange rate movements - -
---------------- ----------------
Cash and cash equivalents at the end of the year 902,689 1,523,851
======== ========

Cash and cash equivalents comprise solely cash at bank and in hand during both the current and prior year.

The notes on pages 19 to 34 form part of these financial statements.

18

TROPICAL HEALTH AND EDUCATION TRUST (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST DECEMBER 2020

1. General Information

Tropical Health and Education Trust is a private company limited by guarantee incorporated in England and Wales and a charity registered with the Charity Commission. The address of the registered office is disclosed on the company information page.

2. Accounting Policies (continued)

a) Accounting basis

The financial statements have been prepared in accordance with Charities SORP (FRS 102) – Accounting and Reporting by Charities: Statement of Recommended Practise applicable in the UK and Republic of Ireland (FRS 102) (Second Edition, effective 1 January 2019), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006.

Tropical Health and Education Trust meets the definition of a public benefit entity under FRS 102. Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy.

b)

Going Concern

The trustees have prepared, reviewed and formally approved detailed operating and cash flow projections covering the next 12 months to July 2022. On the basis of these projections they have assessed that the Charity has adequate financial resources and structures in place to manage its operational risks. In addition, the budgeting and forecasting process has taken account of the current economic and funding climate and its potential impact on our various sources of income and expenditure, including the ongoing COVID-19 pandemic and the drastic reduction in funding from the Foreign and Commonwealth Development Office (FCDO). Therefore, the trustees are confident that there is reasonable expectation that the Charity has adequate resources and control mechanisms to continue in operational existence for the foreseeable future and, on this basis the trustees believe, to the best of their belief and knowledge, that the Charity remains as a going concern for at least the period to July 2022 and, accordingly, these financial statements have been prepared on the going concern basis.

c) Income

Income is recognised when the charity has entitlement to the funds, any performance conditions attached to the item(s) of income have been met, it is probable that the income will be received and the amount can be measured reliably. When income is received in advance of providing services it is deferred until THET becomes entitled to that income.

Donations are recognised in the statement of financial activities in the year which they are received, unless the income recognition criteria set out above are met at an earlier date.

For legacies, entitlement is taken as the earlier of the date on which either (i) the charity is aware that probate has been granted, the estate has been finalised and notification has been made by the executor to THET that a distribution will be made, or (ii) when a distribution is received from the estate. Receipt of a legacy, in whole or in part, is only considered probable when the amount can be measured reliably and the charity has been notified of the executor’s intention to make a distribution. Where legacies have been notified to the charity or the charity is aware of the granting of probate, and the criteria for income recognition have not been met, then the legacy is treated as contingent asset and disclosed if material.

19

TROPICAL HEALTH AND EDUCATION TRUST (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST DECEMBER 2020

2. Accounting Policies (continued)

c) Income (continued)

Grants are included in the statement of financial activities on a receivable basis. The balance of income received for specific purposes but not expended during the period is shown in the relevant funds on the balance sheet. Where income is received in advance of entitlement of receipt, its recognition is deferred and included in creditors as deferred income. Where entitlement occurs before income is received, the income is accrued.

Donated professional services and donated facilities are recognised as income when the charity has control over the item, any conditions associated with the donated item have been met, the receipt of economic benefit from the use by the charity of the item is probable and that economic benefit can be measured reliably.

On receipt, donated professional services and donated facilities are recognised on the basis of the value of the gift of the charity which is the amount the charity would have been willing to pay to obtain services of facilities of equivalent economic benefit on the open market; a corresponding amount is then recognised in expenditure in the period of receipt.

In accordance with the Charities SORP (FRS 102), the donated services from our general volunteers are not included within the financial statements.

Other income is recognised in the period in which it is receivable and to the extent the goods have been provided or on completion of the service.

d) Expenditure

Expenditure is recognised once there is legal or constructive obligation to make a payment to a third party, it is probable that settlement will be required and the amount of the obligation can be measured reliably.

Costs of charitable activities are the costs applied by the charity in undertaking its work and achieving its charitable objectives, as opposed to the cost of raising funds to finance those objectives.

Value Added Tax which is not recoverable by the charity is included in the relevant costs in the statement of financial activities.

Non-directly attributable costs are allocated based on an estimate of time spent.

Expenditure on raising funds includes all expenditure incurred by the Charity to raise funds for its charitable purposes and includes costs of all fundraising activities events and non-charitable trading.

