Uganda: Corruption - Why Aid for HIV/Aids is a Do Or Die
- By News Hound
- Published 07/10/2007
- Uganda
- Unrated
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View all articles by News HoundUganda: Corruption - Why Aid for HIV/Aids is a Do Or Die
by Ben Moses Ilakut
A story is told in Uganda's civil society organisations circles of how AIM, an International NGO, gave a women's group called PACHEGO in Pakwach town money to conduct HIV/AIDS activities.
With the little capacity and skills they had acquired, the women utilised all the money, achieved their targets and accounted for all the money estimated between Ush12 to 15 million.
Mr. Kyahuka, coordinator Uganda Net Work for Aids Service Organisations (UNASO) quickly brings to light this example to stimulate hope that all is not lost on accountability.
"That example demonstrates that people are more responsible about their lives than the health ministry, so they (the people) are the ones who should run their health programmes. Experts should come in as facilitators," says Kyahuka.
Uganda, having been extolled globally for its exemplary approach to the AIDS pandemic, also became one of the first beneficiaries of many global funding.
But in 2005 the first batch of funding amounting to US$45million from the Global Fund to fight malaria, tuberculosis was grossly mismanaged and consequently, the fund was temporarily suspended over gross mismanagement. The lives of HIV/AIDS patients hang in a delicate balance as it became apparent that crucial supplies including ARVs would run out of stock.
The Uganda government instituted a probe headed by a High Court judge, Justice James Ogoola (known as the Ogoola Commission) into the matter. The public hearings that ensued exposed ugly revelations, namely; the line minister and state ministers presided over several management and accounting procedure breaches, the permanent secretary, who is the accounting officer of the health ministry was in several instances falling far below accounting, monitoring procedures in administering the funds, project money was being used to run ministry expenditure, recipients including those meant to politically monitor the use of AIDS funding were withdrawing funds disbursed into their accounts instantly without showing cause for the withdrawals. Flawed recruitment, false accounting to capacity building activities and many more obscenities were also exposed.
During this period, anger and fear of the unknown abound, but good enough the Global Fund agreed to reinstate support having gotten satisfied about the probe handling.
"When a donor pulls out from the pool of donors, there is a back lash on the patients because a funding gap is created and the attendant service may lack. It is particularly delicate because people already on ART must in no way skip their schedule," says Dr Emmanuel M Bukajumbe, the acting Medical Services Coordinator AIDS Information Centre (AIC), a major civil society organisation in Uganda.
This scenario has caused a complex situation where, despite gross abuses and mismanagement, aid for AIDS must continue to be availed, prompting the statement that it is a do-or-die.
"It is difficult to remove accountability issues completely or drastically. But a lot can be done to scale down fraud. Civil society and donors may have to tighten on audit systems and quarterly audit reports produced. The same standard must be applied to government as well," says Bukajumbe.
According to Kyahuka, the problem in Uganda has been that the governance component, especially political leadership has been weak.
"If the leader at the helm of an HIV/AIDS project is weak or corrupt, the rest of the bond is weakened. The theft of AIDS money should not be looked at in isolation of other accountability problems. The Global Fund saga for example could be traced to the setting up of it s' structures. They were both wrong and poorly managed,"Kyahuka argues. "Civil society had for example noticed that the structures set up prior to the Global Fund were weak. At the onset senior officials showed reluctance to be transparent and when the project started, it ended up is shambles."
Yet amidst such a trap the figures are tragically scary.
According to a paper "Assessing Our Past to lay Strategies for the Future" presented by the Director General Uganda AIDS Commission (UAC), Dr. Kihumuro Appuli during the 5th National HIV/AIDS Partnership Forum on May 14, 2007 the epidemic has stabilised at 6.1 - 6.4% over the last five years.
The report indicates among other things that only 12.7% of women and 10.8% of men between 15-49 years had been tested for HIV and received their results; the number of people having aids was over 1 million in 2006; the number of people in need of ART in 2006 was 234,500 and a high number of new infections - 132,500 in 2005 was realised.
The report also reveals that approximately 2.2 million orphans were reported in 2006.
