Audit faults U.S. health spending in Afghanistan

An independent audit released Thursday accused the U.S. Agency for International Development of “reckless disregard toward the management of U.S. taxpayer dollars,” prompting an angry rebuttal from the agency leading American reconstruction efforts in Afghanistan. The special inspector general for Afghanistan reconstruction said the agency funded a $236-million health program without verifying the Afghan government’s cost estimate and provided the money directly to the Afghan Health Ministry despite its weak financial management capabilities. Agency officials rejected the audit's findings. In a letter, the agency’s Afghanistan mission director, William Hammink, said U.S. officials did verify the costs before launching the program and defended measures the agency had taken to reduce the risk that funds would be wasted or misspent.U.S. money isn’t provided directly to the Health Ministry but instead goes into an account at the Afghan Central Bank, where USAID and the ministry’s contract management unit must sign off before any funds are disbursed, officials said. “The report provides no evidence that the extensive measures taken by USAID to safeguard taxpayer resources have resulted in high risk of misuse of funds,” Hammink wrote. The agency has been the subject of a series of highly critical audits by the special inspector general, John F. Sopko, a hard-charging former prosecutor who has railed against the U.S. practice of funneling more aid money directly to the Afghan government. In recent months, Sopko has alleged major problems with a $47-million USAID stabilization program and said the Afghans probably won’t be able to maintain two agency-built hospitals. The reports grab headlines, but agency officials say the audits often overstate problems or cite shortcomings that have already been fixed. “We have a long-standing issue with the spectacular nature of the headlines of his audits,” said one agency official who spoke on condition of anonymity. “They’re all sizzle, and when you get to audit there’s not much steak there.” To be sure, the agency’s decade-long, $15-billion reconstruction effort in Afghanistan is a juicy target for an auditor. Agency officials acknowledge missteps, primarily in the early years, but they say they and the Afghan government have improved oversight and accountability. The audit released Thursday focuses on a program called Partnership Contracts for Health, which helps provide basic health services in 13 provinces serving about half of Afghanistan’s population. USAID officials say the 4-year-old program is a success, citing improved health outcomes across the board in Afghanistan and polls showing that Afghans believe their government has improved health services.