Expenditure on charitable activities is incurred on directly undertaking the activities which further the Charity’s objectives, as well as any associated support costs.

Grants are included in the statement of financial activities as they become payable. THET’s ability to make grant payments is entirely dependent on funding from different Government Bodies (FCDO, DHSC, HEE, Johnson & Johnson) under the contracts that are the subject to annual renegotiation. In the opinion of the Trustees a constructive obligation is only created when (i) ongoing grant conditions are being fulfilled and, (ii) contract renewal has been successfully negotiated with different Grantors.

All expenditure is inclusive of irrecoverable VAT.

20

TROPICAL HEALTH AND EDUCATION TRUST (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST DECEMBER 2020

2. Accounting Policies (continued)

e) Foreign Currencies

Monetary assets and liabilities denominated in foreign currencies are translated into sterling at rates of exchange ruling at the reporting date.

Transactions in foreign currencies are translated into sterling at the rate ruling on the date of transaction.

Exchange gains and losses are recognised in the statement of financial activities.

f) Tangible fixed assets and depreciation

Tangible fixed assets costing £500 or more are capitalised and recognised when future economic benefits are probable and the costs or value of the asset can be measured reliably.

Tangible fixed assets are initially recognised at cost. After recognition, under the cost model, tangible fixed assets are managed at cost less accumulated depreciation and any accumulated impairment losses. All costs incurred to bring a tangible fixed asset into its intended working condition should be included in the measurement of cost.

Depreciation is charged so as to allocate the cost of tangible fixed assets less their residual value over their estimated useful lives, using the straight-line method.

Depreciation is provided on the following basis:

Long-term leasehold property - 33% straight line
Fixtures and fittings - 33% straight line
Office Equipment - 33% straight line
Computer Equipment - 33% straight line

g) Liabilities and provisions

Liabilities are recognised when there is an obligation at the balance sheet date as a result of a past event, it is probable that a transfer of economic benefit will be required in settlement, and the amount of the settlement can be estimated reliably.

Liabilities are recognised at the amount that the Charity anticipates it will pay to settle the debt or the amount it has received as advanced payments for the goods or services it must provide.

h) Financial Instruments

The Charity only has financial assets and financial liabilities of a kind that qualify as basic financial instruments. Basic financial instruments are initially recognised at transaction value and subsequently measured at their settlement value with the exception of bank loans which are subsequently measured at amortised cost using the effective interest method

i) Pensions

THET operates a defined contribution pension scheme for the benefit of staff. Contributions by THET to the scheme are charged in the statement of financial activities in the period in which the employment services qualifying for the benefit are provided. THET has no further obligation once the contributions have been paid.

21

TROPICAL HEALTH AND EDUCATION TRUST (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST DECEMBER 2020

2. Accounting Policies (continued)

j) Fund accounting

General funds are unrestricted funds which are available for use at the discretion of the Trustees in furtherance of the general objectives of the Charity and which have not been designated for other purposes.

Designated funds comprise unrestricted funds that have been set aside by the Trustees for particular purposes. The aim and use of each designated fund is set out in the notes to the financial statements.

Restricted funds are funds which are to be used in accordance with specific restrictions imposed by donors or which have been raised by the Charity for particular purposes. The costs of raising and administrating such funds are charged against the specific fund. The aim and use of each restricted fund is set out in the notes of the financial statements.

Investment income, gains and losses are allocated to the appropriate fund.

3. Critical accounting estimates and areas of judgement

Estimates and judgements are continually evaluated and are based on historical experience and other factors, including expectations of future events that are believed to be reasonable under the circumstances.

Critical accounting estimates and assumptions:

The Charity makes estimates and assumptions concerning the future. The resulting accounting estimates and assumptions will, by definition, seldom equal the related actual results. In the opinion of the Trustees there are however no estimates and assumptions that have a significant risk of causing a material adjustment to the carrying amounts of assets and liabilities within the next financial year.

Income from donations and legacies Total Total
Funds Funds
2020 2019
£ £
Donations 59,162 63,380
Legacies 6,152 -
------------------ ------------------
65,314 63,380
========= =========

4. Income from donations and legacies

All income from donations and legacies was unrestricted in the current and previous year.

5.

