Poor record keeping plagues Bush AIDS effort in developing countries

Tuesday, December 26th 2006, 6:23 am

By: News On 6

WASHINGTON (AP) _ Even Bush administration officials acknowledge it was a lot to expect all at once: rush billions of dollars of help into AIDS-stricken nations, demand quick results from U.S. contractors, and then expect those contractors to produce tidy progress reports.

In the end, it was too much.

Government auditors found that accurate record keeping and monitoring often took a back seat in President Bush's three-year-old, $15 billion plan to fight HIV/AIDS in African and other poor countries.

The Bush administration says the situation has improved greatly because it has imposed tighter, standardized reporting systems on groups that receive U.S. money to ensure the accuracy of their reported results.

Lapses in verification, confusion over how to measure results and errors in counting people served by anti-AIDS programs were significant enough that at least one member of Congress wants lawmakers to investigate.

``While the Global AIDS pandemic is an urgent humanitarian crisis that demands a rapid response, we cannot sacrifice results and accountability for speed,'' said Rep. Barbara Lee, D-Calif.

Rep. Henry Waxman, incoming chairman of the Government Reform Committee, agreed that Congress should probe accountability questions raised by government auditors.

Ambassador Mark Dybul, the administration's global AIDS coordinator, said there is a growing ``culture of accountability'' in the nations receiving U.S. help, and he is confident the overall numbers reported for the program are now accurate.

Early problems were expected as the administration demanded quick results from its contractors, Dybul said.

``You could've waited for three years to get all these systems in place, and an awful lot of people would have died,'' he said. ``Our approach was get the services out, start moving the programs.

``In many of the cases where they say we can't find documentation, that doesn't mean people aren't getting services; that just means the reporting systems are not in place.''

Auditors nonetheless plan to recommend improved reporting methods to ensure ``reasonable assurance that what they say was done was actually carried out,'' said Joe Farinella, the assistant inspector general for the U.S. Agency for International Development which conducted the audits.

He cited ``a constant challenge of insuring the quality of the data reported.''

``It's not good enough for the auditors to hear from the mission that we did A, B and C but we can't prove it to you, or there's no documentation to prove that we did it.''

The investigators focused on groups caring for infected people and AIDS orphans, and working to prevent spread of the disease.

They found that in Guyana, the AIDS program reported inflated numbers to Congress in its annual report. The government claimed 5,200 AIDS orphans received care in that country, but auditors documented fewer than 300, many of them not even affected by AIDS.

The opposite occurred in South Africa, where some provincial governments refused to disclose information on AIDS tests and counseling, causing ``severe underreporting'' of how many benefited from U.S.-backed services, auditors said. Officials said that problem was now resolved.

After reporting that millions of people were reached by mass-media promoting sexual abstinence and use of condoms, the administration now has dropped that measurement completely, on grounds that it is impossible to know how many people hear radio messages.

Tracking orphan care has been a problem. Because local groups were simply tallying individual handouts like meals or clothing, the administration imposed a new rule in July stating that a child can only be counted as receiving care if provided with three of six key services.

Development experts say that some of the new religious and community organizations doing the AIDS work were ill-equipped for the reporting demands that accompanied U.S. grants.

``This whole push for new partners is a double edged sword. You have to build their capacity to manage U.S. government money and particularly meet the reporting guidelines,'' explained Patty Mechael, former program director for the charity CARE.

One of the largest contractors, Family Health International, experienced 83 percent inaccurate or unverified tallies from its subcontractors in impoverished Guyana.

FHI has since strengthened training for its local partners, ``making sure the people clearly understand what they're measuring,'' senior vice president Sheila Mitchell said.

Some groups that didn't measure up have been dropped, and others who complained about reporting demands have warmed to the new systems that also help them track their own needs, Dybul said.

He said the updates the administration released on World AIDS Day Dec. 1 are accurate: 822,000 people receiving life-saying drugs, and 4.5 million receiving care.

Bush's goal is to treat 2 million infected people by 2008, prevent 7 million new infections, and provide support and care for 10 million HIV/AIDS patients and orphans.