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Published On: Thu, Dec 4th, 2014

Nigeria’s Immunisation Programme and contentious GAVI Report

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Minister of State for Health, Dr. Khaliru Alhassan

Minister of State for Health, Dr. Khaliru Alhassan

Nigeria’s immunization programme against the childhood killer diseases has been described as one of the sectors that has achieved considerable measure of success in the country, Doyin Ojosipe reports.

The focus and pursuit of Nigeria’s immunization programme has attracted commendations and further supports from some of the donor agencies, including the Geneva based Global Alliance for Vaccines and Immunisation (GAVI), which appraised and scored Nigeria 80 per cent in terms of commitment to immunization in its 2013 Country Report.

The rating encouraged the Bill and Melinda-Gates foundation, the European Union, Dangote Group, Japan, Canada, Germany and Norway to bring in their support for the immunization program in Nigeria.

GAVI as an organization, is involved in bringing together public and private sectors with shared goal of creating equal access to new and underused vaccines for children living in poor countries with a model designed to leverage financial resources and expertise to make vaccines more affordable, available as well as make provision more sustainable, by working towards a point where developing countries can pay for themselves.

One of the beneficiary countries, GAVI is working with is Nigeria whose programme is being managed by the National Primary Health Care Development Agency (NPHCDA), and supervised by the Federal Ministry of Health, where a team of professionals that are strategically placed to carry out the programme considered vital and critical in the health sector.  Interestingly, since July 2012, when Nigeria signed the Aide Memoire (AM) establishing the terms and conditions of cash grants to it from GAVI and a Partnership Framework Agreement (PFA) in December 2013, the programme has been operated smoothly in accordance with laid down rules drawn up by GAVI.

As part of its policy, GAVI in June this year, sent a team of Auditors to examine the accounting records of its funds to Nigeria being managed by PHCDA, and in October 2014 and went ahead to release a 46 page Audit Report on the country on its cash support programmes for a number of mechanisms that included the Health Systems Strengthening (HSS), Immunisation System Support (ISS), operational Cost for Vaccine campaigns (Measles SIA, Meningitis and Yellow Fever) and Vaccine introduction Grants (VIG).

The GAVI Audit report queried the procurement method adopted by the NPHCDA insisting it did not comply with international competitive bidding process, adding that the specification standards and civil works on some of the incinerators sites constructed by the NPHCDA did not meet up with designed standards.

The Geneva based donor agency also requested that Nigeria’s Economic and Financial Crimes Commission (EFCC) carries out a thorough and detailed investigation saying it and its partners have a zero tolerance on the misuse of funds. The EFCC has the responsibility of pursuing individuals responsible for any criminal activity.

However, a close scrutiny at the GAVI Audit query indicated that there was a mindset of the type of report it wanted even before the audit team commenced their work which led them to throw due process and procedure of auditing to the dogs. Significantly, the GAVI Audit team failed to follow the provisions of the Partnership Framework Agreement (PFA) which was signed by both GAVI and Nigeria.

Curiously too, investigation also shows that the GAVI auditors in its haste to carry out a designed agenda were not careful enough as they dabbled into areas that have no connection whatsoever with its support funding thus made no attempt for indebt verification and double checks as expected in such an important report.

And as if acting a script, GAVI used a sledge hammer on Nigeria by announcing a suspension of the country its funding based on the Audit Report without reference to the Partnership Framework Agreement which ought to be the guide in its dealing with the NPHCDA on the pretext that the overall level of risk of its programme in Nigeria is high.

But records available at the Federal Ministry of Health and the Ministry of Finance faulted the position of GAVI, which faulted the audit methodology adopted by GAVI, saying it deviated from all known auditing procedures and processes as well as their own terms of reference.

The Federal Ministry of Health is particularly concerned over the reason the GAVI team had in visiting some of the sites unaccompanied and in the process went to the wrong places. A clear reference point is the case with the Federal Capital Territory (FCT) where they mistook the Territory’s Cold room as a project of the National Primary Health Care Development Agency’s (NPHCDA) project. The two projects are different in size and capacity, yet the team recorded that of the FCT for NPHCDA.