Income from charitable activities Unrestricted Restricted Total Total
Funds Funds Funds Funds
2020 2020 2020 2019
£ £ £ £
Income from charitable activities –
Programmes & Projects 18,551 3,299,136 3,317,687 3,491,525
========= ========= ========= =========
Total 2019 19,196 3,472,329 3,491,525
========= ========= =========

22

TROPICAL HEALTH AND EDUCATION TRUST

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST DECEMBER 2020

6. Investment income Total Total
Funds Funds
2020 2019
£ £
Investment income – local cash 43 7,252
========= =========
All income from investments was unrestricted in the current and previous year.
7. Other income Total Total
Funds Funds
2020 2019
£ £
Conference fees 67,142 30,286
Consultancy work - 6,988
Other - 9,304
------------------ ------------------
67,142 46,578
========= =========
All other income was unrestricted in the current and previous year
8. Expenditure on raising funds
Costs of raising voluntary income
Total Total
Funds Funds
2020 2019
£ £
Other direct costs 4,696 1,026
Direct salaries 24,546 27,871
Allocated centrally incurred fundraising and governance costs 5,405 17,537
------------------ ------------------
34,647 46,434
Fundraising trading expenses
Indirect salaries 7,814 13,237
------------------ ------------------
42,461 59,671
========= =========

All costs of raising voluntary income were allocated against unrestricted funds in both the current and prior year.

23

TROPICAL HEALTH AND EDUCATION TRUST

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST DECEMBER 2020

9. Analysis of grants
Grants to Total Total
Institutions Funds Funds
2020 2020 2019
£ £ £
Grants, Grants awarded to NHS and academic partners 324,488 324,488 830,502
========= ========= =========
Total 2019 830,502 830,502
========= =========
The Charity has made the following material grants to institutions during the year.
2020
£
Name of institution
Global Anaesthesia Development Project 29,740
Nursing and Midwifery Council 15,916
Uganda UK Health Alliance 103,502
University College London 60,162
University of Oxford 23,950
University of Sussex 23,041
------------------
Other grants to institutions 68,177
------------------
324,488
------------------

24

TROPICAL HEALTH AND EDUCATION TRUST (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST DECEMBER 2020

10. Analysis of expenditure by activities
Activities Grant
undertaken funding of Support Total Total
directly activities costs Funds Funds
2020 2020 2020 2020 2019
£ £ £ £ £
Programmes & Projects 3,093,229 - 79,321 3,172,550 2,566,176
Grants awarded to NHS and academic
partners - 324,488 - 324,488 830,502
----------------- ------------------ --------------- ------------------- -------------------
3,093,229 324,488 79,321 3,497,038 3,396,678
======== ========= ======= ========== ==========
----------------- ------------------ --------------- -------------------
Total 2019 2,192,026 830,502 374,150 3,396,678
======== ========= ======= ==========
Analysis of direct costs Total Total
Funds Funds
2020 2019
£ £
Staff costs 1,567,589 1,058,981
Direct expenditure on programmes and
projects 1,525,640 1,133,045
------------------- --------------------
Total 3,093,229 2,192,026
========== ==========
Analysis of support costs
Total Total
Funds Funds
2020 2019
£ £
Staff costs 46,887 160,941
Governance costs 17,293 29,162
Personnel - 10,285
Administration and office expenses 2,112 128,514
Rent and rates 13,029 45,248
-------------------- --------------------
79,321 374,150
========== ==========

25

TROPICAL HEALTH AND EDUCATION TRUST (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST DECEMBER 2020

11. Auditor’s renumeration

The auditor’s renumeration amounts to an auditor fee of £12,750 (2019: £12,450), and accounts preparation services of £2,250 (2019: £3,800).

12. Staff costs

Staff costs
2020 2019
£ £
Wages and salaries 1,292,773 1,176,552
Social security costs 81,910 62,102
Contribution to defined contribution pension schemes 30,991 22,376
----------------- -----------------
1,405,674 1,261,030
======== ========

The average number of persons employed by the Charity during the year was as follows:

No. No.
Charitable activities programme and Projects 61 41
Administration 6 7
Generating income 1 1
----------------- -----------------
68 49
======== ========

The number of employees whose employee benefits (excluding employer pension costs) exceeded £60,000 was:

2020 2019
No. No.
In the band £60,001 - £70,000 1 1
In the band £70,001 - £80,000 - 1
In the bank £80,001 - £90,000 1 -

======== ========

The key management personnel of THET comprise the Chief Executive and the Senior Management Team (SMT). The SMT consists of the Director of Finance & Operations, and the Director of Programmes. The total employee benefits for the key management personnel was £229,594 (2019: £219,190).