The report predicts worrying future trends including an increasing national population - 3.4% per annum, a high number of new infections - 132,500 in 2005, the number of people having HIV/AIDS to increase from 1.1 million in 2006 to 1.3 million in 2012 to 1.7 million in 2020 and the number in need of ART from 234,500 in 2006 to 263,000 in 2012 and 342,200 in 2020.
A report by Dr Jim Arinaitwe, a monitoring and evaluation specialist entitled "Systems for HIV/AIDS Services Delivery" delivered to the 5th National AIDS Partnership Forum May 14-15, 2007, suggests that if there is improved mobilisation and effective management of resources, harmonised funding modalities, government support, donor support, mainstreaming of HIV/AIDS in plans and budgets and financial accountability and reporting, corruption can be drastically reduced and impressive results in the HIV/AIDS fight will be posted .
"Systems are in place, but they are not followed. They are on paper and they are good. I am optimistic that because of what happened in the case of the Global Fund, systems will be followed. There is already enough scare about dipping into project money. Uganda has monitoring and record systems," he says. "We have handled bigger money before, government for example has handled big money before, and so it could not be that we lack capacity for huge money."
In the runner up to the Global Fund exposure, donor money into the country came in an ad hoc manner.
"There has been no harmonised system for which HIV/AIDS money is channelled into the country. Currently each CSO campaigns for support from various donors and gets it directly," says Kyahuka, This, partly may have exposed the funds mismanagement.
But after the Paris declaration on Universal Access to Treatment and Care, donors have been asked to harmonise funding and support national priorities.
In this kind of approach, money is put into a fund, and the service providers will apply for funds from the national pool.
"This means that the Global Fund, bilateral donors like the EU, USAID, will channel funding into the basket," says Kyahuka.
"Under the new arrangement, money will be sent to the Ministry of Finance. The Ministry of Health will be the main agent for money meant for Tuberculosis and Malaria while Uganda Aids Commission will be the main agent for money meant for HIV/AIDS. That means that the Country Coordinating Mechanism (CCM) that will be formed, will comprise representatives of CSOs. DFID, Irish Aid, DANIDA, USAID have so far accepted to fund the harmonised funding mechanism."
That approach, dubbed the Long Term Institutional Arrangement (LTIA) is in the offing and is hoped to reform the management of HIV/AIDS money by crystallising structures. The LTIA was formed after the suspension of the Global Fund in August 2005.
LTIA among other things looks forward to the formation of a Global Task team on Improving AIDS coordination among multilateral institutions and international donors; the alignment of support to national strategies, policies, systems, cycles and annual priority action plans.
Under the arrangement the financial management procedures should follow the Government of Uganda channels for disbursement of project funds, individual sectors and local governments should be responsible for routine utilisation and accountability of funds, civil society should follow agreed guidelines and procedures and the procurement systems should follow the government procedures for large ticket offshore procurements under the Public Procurement and Disposal of Public Assets Authority (PPDA) guidelines.
It also highlights the need to follow existing reporting, monitoring and audit arrangements used for project funds, sector and district joint reviews, annual, bi-annual, quarterly, specific reviews among others.
But just like Bukajumbe observes, the structures may be put in place, but the big question remains; will the stewards-the politicians, the natural scientists, the social scientists respect support and implement this systems?
And while the answer for that question still eludes us, another question boils in the mind: will, or can, the donors close the taps? If they did so, wouldn't it be appropriate to render a verdict of murder?
Aid figures may give clues to this puzzle.
According to Uganda's national strategic plan, donors have been more or less in charge of funding HIV/AIDS activities in the country.
While US government support, the biggest ever has grown from US $10million in 2003/2004 to $40million in 2004/2005 to about $110 million in 2005/2006, the Uganda government support has been growing only towards $5million mark since then.
Other donors together including UNHCR, UNESCO, UNDP, ILO, Norway, Italy, WHO, EU, UNFPA, Sweden, Denmark, UNICEF, Ireland, UK, WFP, WB, GFATM, have also been increasing their funding.
The figures are out there, the realities are as grotesque as they are tragic.
