14 April 2016
An Office of the Inspector General (OIG) investigation in Guyana found evidence that employees from the Guyana Ministry of Health, a Principal Recipient of a Global Fund malaria grant, had inflated the number of bed nets reported as distributed and fabricated documents to support the inflated figures. The employees had also fabricated documentation for another surveillance activity relating to the operation of malaria committees. The OIG identified US$56,966 worth of non-compliant expenditures. The Global Fund is putting in place corrective actions including strengthened record-keeping at the recipient level.
The Global Fund has invested US$42,111,127 in Guyana to date. There are 4,400 people currently on antiretroviral therapy, 2,100 new smear-positive tuberculosis cases have been detected and treated, and 121,000 insecticide-treated nets have been distributed.
Malaria surveillance activities and the distribution of bed nets under the Global Fund malaria grant are implemented by Vector Control Services (VCS), a department of the Ministry of Health. The alleged irregularities were reported to have taken place while VCS was under the management of its former director who resigned and left VCS on 9 December 2015. The OIG investigation focused on the malaria surveillance activities of VCS during the periods in which the ex-director of VCS was responsible for the Global Fund malaria program, between 1 January 2013 and 30 June 2015.
The OIG found evidence that VCS employees had inflated the number of bed nets distributed. By analyzing over 46,000 individual names and signatures on bed net distribution activity sheets, the OIG found indicators that bed nets had not been distributed to beneficiaries, such as the absence of a signature to acknowledge receipt, the presence of celebrity names (a common practice in fabricating documents) and the use of similar handwriting to sign for multiple unconnected individuals. The OIG’s analysis found that the average incidence of signature anomalies across the regions and periods under review was similar, indicating that the fabrication of bed net distribution documentation was systematic.
Two VCS malaria supervisors had reported fabricating bed net distribution documentation, as well as documents relating to malaria committees. Forty percent of all malaria committee minutes reviewed were identical photocopies with only the date, school name, or participants’ names changed. Almost 90% of the malaria committee minutes exhibited evidence of having been fabricated.
The OIG also identified inaccurate record keeping and poor oversight on the part of VCS. Additionally, the investigation found that a substantial proportion of the fuel purchased by VCS in the periods under review was misappropriated. Some claims for ‘per diem’ expenses by VCS drivers in certain periods were inconsistent with vehicle logbooks.
The Global Fund has requested the following corrective actions from the Ministry of Health: to improve its record keeping process and to implement a longer term technology-based solution to record the whereabouts of VCS vehicles, employees and the dates and locations of programmatic activity; an improved procurement and supply management plan to address the identified issues of inventory management and the distribution of Global Fund-financed health products. It will also ensure that the terms of reference of the Local Fund Agent include spot checks of programmatic documentation aimed at identifying indicators of fraudulent reporting.
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The Office of the Inspector General safeguards the assets, investments, reputation and sustainability of the Global Fund by ensuring that it takes the right action to defeat AIDS, tuberculosis and malaria. Through audits, investigations and consultancy work, it promotes good practice, reduces risk and reports fully and transparently on abuse.
Established in 2005, the Office of the Inspector General is an independent yet integral part of the Global Fund. It is accountable to the Board through its Audit and Ethics Committee and serves the interests of all Global Fund stakeholders. Its work conforms to the International Standards for the Professional Practice of Internal Auditing and the Uniform Guidelines for Investigations of the Conference of International Investigators.
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