• Thursday, November 30, 2023
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Health workers stranded as $1.5bn Mastercard vaccine scheme halts

More than 22, 000 health workers including Nigerians have become stranded after a $1.5 billion COVID-19 delivery scheme initiated by the Mastercard Foundation and Africa Centres for Disease Control and Prevention came to an abrupt halt.

The financiers called for an investigation of all programmes across the continent following allegations of misappropriation.

An internal circular from July shows that donors are focusing on cases of unbudgeted roles, workers paid without verification of completed work, and missing contracts and receipts, according to a Devex report.

The Saving Lives and Livelihoods (SLL) is the largest public health partnership between a global philanthropic organisation and an African institution.

Some workers in Nigeria have not been paid for four to six months of their work. They’ve been told that Mastercard Foundation and Africa CDC have not released the funding for their payment.

Some have been told it is because of the ongoing audit and because proper procedures were not followed, including a lack of employment letters, signed attendance records, and verification of worker identity.

Helen Adesina, a 32-year-old single parent affected by the halt has struggled to cater for her child since the problem began.

She worked for SLL between December 2022 and July 2023, entering patient information into a book. She was promised N1,500 for seven-hour workdays, six to seven days a week and is now owed about N150,000.

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Michael Alabi, 37, a COVID-19 vaccination team member, is also owed over N160,000 and hasn’t been paid for months. He entered patient information into a database and issued vaccination cards.

“I’m angry at the situation, but what can I do? I have to hope in God,” Alabi told Devex.

He was hired by Nigeria’s National Primary Health Care Development Agency and Lagos State Primary Health Care Board — with AFENET responsible for the payment.

The Africa CDC and Mastercard Foundation have declined to comment on what’s happening in Nigeria Devex stated.

In two years of programming, the SLL initiative delivered over 34 million doses of COVID-19 vaccines in 25 African countries, distributed cold chain equipment to 32 countries, and equipped 30 laboratories for genomic sequencing.

It’s been a complex partnership with a variety of partner organizations.

The Mastercard Foundation contracted the African Field Epidemiology Network, or AFENET. This Uganda-based nonprofit operates in 31 African nations, to play a funds management and disbursement role to organisations carrying out the program. Africa CDC has led the monitoring and evaluation of the work.

But in early May, the program needed a strategic shift after the World Health Organization declared that the COVID-19 pandemic was no longer considered a global health emergency.

To discuss a new path forward, a meeting was held in Addis Ababa, Ethiopia, on July 5. The organizations came together to discuss their challenges and priorities moving forward as the program evolves into its next phase.

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But a redefining decision was taken at the meeting and by July 27, the Mastercard Foundation and Africa CDC sent a letter announcing the audit and halt in spending.

“Until the audit is complete, we request that our partners pause program activities and any new financial obligations or expenditures in relation to the Public Health emergency support. Activities in the interim and any expenditures must be approved on a case-by-case basis. An update will be shared once the audit review process concludes,” they wrote in the letter.

By the time this letter was sent, SLL leadership already had some insight into the challenges facing the program in terms of governance and financial accountability.

The internal draft report circulated in July examined spending in a small portion of the programming which took place in Cameroon, Sierra Leone, Liberia, South Sudan, Kenya, Tanzania, Zambia, Uganda, and Lesotho.

It was a subset of the programming designed to get funding to countries quickly, in which $5.5 million, less than 1 percent of SLL’s overall three-year budget, was disbursed.

The draft, which Deloitte was contracted to write, flagged for further investigation expenses unsupported by documentation; salaries paid for unbudgeted roles and paid higher than budgeted; salaries unsupported with timesheets or without verification that assigned tasks were completed; and allowances paid at higher rates than budgeted. It flagged missing receipts, attendance lists signed contracts, and discrepancies over exchange rates.

It suggested a “comprehensive review of the reported expenses” didn’t take place and that there were multiple instances where AFENET and organizations implementing programs had different versions of country plans and thus prepared financial reports based on their own versions.

There were also discrepancies in the number of vaccine doses reported by Africa CDC and the organizations operating in countries.