Similarly, it was gathered that the GAVI team of Auditors for reasons best known to them refused to meet with the relevant people in key positions that were prepared with details situation reports and explanation on various projects and expected to give explanations to questions that might be raised by the team. This lack of adherence to laid down procedure may have led to the discrepancies in its Report.

For instance, the response to the GAVI query was given within the stipulated deadline of June 30, 2014 with attached evidence that captured all details that GAVI needed to know and verify. In the response by Nigeria, it stated that contrary to the CPA report which alleged that about USD 8.077m was unaccounted for; available and authenticated records showed that it was only USD 233,000 that was yet to be verified but being compiled.

Moreover, GAVI team of auditors indicated that they were coming back to Nigeria for reconciliation and verification on three different occasions between June 30, and September 19, 2014 but later gave reasons for postponement on each occasion.

Again, curiously, on September 19, 2014, the CPA requested for information pertaining to 2014 accounts which was outside the Audit year and this led the Nigerian team to seek for clarification if the CPA intended to open a new Audit for 2014 and on October 25, the CPA team responded by saying that there was no new Audit and without any suspicion, the available requested materials were forwarded to the team.

After this, officials from GAVI met with the Chief Executive Officer of the NPHCDA during which it was agreed that a team from GAVI would stay back in Nigeria to reconcile and verify the NPHCDA finance, but nobody showed up.

Interestingly, at another meeting with the former Minister of Health, Professor Chukwu, GAVI officials notified the Nigerian team that a larger Audit was being planned to create an opportunity to verify the country’s performance and therefore requested that a joint statement be issued to enable it enter its funding cycle and accordingly, a letter of understanding dated October 17, 2014 was subsequently signed jointly by GAVI and the former minister. Surprisingly, GAVI later sent a report without Nigeria’s comments claiming that USD 2.2m was unaccounted for using the joint statement as basis.

According to GAVI, the USD 2.2m in contention was meant for Advances to staff, Printing contracts, Incinerators, Motor vehicle procurement, tax remittance to FIRS and disbursement to UNICEF. The initial CPA report had alleged that USD 4.22m was unaccounted for but when Nigeria responded in its June report with evidence of expenditure and retirements under staff advances, GAVI refused to take note of it even though it did not complain of any imbalance relating to Nigeria’s responses in that regard.

Further verification indicated that on the printing contracts, for which USD 0.44m was the issue in contention, Bauchi and Kaduna States confirmed that cards were not only received but utilized for the campaign while the balances are presently in stock.

Findings further showed that the audit report with regards to tax remittance to FIRS by the NPHCDA is far from what is contained in the FIRS records. This was captured in the letter by the FIRS to the NPHCDA dated November 6, 2014, with the title; “RE: REQUEST FOR CONFIRMATION OF TAX REMITTANCES” in which the tax agency stated that a total of N237, 621,198.30 on the GAVI Alliance funded project was remitted to it. In the same vein, the Corporate Affairs Commission in another letter to the NPHCDA upon request of the verification of the status confirmed that the 107 companies carrying out contracts with NPHCDA were legally registered companies but these were ignored by the GAVI team of Auditors.

Interestingly too, remittance to UNICEF by Nigeria, which was alleged by the GAVI team to have been diverted was found to have been unfounded as UNICEF confirmed in writing the receipt of funds due to it from NPHCDA.

On the disbursement of cash to staff, it was gathered that it followed laid-down financial regulations, in line with the World Health Organisation (WHO) practice, which pays Duty Travel Allowance (DTA) as well as in line with the monetization policy of government where staff are paid their entitlements for outside field works.

Stakeholders have said there is need for GAVI to clear all ambiguities before taking a position on any of the beneficiary countries of its support funding programme in the overall interest of its set objective.

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