13. Trustees’ renumeration and expenses

During the year, no Trustees received any remuneration or other benefits (2019 - £nil)

During the year ended 31 December 2020, £1,093 in expenses were reimbursed to trustees (2019: £nil).

26

TROPICAL HEALTH AND EDUCATION TRUST

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST DECEMBER 2020

14. Tangible fixed assets
Long-term
leasehold Computer
property Equipment Total
Cost £ £ £
At 1st January 2020 30,767 66,522 97,289
Additions - 3,559 3,559
Disposals (30,767) (40,666) (71,433)
------------------ ---------------- ---------------------
At 31st December 2020 - 29,415 29,415
------------------ --------------- --------------------
Depreciation
At 1st January 2020 30,767 52,027 82,794
Charge for year - 3,551 3,551
Released on disposals (30,767) (40,666) (71,433)
------------------ ---------------- -------------------
At 31st December 2020 - 14,912 14,912
---------------- ---------------- -----------------
Net Book Value
At 31st December 2020 - 14,503 14,503
======== ======= =========
At 31st December 2019 - 14,495 14,495
======== ======= =========
15. Debtors
2020 2019
£ £
Due within one year
Trade debtors 497,654 90,075
Other debtors 165,272 185,519
Prepayments and accrued income 392,645 328,478
------------------- ------------------
1,055,571 604,072
========= =========
16. Creditors: amounts falling due within one year
2020 2019
£ £
Trade creditors 56,056 63,627
Other taxation and social security 51,557 35,395
Other creditors 40,744 34,113
Accruals 143,309 238,873
---------------- ----------------
291,666 372,008
======== ========
.

27

TROPICAL HEALTH AND EDUCATION TRUST

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST DECEMBER 2020

17. Statement of Funds

Statement of funds – Current year
Balance at 1 Balance at 31
January Income Expenditure Transfers December
2020 in/out 2020
£ £ £ £ £
Unrestricted funds
General funds 203,915 151,050 (121,782) (5,611) 227,572
--------------------------- ------------------------ --------------------------- ------------------------- ------------------------------
Restricted funds
CwPAMS 228,674 102,739 (225,693) - 105,720
Bill and Melinda Gates
Foundation 11,835 124,402 (101,673) - 34,564
Biomedical Engineering 18,326 - - - 18,326
Comic Relief 70,485 33,748 (107,186) 2,953 -
Other restricted funds 18,798 174,620 (121,119) 3,225 75,524
Fraxinus 48,181 - - - 48,181
Health Education England 64,975 1,489,567 (908,439) - 646,103
Johnson and Johnson 429,273 - (186,346) - 242,927
Novartis 247,625 - (182,423) - 65,202
SHINE 19,609 125,687 (131,345) - 13,951
King’s College London (10,688) 126,179 (124,043) - (8,552)
SIDA 419,402 55,295 (449,717) (567) 24,413
Saving mothers at delivery - 212,450 (22,816) - 189,634
UKPHS - 854,449 (856,917) - (2,468)
--------------------------- ------------------------ --------------------------- ------------------------- ------------------------------
1,566,495 3,299,136 (3,417,717) 5,611 1,453,525
--------------------------- ------------------------ --------------------------- ------------------------- ------------------------------
Total of funds 1,770,410 3,450,186 (3,539,499) - 1,681,097
============ =========== ============= ============ ==============

