By Mable Nakibuuka
Officials of the Ministry of Health have come under fire over allegations that they misappropriated billions of shillings that was collected from the international community and Ugandans to help government in the fight against Coronavirus (COVID-19).
This comes after a new report released by a group of Civil Society Organisations pinned the Ministry officials on failing to show accountability for billions of shillings.
The report, titled ‘Prudent Public Finance Management for Greater Accountable Governance, assessed expenditure and deployment of COVID-19 resources by the Ministry.
Compiled by CSOs that include the Uganda Debt Network (UDN), Anti-Corruption Coalition Uganda, Action Aid, and Transparency International Uganda, the report details how much money was donated by various international organisations, how much was collected from individual Ugandans, companies and friends of Uganda, plus how much the Ministry spent on various items.
In the report, the anticorruption agencies noted that several decisions taken before deployment of the COVOID-19 funds were not well thought out, justified or based on due diligence of the Public Procurement and Disposal of Assets (PPDA) regulations.
This is because most items ordered were not delivered on time, and prices of many items were inflated, besides procurement of substandard items, like the current lack of enough oxygen machines at Mulago National Referral Hospital yet money for procuring the same was disbursed.
It was also noted that the sleeper tents procured for the National Quarantine Centre at Namboole Stadium were blown away by wind and could not be utilised by end of August, despite the rising numbers of COVID-19 infections.
The procurement of spray pumps was another issue raised in the report, whereby the contract was awarded to N2M Company Limited at Shs530m in June, but the only to deliver some in October.
The pumps, which included 80 mist sprayers, 99 power sprayers and 19 transport jet pumps, were meant for use in disinfecting places, materials of COVID-19 confined places, treatment centres, homes, ambulances, among others but their intended purpose was never fully achieved because of delays in delivery.
The report says that by August and September, none of the treatment centres had received the spray pumps except Entebbe Regional Referral Hospital.
In his remarks, Patrick Tumwebaze, the Uganda Debt Network Managing Director, questioned whether the money, most of which was borrowed, was used for the intended purpose.
“Overall, the budget for the multi-sectoral COVID-19 response, between the months of March and June, amounted to Shs2.2 trillion.
By June 30, a total of Shs767 billion was received and committed towards COVID-19 prevention and response interventions. But with what we are seeing we might not have gotten value for our money and because of that an audit that should result into prosecution must be done.”
Arthur Oyako, of Anti-Corruption Coalition Uganda and David Kizito, of Transparency International Uganda said government has not provided any accountability regarding the utilisation and impact, if any, of the COVID-19 funds to enable citizens follow up and report cases of misuse as and when they arise.
They noted that this is worsened by the understaffed anti-corruption agencies, namely the Inspectorate of Government, who should take up the abuse of Covid-19 funds, but without a substantial head at the helm, the blatant abuse of public resources may go unpunished.
Ministry Of Health Speaks Out
The same allegations in the above report are also contained in another report compiled by the Budget Monitoring and Accountability Unit of the Ministry of Finance, Planning and Economic Development.
In a thread that is trending twitter, Dr Diana Atwine, who is the Ministry of Health Permanent Secretary, had this to say;
“I would like to respond and set the record straight on the above-mentioned report authored by a team led by Ms. Annette Mutoni Kyakuwa, of the Budget Monitoring and Accountability Unit of the
Ministry of Finance, Planning and Economic Development.
The Ministry of Health appreciates the support rendered by the Ministry of Finance, Planning and Economic Development (MoFPED) in the preparedness and response to the ongoing COVID-19 pandemic.
Ministry of Health acknowledges the positive comments on the efforts and achievements of the Ministry of Health in its response to the pandemic as contained in the aforementioned report.
However, Ministry of Health would like to express its concern on the modus operandi of the Monitoring team that was assigned to undertake monitoring of the COVID-19 budget and accountability interventions.
Ministry of Health would like to also note that BMAU hurriedly released an incomplete and unsigned report in October 2020 to social media without receiving feedback from the Ministry of Health as it was expected.
While the team states in its report that there was physical monitoring of the various interventions, most of their work was done over the phone and also promised to come at a later time to follow up.
Even in areas where they did physical verification, information was obtained from junior officers who had little information to provide. The documentary review of the procurement files that was done lacked clarity from contract managers hence the distortions in the report.
Although monitors are not auditors it would have been courteous for them to share their report for complete feedback as expected. The Ministry of Health only noticed this report circulating on social media which the sector objected to in writing to MOFPED.
Instead of sending the report formally, the Commissioner in charge of Planning at Ministry of Health received an unsigned copy via email. However, to-date Ministry of Health has never received an authentic and signed copy of this report.
The monitoring team raised a number of issues which have since become a subject of seemingly planned and malicious attacks against the Ministry of Health in mainstream and social media.
While we acknowledge that this is a Government report and we don’t want to be contradicting each other, it is important that the distortions are clarified for record purposes.
