The Association of Nigerian Physicians in the Americas annual convention held in Abuja, Nigeria in the summer of 2009 provided an opportunity for many Nigerian physicians practising in the US to connect with their colleagues back home. On one of the evenings after scientific sessions were over, and it was time for pepper soup and beer, I gathered with some of my colleagues in the ultra expensive bar at the Transcorp Hilton Hotel. We had very lively discussions concerning how those of us practicing outside of Nigeria had abandoned the healthcare ship in Nigeria.

 It was during the discussion that I discussed my work in HIV and AIDS and the apparent ineptitude of the Nigerian government towards the prevention of HIV infection and transmission in Nigeria. I told some of my Nigeria-based colleagues that the Nigerian government and its agencies have not taken full advantage of international funding for HIV/AIDS and that when they have received grants the money has more often than not been mismanaged. One of my Nigeria-based colleagues who happen to work for the Ministry of Defense and manages the HIV/AIDS program took exception to what I said. I proceeded to give facts on how Nigeria had to return millions of dollars given to the country under the President’s Emergency Plan for AIDS Relief (PEPFAR) because the government and its agencies could not meet set deliverables. This is I said is unpardonable given the level of need for HIV prevention, treatment and care in Nigeria. After the first few years of PEPFAR, perceived corruption in recipient countries prompted the US government to institute a performance-based system with in-built deliverables. When benchmarks/objectives are not met, costs tied to such objectives are returned to PEPFAR.  This was foreign to many in Nigeria who will just pocket unused monies when projects are partly implemented or not implemented at all.

 The Nigeria Ministry of Defense that my Nigeria-based colleague works for and directs their HIV/AIDS program happens to be one of the recipients of PEPFAR funds. It was therefore not surprising to see him put up a big fight to defend the running of HIV/AIDS programs in the countries and that my assertions were untrue.

 I was doing my morning routine of catching up with Nigerian news before heading to work yesterday morning when I saw the headline in The Guardian Newspapers “Charges of fraud, controversies rock grants for AIDS, tuberculosis, and malaria.” This story on the mismanagement of grants from the Global Fund (full story at http://odili.net/news/source/2011/nov/9/4.html) not only confirmed my summer 2009 assertions in Abuja but paints the sorry state of ineptitude, outright corruption, irresponsibility, and recklessness on the part of the Nigerian government, its agencies and non-governmental agencies receiving grants for HIV/AIDS programs in Nigeria. It is sad that not only are we unable or unwilling to provide needed resources to combat the scourge of HIV/AIDS in Nigeria, we also mismanaging and stealing monies provided through grants by other countries who see the need to help us take care of our own. The non-governmental agencies, some of them not-for-profit that should serve as the conscience of the people including religious ones have joined governmental agencies known for corruption in lining their pockets with monie meant for improving the health of Nigerians. Nigerians here are double victims; victims of inadequate government funding for healthcare and victims of the siphoning and laundering of grants funds meant for providing preventin, treatment and care for them.

I wish I could see my Nigeria-based colleague who I met for first time during Abuja conference and ask him to look at me straight in face and repeat to me the statements he made in 2009 in the light of current revelations.

 Highlights of the report from the Office of the Inspector-General (OIG) of the Global Fund based on the Guardian report show that:

 * National Action Committee on HIV/AIDS in Nigeria (NACA) incurred extra-budgetary expenditures of $71,000, as well as $679,000 in unretired expenditures.

*    The Yakubu Gowon Center for International Cooperation (YGC), which had received four grants totaling $172 million. It is to refund to the Global Fund $5.2m, which could not be properly accounted for, and its financial activities would be further investigated by the OIG.

*    The Society for Family Health (SFH), at the end of 2009, had administrative charges of five per cent of the budget, amounting to $861,000 that was not accounted for, as well as $68,000 unretired expenditures.

*    The National Malaria Control Program (NMCP) had $711,000 unretired staff advances and $10,000 underfunded balance of rent grant. It is to refund $132,000, which could not be properly accounted for, or was not in the approved work plan and budget.

*    The Association for Reproductive and Family Health (ARFH) had $335,000 in management fees, which it could not justify, and could provide no accountability for.  It is to refund $504,000 it could not account for, or which was not in the approved work plan and budget.

*    The Christian Health Association of Nigeria (CHAN) illegally transferred foreign currency amounting to $11.6m to non-programme-related bank accounts abroad; the funds were later refunded into the local Naira bank account.  CHAN grant Sub-Recipients (SRs) had not accounted for $1.4million at the time of the audit, and CHAN is to refund $2.9 million which could not be adequately accounted for or which was not in the approved work plan or budget.

*    CHAN MEDIPHARM overcharged on distribution of products to the tune of $256,000; with $77,000 as unexpended amount on training.

The OIG said that “these transactions constitute high risk money laundering activity and pose a risk that grant funds were used in furtherance of underlying criminal activities perpetrated by third parties in country.”

Corruption has led to the suspension of Global Fund’s grants to Mali and the same might happen to Nigeria very soon. Cry my beloved country.

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