28

TROPICAL HEALTH AND EDUCATION TRUST

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST DECEMBER 2020

17. Statement of Funds (continued)

----- Start of picture text -----
||||||||| |---|---|---|---|---|---|---|---| |Statement of funds – Prior year| |Balance at 1|Balance at 31| |January|Income|Expenditure|Transfers|December| |2019|in/out|2019| |£|£|£|£|£| |Unrestricted funds| |General funds|262,899|136,406|(211,574)|16,184|203,915| |--------------------------- ------------------------|---------------------------|------------------------- ---------------------------| |Restricted funds| |CwPAMS|415,890|735,982|(923,198)|-|228,674| |Bill and Melinda Gates|-|49,579|(37,744)|-|11,835| |Foundation| |Biomedical Engineering|18,326|-|-|-|18,326| |Comic Relief|60,341|151,868|(141,724)|-|70,485| |Department|for|International|3,488|172,920|(172,920)|(3,488)|-| |Development| |Other restricted funds|21,170|16,644|(9,001)|(10,015)|18,798| |Fraxinus|-|96,000|(47,819)|-|48,181| |Guernsey Overseas Aid|-|10,299|(10,299)|-|-| |Commission| |Health Education England|50,288|610,308|(652,333)|56,712|64,975| |Johnson and Johnson|191,313|579,368|(327,741)|(13,667)|429,273| |Novartis|211,266|258,203|(221,844)|-|247,625| |SHINE|-|96,262|(76,653)|-|19,609| |King’s College London|123|249,041|(259,852)|-|(10,688)| |Tropical Doctor Subscriptions|22,436|10,696|(7,437)|(25,695)|-| |SIDA|360,484|435,159|(356,210)|(20,031)|419,402| |--------------------------- ------------------------|---------------------------|------------------------- ---------------------------| |1,355,125|3,472,329|(3,244,775)|(16,184)|1,566,495| |--------------------------- ------------------------|---------------------------|------------------------|---------------------------| |Total of funds|1,618,024|3,608,735|(3,456,349)|-|1,770,410| |============ ===========|=============|============ ==============|

----- End of picture text -----

DFID Accountable Grant

On completion of the Health Partnership Scheme DIFD awarded THET an accountable grant designed to maintain the momentum behind some of the work undertaken by partners across the UK healthcare community. This grant scheme, valued at £1.3m, has enabled THET to award grants to 20 institutions across six countries in Africa and scheme, for projects running up until March 2019. Projects focus on a wide-range of areas, including scaling up and improving access to childhood cancer services for children in Myanmar; raising standards of care for children with epilepsy in Ghana, Tanzania, Uganda, Kenya by scaling up sustainable Paediatric Epilepsy Training (PET) targeted at high-level health workers; and increasing access to eye healthcare in two Ugandan health regions through an innovative outreach clinic training program.

“Tropical Doctor” subscriptions

The Beit Trust has supported THET for 20 years to enable the provision of subscriptions to the Tropical Doctor journal for clinicians in approximately 200 hospitals in Zimbabwe, Malawi, and Zambia. The Tropical Doctor is the only journal written by, and for health care workers in developing countries. It provides an essential forum for sharing experiences and establishing best practice – aiding communication between medical professionals around the world.

29

TROPICAL HEALTH AND EDUCATION TRUST (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST DECEMBER 2020

17. Statement of Funds (continued)

Johnson & Johnson Africa Grants Programme

THET received funds in 2016 to set up the Africa Grants Programme. This programme has consisted of 4 rounds of $500,000 each to support projects of up to 18 months working on global surgery and anaesthesia and increasing access to community healthcare. There are currently 2 programmes running concurrently – the 2018-20 grant which was due to end in September 2020 and the 2019-21 grant which was due to end in September 2021. Both have been extended in order to take into account delays brought about by the COVID-19 global pandemic.

CwPAMS

Funded by the UK Department for Health and Social Care, CwPAMS is a £1.3million grants programme for UK-LMIC health partnerships originally running from September 2018 to May 2020. As a result of the impact of the COVID-19 global pandemic, the programme has now been extended until March 2021. THET manages the programme in partnership with Commonwealth Pharmacists Association, who provide technical support to grant holders. 12 partnerships are funded through the programme, operating in Ghana, Tanzania, Uganda and Zambia, with the aim of implementing antimicrobial stewardship improvement projects in alignment with each country’s National Action Plan on antimicrobial resistance.

UKPHS

The UK Partnerships for Health Systems programme was originally a £28.5 million programme, awarded by the UK Department for International Development, running for 43 months from December 2019 to July 2023. The programme is being managed by THET with technical input from the Liverpool School of Tropical Medicine. The programme aims to help LIMCs build stronger, and more resilient health system, making progress towards universal health coverage through improved health service performance, particularly targeting poor and vulnerable populations. In April 2021, the Foreign, Commonwealth & Development Office (formerly the Department for International Development) decided to cut all of THET’s funding, meaning that the UKPHS programme will now be closed down earlier than the original date. Full programme activities will continue until the end of July 2021, with minimal activities then continuing until February 2022.

HEE

Health Education England (HEE) and the Tropical Health and Education Trust (THET) have been working in partnership since 2016. The partnership allows HEE to offer quality education and training opportunities to NHS staff in Low- and Middle-Income Countries (LMICS). It builds on THET’s long-standing role in managing health partnerships between health institutions in the UK and their counterparts across 31 countries in Africa and Asia.