Budgetary allocation and Expenditure as of June 2020
The BMAU report states that Ministry of Health received UGX766.7 billion which was committed to the #COVID19 prevention and response interventions.
The support from GAVI was disbursed to UNICEF & WHO. Of the UGX10Bn released by GAVI in June 2020, UGX6.5Bn was disbursed to UNICEF to procure medical supplies while UGX3.5Bn to WHO for test kits and others. It is clear that by end of June 2020 the UGX10Bn had not yet been spent.
It is therefore pertinent to note that the total resources disbursed to MOH is UGX174billion (UGX 119 billion from Government of Uganda
and UGX 55 billion from World Bank) while the rest of the funding stated in the report did not come to MOH.
It is also worth noting that the other monies cited are either off-budget expenditure or future commitments. It should not be portrayed that all the entire money was disbursed by the Ministry of Health.
The Ministry of Health would like to state that the contract to supply the megaphones was worth UGX2.9Bn, (i.e. a total of 10,863 megaphones, 43,450 rechargeable and dry cell batteries) were procured.
This is contrary to the number of 108,863 megaphones quoted by the monitoring team in their report, which implied that Government would have spent approximately UGX25.47Bn on the megaphones and batteries.
The monitoring took place at the time when the distribution of the megaphones was ongoing. The megaphones were delivered to the Ministry on the 21st September 2020. So far, all districts except 10 districts have received the megaphones.
The 10 districts include: Amudat, Bushenyi, Butaleja, Kaabong, Kamwenge, Kalangala, Karenga, Lwengo, Mitooma and Napak. MOH did not have funds to distribute the megaphones country wide.
Therefore, it relied on using every opportunity that was available which are:
Either for the districts to pick them or to take advantage of any available means to deliver them to the respective districts.
Emergency Ambulances And Boats:
33 type B ambulances have since been received at the Ministry and another 5 ambulances (3 water boat intensive care ambulances and two type C road intensive care ambulances) are going through Customs clearing at Kenya Port of Mombasa.
The presumed delay in delivery of the ambulances was due to the customized manufacturing process of the ambulances as per the contract specifications and due to the global movement restrictions which also affected shipping of equipment and other commodities.
At the onset of COVID-19 Pandemic in Uganda, the Ministry of Health undertook a needs-assessment, revised specifications and procured 7 oxygen plants, 450 oxygen cylinders, 5 filling stations and other accessories.
Four of the seven plants have been installed at Mulago National Referral Hospital while the 2 in Entebbe Grade B and Mbarara Regional Referral Hospital. One has been allocated to Kayunga Regional Referral Hospital.
These are high tech, high volume, high flow and high purity oxygen plants procured to ensure continuous supply of oxygen to patients, which is critical in the management of COVID-19, as we are now experiencing more patients progress from moderate to severe conditions.
The report highlights that the contract was signed in May 2020 and deliveries and installations had not commenced by September 2020.
While the Ministry acknowledges that the contract was signed in May 2020, the public and the authors of this report are aware that Uganda went into a total lockdown in March 2020 and this greatly affected logistics among others.
Contrary to what the report stated ‘deliveries and installations had not commenced by September 2020’, the plants were delivered in Aug 2020. The 4 oxygen plants that were procured for Mulago required additional space, prompting the Ministry to quickly create space.
As a result, the installation and commissioning processes were finalized early October 2020. Suffice it to note that Mulago National Referral Hospital uses pure piped oxygen (99 -100%
Ministry of Health would like to categorically state that the tents couldn’t be erected in Namboole as this would damage the turf at the premises. In order to expand capacity for COVID-19 treatment at district level, the tents were reallocated to Regional Referral Hospitals.
All the 20 tents have since been delivered, erected and are under use at the Regional Referral Hospitals across the country. For purposes of clarification, all the tents supplied meet the required specification.
Mobile Health Facilities At Border Points Of Entry
Following the decision by Cabinet and the COVID-19 (National Task Force (NTF) to ease port health testing because of the long queues of truck drivers, MOH contacted Uganda Revenue Authority (URA) and the respective local governments who agreed to avail land.
The local governments delayed to identify land for the development. Although, they had earlier indicated willingness to provide land.
Additionally, the contractor had fabricated 50% of the buildings by the end of June 2020 but land allocation delayed completion.
Accommodation Hired To Quarantine Abroad Returnees And COVID-19 Suspects
The report questions the engagement of Kirigime guest house in Kabale District and further asks why the same measures were not undertaken in other points of entry.
Ministry of Health would like to clarify that this is because unlike other borders, 86 Ugandans who were stranded abroad were dropped off at the border in Kabale District. It was more economical to quickly set up an institutional quarantine site rather than transport all of them to Kampala.
The process of identifying a hotel (Kirigme guest house) was done by the Kabale District Taskforce to urgently accommodate the stranded nationals who returned through the Uganda-Rwanda border point at Katuna. MOH worked with the
Ministry of Tourism, Wildlife and Antiquities (MTWAU) to identify hotels.