May 5th, 2016.
By: Our Reporter
The fate of 3.4million Nigerians living with HIV/AIDS now hangs in the balance! No thanks to what The Global Fund, the highest contributor to the nation’s HIV/AIDS intervention calls ‘‘challenges of grants not achieving impact targets, poor quality of health services, treatment disruptions and fraud, corruption and misuse of funds’’ all criminal allegations on the part of the National Agency for the Control of AIDS (NACA), and the National Malaria Elimination Program (NMEP).
Meanwhile, Prjekthope, host NGO of this news medium has resorted to the instrumentality of the Freedom of Information Act (FOI) to request detailed information from the Director General of NACA to initiate independent effort to ensure justice is served on this case given the criminal dimension of many of Global Fund’s allegation (download the FOI request here).
Funds to Nigeria to date
The Global Fund said it has disbursed more than US$1.4 billion in Nigeria since 2003. Nigeria currently represents the Global Fund’s largest portfolio with a total of US$1.1 billion allocated to fighting HIV/AIDS, TB and Malaria for 2014-16. ‘‘Global Fund programs to date have contributed to 750,000 people living with HIV/AIDS currently on antiretroviral therapy and 310,000 new smear-positive TB cases detected and treated.’
Incompetence, fraud and mismanagement by NACA
However, despite significant investments in Nigeria, the Global Fund said it continued to face these serious challenges ‘‘despite the efforts made by the Secretariat and with over US$800 million disbursed to the country in the past four years, major deficiencies in the internal control environment persist in the portfolio.’’
For instance, NACA was among other allegation charged with making a US$20 million to suppliers without confirmation of delivery under the procurement of health and non-health commodities which represented one of the risks to the Nigerian portfolio. There is also a US$3.7 million in differences for antiretroviral drugs. ‘‘At the time of the audit, no explanation for the differences could be provided by NACA. After the end of the audit, NACA indicated that the stock was being held in a different medical store; however, the evidence provided to support this was not adequate,’’ the fund said.
A history of mismanagement of fund
Not done, Global Fund in arriving at its decision to suspend further disbursement of fund to the country noted that the Nigeria portfolio has historically faced significant challenges around financial and fiduciary management which has led to a number of investigations and recoveries of grant money in the past years. But this time, the Fund has written the Nigerian president to have a look at what is happening at the Agency. It is our hope that the president will take action in line with his stance on corruption.
Lack of financial discipline
The Agency is said to have inadequate financial management controls and a lack of financial discipline at the implementer level which resulted in US$7.65 million of unsupported expenditures, including irregular human resource payments and unreconciled project advances, as well as insufficient monitoring of sub-recipient expenditures
Non-compliance with procurement policies
Among other details, NACA has been accused of non-compliance with procurement policies, it is credited with inadequate controls over the distribution of health commodities for HIV and malaria programs resulting in stock-outs at all 42 health facilities visited by the Fund’s Office of Inspector General for periods as long as 8 months. In addition, investigators also complained of inadequate inventory management which resulted in expired HIV commodities worth US$5.4 million in the last 2 years and 35 tons of expired commodities accumulated since 2005 that were not appropriately disposed of.
Impact on the community of people living with HIV/AIDS in Nigeria
Of 1.8million HIV/AIDS positive persons who require treatment, Nigeria is only able to treat about 750, 000 from the support of the Global Fund and other partners. HIV/AIDS in Nigeria is funded mainly by donor money, accounting for over 90% of funds available for the intervention in the country. Common distortion to the treatment program being experienced include: drug stock-outs, introduction of various regimes of fee to access treatment by a largely poor population, several people have dropped out of the treatment program due to this reality and now, with this suspension, a climate of uncertainty hovers around the future of HIV treatment in Nigeria.
What should be done?
We join Global Fund to prevail on the Nigerian president to prosecute all officials of the Agency and of its sub-recipient guilty of fraud and mismanagement, but will prevail on the Global Fund to further entrench a stronger system of accountability and monitoring that ensures grants are devoted to their purposes while the decision to suspend the grant should be reviewed for the sake of millions of very poor and sick Nigerians who will ultimately bear the brunt of the Fund’s decision.