Global Fund finds…Guyana’s treated bed net distribution process flawed

Apr 29, 2016 News

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The public health sector has long been advancing its fight against malaria.  Primary among its tactics has been the distribution of long-lasting insecticidal mosquito nets.
Guyana’s fight against malaria has for a number of years been supported by grants from the Global Fund. Global Fund is an international financing organisation that aims to attract and disburse additional resources to prevent and treat HIV and AIDS, Tuberculosis and Malaria.
Chief Medical Officer, Dr. Shamdeo Persaud had earlier this year told this publication about 8,000 cases of malaria that were recorded by the Ministry of Public Health’s Vector Control Services Unit for the past year. But, Dr. Persaud, who was tasked with reviewing the tabulated figures, confided that there might have been some under reporting of the recorded cases.
Based on his consideration of the data input into the malaria programme information system, Dr. Persaud said that he observed that there was under reporting of about 30 per cent.  “There is an element of under reporting in some instances,” said the CMO, who pointed out too, that there were also instances of multiple reporting.
He however noted that there has been a decline in malaria cases.
And this state of affairs has been substantiated by the Pan American Health Organisation (PAHO) which usually collaborates with the Ministry to review the reported cases.
Through its VCS Unit, the Ministry has been advancing its malaria fight by distributing treated mosquito nets. Over the course of the past two years, Dr. Persaud said that more than 70,000 nets were distributed in many of the malaria endemic areas of Regions One, Seven, Eight and Nine.
But based on an Investigative Report recently released by Global Fund, Guyana has not been accurately reporting on its mosquito net distribution.
According to Global Fund, based on investigations done by its Office of the Inspector General (OIG), it was detected that in 2015, employees attached to the Ministry of Health’s VCS Unit had inflated the number of nets reported as distributed.  In fact it was found, according to Global Fund, that the employees had fabricated underlying bed net distribution documents to support the inflated figures.
Added to this, Global Fund said that VSC employees fabricated documentation for another surveillance activity relating to the operation of malaria committees. It was pointed out too that due to inaccurate record-keeping by VCS and the Ministry of Health, the OIG was unable to establish how many bed nets financed by the Global Fund had been distributed by VCS.
“As a result of this fraudulent misrepresentation of information and inadequate procurement and supply management, the OIG finds that the sum of US$41,789, corresponding to the value of the bed nets, is non-compliant expenditure and therefore should be recovered,” the Report highlights.
The investigation also found that a substantial proportion of the fuel purchased by VCS in the periods under review was misappropriated. These irregularities, it was pointed out, affected fuel purchases totalling US$11,290 which the OIG finds to be non-compliant and therefore potentially recoverable expenditures.
Some claims for ‘per diem’ expenses by VCS drivers in certain periods were inconsistent with entries in vehicle log books and therefore the OIG found that ‘per diem’ claims totalling US$3,887 were non-compliant expenditures and were also potentially recoverable.
The investigation has concluded that the overall management of the Global Fund malaria programme by the former director of VCS and the standard of oversight exercised by a former VCS senior Monitoring and Evaluation (M&E) technician were inadequate.
The OIG therefore considers that this poor oversight facilitated the fraudulent misrepresentation and other irregularities identified in the investigation.
Among the agreed management actions, following the resignation of the former director, the Ministry appointed an interim director and two interim deputy directors, with one having responsibility for the malaria programme.
And to mitigate the risk of the issues identified in the investigation reoccurring, the OIG and the Global Fund Secretariat have agreed on a series of corrective management actions. These include requesting the Principal Recipient (the Ministry) to implement: an improved process to record the distribution of bed nets; a new longer term technology-based solution to record the whereabouts of VCS vehicles, employees and the dates and locations of programmatic activity; and an improved procurement and supply management plan to address the identified issues of inventory management and the distribution of Global Fund-financed health products.
The Global Fund Secretariat will also be seeking to ensure that the terms of reference of the Local Fund Agent include spot checks of underlying programmatic documentation aimed at identifying indicators of fraudulent reporting.

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