The 2020 Service Level Agreement (SLA) is contracting THET to deliver activities aimed at developing the evidence base for this approach, publicising these opportunities to NHS staff, and continuing activity in Myanmar and Uganda, two countries with especially close ties to the UK health community, through Alliances.

Guernsey Overseas Aid Commission

GOAC has awarded a grant to THET to cover the cost of the equipment included in medical intern kits for recent graduates in Somaliland. Currently the Somaliland government does not provide interns with their own equipment, so these kits allow them to treat and diagnose patients as they embark on their career in medicine.

The Bill & Melinda Gates Foundation:

A three-year programme which seeks to take a systematic approach to raising awareness of health and ODA issues amongst sectors of the British public.

Somaliland

SPHEIR:

Part of the Prepared for Practise programme to prepare newly qualified doctors to meet the health care needs of the people and communities in Somaliland.

SHINE

The Somalia Health & Nutrition Programme aims at providing access to basic health and nutrition services as defined by the Essential Package of Health Services (EPHS) to inhabitants of Somalia and Somaliland, and strengthen the capacity of Somalia and Somaliland’s Health Authorities to oversee, coordinate, plan and manage the implementation of essential health service provision as defined in the EPHS framework.

30

TROPICAL HEALTH AND EDUCATION TRUST (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST DECEMBER 2020

17. Statement of Funds (continued)

Ethiopia

Novartis:

This project enables rural people suffering from chronic diseases to receive essential care near to their homes from health care workers who are appropriately trained and continuously supported and encouraged to develop their skills.

Zambia:

The Pathological Society:

THET supports a 4-year Master of Medicine (MMed) postgraduate course in Pathology at the University of Zambia. Clinical placements outside Zambia are an integral part of the course. They provide trainees with the opportunity to experience techniques and specialisms that are of limited availability in Zambia – liver, renal, neuro, bone/joint and specialist cytology – and thus acquire new clinical and service development skills. THET has a partnership with Aga Khan University in Kenya to host the trainees on 5-month clinical placements. Funds from the Pathological Society support these placements.

SIDA:

The Swedish International Development Cooperation Agency (SIDA) awarded funding for a programme with the objective of improved maintenance of equipment by 16 qualified Biomedical Engineering Technologists in four Zambian provinces of Eastern, Southern, Muchinga and Luapula, leading to improved availability of equipment for clinical and diagnostic services in support of the Reproductive Maternal Newborn Child Adolescent Health/Nutrition Programme under the Ministry of Health

Tanzania

Comic Relief - Building National Training Capacity:

THET is working with the Benjamin W.Mkapa Foundation (BMF) to implement a 3-year project which aims to support the Ministry of Health, Community Development, Gender, Elderly and Children-(MoHCDGEC) to roll out a new formal cadre of community health workers. The project supports the Ministry in the development of policies to implement based health programs as well as to build capacity of zonal, regional, and district levels on effective training, recruitment, and retention of Community Health workers.

Johnson & Johnson - Saving Mothers at Delivery

The vision of this project is that public health facilities in Myanmar are safer places for mothers to undergo emergency procedures related to delivery, and that mortality and morbidity arising from these procedures are minimised.

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TROPICAL HEALTH AND EDUCATION TRUST

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST DECEMBER 2020

18. Analysis of net assets between funds

Analysis of net assets between funds -
Current year Unrestricted Restricted Total
funds Funds Funds
2020 2020 2020
£ £ £
Tangible fixed assets 14,503 - 14,503
Current assets 255,167 1,703,093 1,958,260
Creditors due within one year (42,098) (249,568) (291,666)
----------------- ----------------- ---------------------
Total 227,572 1,453,525 1,681,097
======== ======== =========
Analysis of net assets between funds -
Prior year Unrestricted Restricted Total
Funds Funds Funds
2019 2019 2019
£ £ £
Tangible fixed assets 14,495 - 14,495
Current assets 342,638 1,785,285 2,127,923
Creditors due within one year (153,218) (218,790) (372,008)
-------------------- ----------------- ---------------------
203,915 1,566,495 1,770,410
========== ======== =========

