Duties and functions

Health Ministry rejects Global Fund claims of ‘systematic fraud’

Ministry of Health officials have dismissed claims by the Global Fund watchdog that the ministry wasted and misappropriated US$0.99 million earmarked to fight AIDS, tuberculosis and malaria in Liberia.

The investigation by the Office of the Inspector General (OIG), an agency responsible for protecting the Global Fund’s assets, investments, reputation and sustainability, found that the Global Fund lost $0.19 million in systemic procurement fraud and $0.52 million in grant funds. were wasted or misused for mother-peer program and travel expenses; while the Department of Health covered up abusive fuel tax payments of at least $0.16 million.

However, the ministry in a statement, while acknowledging the OIG report, noted that it is impossible to engage in massive corruption undetected over a long period of time, as described in the OIG report. OIG.

The Ministry of Health added that it did not agree with the entire report and that claims that services had not been provided as stated in the OIG cast a general disparagement on the achievements of the project in Liberia – which, among other things, include significant progress towards HIV interventions over the years – with prevalence among the sexually active population (15-49 years) decreasing each year – from the peak of 2.8 in 1996 to 1.2 in 2018 and 1.1 in 2020 (HIV prevalence, total (% of population 15-49).

“We believe that the strong checks and balances that the Global Fund grant management system has in place at the Ministry of Health, together with our robust financial management system and many years of grant management, we can safely say that it is impossible to engage in massive corruption undetected over a long period of time as described in the OIG report,” Ministry of Health authorities said in a statement signed by Felicia Gbesioh , Director of Communications, “OIG findings declared an aggregate expense of $990,000 non-compliant and recommended restitution.”

“While we do not agree with everything in the report, the department wishes to assure the public that the OIG investigation was triggered by the department when it discovered irregularities in one of its programs, the National AIDS Control Program (NACP) by an internal audit unit of the ministry in 2020, after which the Global Fund was alerted in accordance with the grant agreement,” the statement added.

He further stated that “We also wish to inform the public that for the reporting period, in accordance with the Global Fund’s grant management and procedure, fiduciary responsibilities such as procurement, financial management (including co-signature checks, local purchase orders, and vouchers), the internal audit and external audit functions were all performed jointly by many international firms.

The OIG report, which was released earlier this month, said it uncovered systemic fraud and misappropriation by staff at the Ministry of Health, one of the Fund’s top grant recipients. worldwide in Liberia.

“Our investigation found non-compliant spend and/or various types of wrongdoing in 91% of the spend examined. Non-compliant expenses totaled $1.1 million, of which we recommend $0.99 million be recovered,” OIG said. “National AIDS Program (NACP) staff made fraudulent purchases of vehicle repairs and advertising services. No assurance could be provided on program delivery in 75% of the MOH field activities we examined, and the MOH overcharged daily subsistence allowances and misused grant funds. grant by providing incorrect allowances and restoration costs. »

“This investigation revealed prohibited practices and/or no reasonable assurance of program performance in 91% of the expenditures examined. Our findings implicate more than 200 Department of Health staff. This includes staff who were directly responsible for fraud and other wrongdoing in procurement and program activities, as well as staff who benefited from such wrongdoing by receiving daily subsistence allowances for more days than the number days allowed, or receiving daily subsistence allowances for activities that did not take place,” he added.

The report notes that the findings indicate that fraud and wrongdoing at the Department of Health are systemic and raise concerns about all expenditures incurred by the Department of Health and its national programs (representing $47.8 million in grants between January 2018 and June 2021).

But the department said that while it was paying close attention to allegations of fraud and misappropriation, the sourcing and financial management of the funds in question were carried out by Cardno International Development, a US-based financial management company. United ; Swiss Center for International Health; and The Moore Stevens International Auditing Firm based in the UK.

According to the ministry, Cardno was engaged by the global fund as a Fiscal Agent (FA) and was stationed in the Ministry of Health with fiduciary responsibility to review all procurement and financial transactions as well as provide pre-audit and post-audit functions on the global fund. transactions.

“If the LFA is not satisfied with a particular transaction or transactions, it is not processed until it is corrected and signed off by the FA. The FA also has the right to declare a transaction as unreadable even after it has taken place,” the Department of Health noted in a statement. “Cardno served the ministry in this capacity from 2015 to 2021 and has now been replaced by GFA Consulting Group, another internal finance group. and purchasing management company from January 2022.”

For the Swiss Center for International Health, Ministry of Health authorities noted that the company was also under contract with the Global Fund as a Local Fund Agent (LFA), overseeing the review and certification of all quarterly transactions submitted to the Global Fund with their supporting documents. .

“They also provide assurances on all quarterly reports periodically submitted to the Global Fund. The LFA performed a post-audit of all transactions quarterly and reported any irregularities to the Global. The LFA also has the right to declare the expenses indicated in the quarterly report unreadable after reviewing the transactions. In this case, the Ministry of Health will have to reimburse the Global Fund for these expenses deemed illegible. Since 2015, the Swiss Center for International Health has acted as the local fund agent,” added the Ministry of Health.

And for the audit firm Moore Stevens International, according to the Ministry of Health, was engaged by the Global for the period of the OIG report, to provide assurances on all transactions carried out by the Ministry during the period 2015 -2020.

“These same transactions, which were reviewed by the FA, and the LFA were also authenticated by the external auditors through the provision of an unqualified opinion (unqualified opinion),” the health authorities revealed. “Moore Stevens’ five-year contract has ended and has been replaced by Ernst & Young, another international audit firm which is currently auditing global transactions for the year ended December 31, 2021.”

The department’s latest clarification comes after it submitted a written response to the OIG – noting that they had removed the former NACP chief financial officer and that the OIG’s report will form the basis of its investigation. to help the Ministry of Health in its decisions against people. found responsible or guilty of the fraud and misappropriation identified in this report.

“The [MOH] The Department of Health’s Board of Inquiry findings could result in suspension, restitution, dismissal, or possible criminal prosecution,” noted the Department of Health’s response. The findings of the OIG investigation. »

Meanwhile, the Ministry says it has so many dedicated staff who are committed to providing the required HIV/AIDS, TB and Malaria services and without some of these staff, Liberia could not accomplish the exploits in the fight against these diseases.

“However, as in all societies, few bad actors tend to derail the efforts of many good ones. That appears to be the case here where a few unacceptable behaviors cast doubt on the progress of our dedicated staff, some of whom have devoted most of their productive lives to the fight against HIV, TB and malaria,” the ministry said. of Health. accused of fraud and embezzlement are being further investigated and plans are underway to ensure dismissal in some cases, restitution of funds in others and LACC involvement if necessary.

The department has, however, indicated that it intends to keep the public informed of progress towards administrative measures taken to reduce the recurrence of the prohibited practices identified and remains committed to transparent compliance with our laws on the management of public finances and the procurement.

“As Principal Recipient, the Ministry of Health remains committed to the fight against AIDS, Tuberculosis and Malaria and will not compromise the health and safety of those inside and outside Liberia’s borders. , because to do otherwise will not only violate the grant agreements with the Global Fund, but it will also be a breach of the statutory duties of the Ministry of Health,” he added.