The message in big and small talk is that there is no turning back in financing HIV/AIDS activities.
Are no donors also thinking so?
http://allafrica.com/stories/200707091150.html
A story is told in Uganda's civil society organisations circles of how AIM, an International NGO, gave a women's group called PACHEGO in Pakwach town money to conduct HIV/AIDS activities.
With the little capacity and skills they had acquired, the women utilised all the money, achieved their targets and accounted for all the money estimated between Ush12 to 15 million.
Mr. Kyahuka, coordinator Uganda Net Work for Aids Service Organisations (UNASO) quickly brings to light this example to stimulate hope that all is not lost on accountability.
"That example demonstrates that people are more responsible about their lives than the health ministry, so they (the people) are the ones who should run their health programmes. Experts should come in as facilitators," says Kyahuka.
Uganda, having been extolled globally for its exemplary approach to the AIDS pandemic, also became one of the first beneficiaries of many global funding.
But in 2005 the first batch of funding amounting to US$45million from the Global Fund to fight malaria, tuberculosis was grossly mismanaged and consequently, the fund was temporarily suspended over gross mismanagement. The lives of HIV/AIDS patients hang in a delicate balance as it became apparent that crucial supplies including ARVs would run out of stock.
The Uganda government instituted a probe headed by a High Court judge, Justice James Ogoola (known as the Ogoola Commission) into the matter. The public hearings that ensued exposed ugly revelations, namely; the line minister and state ministers presided over several management and accounting procedure breaches, the permanent secretary, who is the accounting officer of the health ministry was in several instances falling far below accounting, monitoring procedures in administering the funds, project money was being used to run ministry expenditure, recipients including those meant to politically monitor the use of AIDS funding were withdrawing funds disbursed into their accounts instantly without showing cause for the withdrawals. Flawed recruitment, false accounting to capacity building activities and many more obscenities were also exposed.
During this period, anger and fear of the unknown abound, but good enough the Global Fund agreed to reinstate support having gotten satisfied about the probe handling.
"When a donor pulls out from the pool of donors, there is a back lash on the patients because a funding gap is created and the attendant service may lack. It is particularly delicate because people already on ART must in no way skip their schedule," says Dr Emmanuel M Bukajumbe, the acting Medical Services Coordinator AIDS Information Centre (AIC), a major civil society organisation in Uganda.
This scenario has caused a complex situation where, despite gross abuses and mismanagement, aid for AIDS must continue to be availed, prompting the statement that it is a do-or-die.
"It is difficult to remove accountability issues completely or drastically. But a lot can be done to scale down fraud. Civil society and donors may have to tighten on audit systems and quarterly audit reports produced. The same standard must be applied to government as well," says Bukajumbe.
According to Kyahuka, the problem in Uganda has been that the governance component, especially political leadership has been weak.
"If the leader at the helm of an HIV/AIDS project is weak or corrupt, the rest of the bond is weakened. The theft of AIDS money should not be looked at in isolation of other accountability problems. The Global Fund saga for example could be traced to the setting up of it s' structures. They were both wrong and poorly managed,"Kyahuka argues. "Civil society had for example noticed that the structures set up prior to the Global Fund were weak. At the onset senior officials showed reluctance to be transparent and when the project started, it ended up is shambles."
Yet amidst such a trap the figures are tragically scary.
According to a paper "Assessing Our Past to lay Strategies for the Future" presented by the Director General Uganda AIDS Commission (UAC), Dr. Kihumuro Appuli during the 5th National HIV/AIDS Partnership Forum on May 14, 2007 the epidemic has stabilised at 6.1 - 6.4% over the last five years.
The report indicates among other things that only 12.7% of women and 10.8% of men between 15-49 years had been tested for HIV and received their results; the number of people having aids was over 1 million in 2006; the number of people in need of ART in 2006 was 234,500 and a high number of new infections - 132,500 in 2005 was realised.
The report also reveals that approximately 2.2 million orphans were reported in 2006.