19. Reconciliation of net movements in funds to net cash flow from operating activities

2020 2019
£ £
Net (expenditure)/income for the year (as per Statement of Financial Activities) (89,313) 152,386
----------------- -----------------
Adjustments for:
Depreciation charges 3,551 7,579
Increase in debtors (451,499) (109,473)
Decrease in creditors (80,342) (290,133)
Interest received (43) (7,252)
----------------- -----------------
Net cash (used in)/used in operating activities (617,646) (246,893)
======== ========

20. Pension commitments

The Charity operates a defined contribution pension scheme. The assets of this scheme are held separately from those of the group in an independently administrated fund. The pension cost charge represents contributions payable by the Charity to the fund and amounted to £30,991 (2019: - £22,376). £6,122 (2019 - £9,693) was payable to the fund at the balance sheet date and are included in creditors on the balance sheet.

32

TROPICAL HEALTH AND EDUCATION TRUST (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST DECEMBER 2020

21. Funds held as intermediary agent

At the year end THET acted as intermediary agent for the following organisations. The balances stated represent cash at bank. The following balances, and any income and expenditure in the period, have not been included in the financial statements:

Balance held Net receipts/ Balance held at
at 1 January payments 31 December
2020 2020 2020
£ £ £
Andrew Quayle - 1,175 1,175
Links Lusaka 464 (61) 403
NIHRGHRG 816 (2,724) (1,908)
Clinical Officer Support Zambia 1,073 (1,073) -
NHR – MY 4,506 - 4,506
Veta Bailey – TA 4,209 - 4,209
Veta Bailey – ET 1,140 (2,012) (872)
--------------------- ---------------- --------------------
12,208 (4,695) 7,513
=========== ======== ===========
Balance held Net receipts/ Balance held at
at 1 January payments 31 December
2019 2019 2019
£ £ £
Andrew Quayle 4,394 (3,930) 464
Gondar Dermatology Research 2,410 (2,410) -
Island Hospice 354 (354) -
Charitable Giving 2,540 (2,540) -
NIHRGHRG - 816 816
Clinical Officer Support Zambia - 1,073 1,073
NHR – MY - 4,506 4,506
Veta Bailey – TA - 4,209 4,209
Veta Bailey – ET - 1,140 1,140
--------------------- ---------------- ---------------------
9,698 2,510 12,208
=========== ======== ===========

Links Lusaka

These funds are being held by THET on behalf of a Link between Lusaka’s University Teaching Hospital and Bright and Sussex University Hospitals and Medical School to support their two-way trips by nurses, doctors and librarians and other allied health professionals for teaching and CPD.

NIHRGRG

Funds received from the National Institute for Health Research to provide cover the cost of employment and payroll services for NIHR Fellows in Zambia.

Veta Bailey TA

Funds received to support the development an academic partnership between UK and a Tanzanian partner which will lead to joint research activities with a focus on decentralised care and quality service provision.

Veta Bailey ET

Support to provide training to trainers in stoke care at Jimma and Gondar University Teaching Hospitals in Ethiopia in collaboration with the University of Southampton.

33

TROPICAL HEALTH AND EDUCATION TRUST (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST DECEMBER 2020

21. Funds held as intermediary agent (continued)

NIHR

Funds received from Cambridge University for the support of two fellows involved in joint research on Neurotrauma based at Yangon General Hospital.

22. Related Party Transactions

There have been no related party transactions during the year or in the prior year that require disclosure.

23. Comparative Statement of Financial Activities (year ended 31 December 2019)

Unrestricted Restricted Total
funds funds 2019
£ £ £
Income from:
Donations and legacies 63,380 - 63,380
Charitable activities 19,196 3,472,329 3,491,525
Investments 7,252 - 7,252
Other income 46,578 - 46,578
------------------- ------------------- --------------------
Total income 136,406 3,472,329 3,608,735
-------------------- ------------------- --------------------
Expenditure on:
Raising Funds 59,671 - 59,671
Charitable activities 151,903 3,244,775 3,396,678
-------------------- -------------------- --------------------
Total expenditure 211,574 3,244,775 3,456,349
------------------- -------------------- --------------------
Net (expenditure)/income (75,168) 227,554 152,386
------------------- ----------------- --------------------
Transfers between funds 16,184 (16,184) -
------------------- ------------------- -------------------
Net movement in funds (58,984) 211,370 152,386
Reconciliation of funds:
Total funds brought forward 262,899 1,355,125 1,618,024
-------------------- ------------------- --------------------
Total funds carried forward 203,915 1,566,495 1,770,410
========== ========= ==========

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