The report predicts worrying future trends including an increasing national population - 3.4% per annum, a high number of new infections - 132,500 in 2005, the number of people having HIV/AIDS to increase from 1.1 million in 2006 to 1.3 million in 2012 to 1.7 million in 2020 and the number in need of ART from 234,500 in 2006 to 263,000 in 2012 and 342,200 in 2020.
A report by Dr Jim Arinaitwe, a monitoring and evaluation specialist entitled "Systems for HIV/AIDS Services Delivery" delivered to the 5th National AIDS Partnership Forum May 14-15, 2007, suggests that if there is improved mobilisation and effective management of resources, harmonised funding modalities, government support, donor support, mainstreaming of HIV/AIDS in plans and budgets and financial accountability and reporting, corruption can be drastically reduced and impressive results in the HIV/AIDS fight will be posted .
"Systems are in place, but they are not followed. They are on paper and they are good. I am optimistic that because of what happened in the case of the Global Fund, systems will be followed. There is already enough scare about dipping into project money. Uganda has monitoring and record systems," he says. "We have handled bigger money before, government for example has handled big money before, and so it could not be that we lack capacity for huge money."
In the runner up to the Global Fund exposure, donor money into the country came in an ad hoc manner.
"There has been no harmonised system for which HIV/AIDS money is channelled into the country. Currently each CSO campaigns for support from various donors and gets it directly," says Kyahuka, This, partly may have exposed the funds mismanagement.
But after the Paris declaration on Universal Access to Treatment and Care, donors have been asked to harmonise funding and support national priorities.
In this kind of approach, money is put into a fund, and the service providers will apply for funds from the national pool.
"This means that the Global Fund, bilateral donors like the EU, USAID, will channel funding into the basket," says Kyahuka.
"Under the new arrangement, money will be sent to the Ministry of Finance. The Ministry of Health will be the main agent for money meant for Tuberculosis and Malaria while Uganda Aids Commission will be the main agent for money meant for HIV/AIDS. That means that the Country Coordinating Mechanism (CCM) that will be formed, will comprise representatives of CSOs. DFID, Irish Aid, DANIDA, USAID have so far accepted to fund the harmonised funding mechanism."
That approach, dubbed the Long Term Institutional Arrangement (LTIA) is in the offing and is hoped to reform the management of HIV/AIDS money by crystallising structures. The LTIA was formed after the suspension of the Global Fund in August 2005.
LTIA among other things looks forward to the formation of a Global Task team on Improving AIDS coordination among multilateral institutions and international donors; the alignment of support to national strategies, policies, systems, cycles and annual priority action plans.
Under the arrangement the financial management procedures should follow the Government of Uganda channels for disbursement of project funds, individual sectors and local governments should be responsible for routine utilisation and accountability of funds, civil society should follow agreed guidelines and procedures and the procurement systems should follow the government procedures for large ticket offshore procurements under the Public Procurement and Disposal of Public Assets Authority (PPDA) guidelines.
It also highlights the need to follow existing reporting, monitoring and audit arrangements used for project funds, sector and district joint reviews, annual, bi-annual, quarterly, specific reviews among others.
But just like Bukajumbe observes, the structures may be put in place, but the big question remains; will the stewards-the politicians, the natural scientists, the social scientists respect support and implement this systems?
And while the answer for that question still eludes us, another question boils in the mind: will, or can, the donors close the taps? If they did so, wouldn't it be appropriate to render a verdict of murder?
Aid figures may give clues to this puzzle.
According to Uganda's national strategic plan, donors have been more or less in charge of funding HIV/AIDS activities in the country.
While US government support, the biggest ever has grown from US $10million in 2003/2004 to $40million in 2004/2005 to about $110 million in 2005/2006, the Uganda government support has been growing only towards $5million mark since then.
Other donors together including UNHCR, UNESCO, UNDP, ILO, Norway, Italy, WHO, EU, UNFPA, Sweden, Denmark, UNICEF, Ireland, UK, WFP, WB, GFATM, have also been increasing their funding.
The figures are out there, the realities are as grotesque as they are tragic.
The message in big and small talk is that there is no turning back in financing HIV/AIDS activities.
Are no donors also thinking so?
http://allafrica.com/stories/200707091150.html
