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When foreign aid is an ATM

April 02, 2006|Helen Epstein | Helen Epstein is a visiting scholar at the Center for Health and Wellbeing at Princeton University's Woodrow Wilson School of Public and International Affairs. She is the author of "Why Don't They Listen: Africa, the West and the Fight Against AIDS," forthcoming from Farrar, Straus & Giroux in early 2007.

ON A RECENT trip to Uganda, I stopped by the local offices of the Global Fund to Fight AIDS, Tuberculosis and Malaria. Since it was created in 2002, the Geneva-based multibillion-dollar health agency had disbursed $54 million to Uganda. But in August 2005, the auditing firm Pricewaterhouse Coopers concluded that the whereabouts of much of the money was unknown.

No one knows the exact amount that is missing, but estimates range in the tens of millions of dollars. According to the Pricewaterhouse report and to local newspaper accounts, some of the money ended up in the private bank accounts of government officials. Some was spent on campaign junkets and bogus trips abroad to meetings and "workshops." Some may have been spent on the campaign to lift presidential term limits so that Ugandan President Yoweri Museveni could compete in the country's recent elections.

In September, Global Fund headquarters temporarily suspended all disbursements to Uganda. Ugandan authorities responded promptly, sacking the entire project management unit, the local body overseeing the grant -- including secretaries and cleaning ladies. A new team was hired and a commission of inquiry was set up to find out how much money had been stolen, who stole it and what they did with it.

When I visited the local Global Fund offices in Kampala in February, four armed guards stood at the entrance, and the new receptionists were reading Bibles. Although it is heartening to see how seriously the Ugandans are taking the matter, none of this can erase the fact that an enormous act of international goodwill that may not come again has been squandered.

The shenanigans had fatal consequences. Programs to deliver treatment for the three diseases are behind schedule. One Ugandan recently complained on an Internet blog that his child almost died of malaria because all the health workers at the local clinic were at a "workshop" in the capital or out of the country. In Kampala, I heard the officials involved in the scandal referred to as "nightdancers" -- evil spirits of Ugandan mythology who haunt graveyards and feed on the dead.

The irony of all this is that the Global Fund was intended to be a transparent, efficient mechanism that would avoid the inevitable politicization of bilateral aid programs and the hopelessly entangled bureaucracy of United Nations agencies. When it was created with great fanfare, fund officials announced that the money would be controlled by local players, including officials from local government and nongovernmental organizations. Donor governments, including the U.S. and Britain, as well as private philanthropists, including Bill Gates, have so far given about $5 billion to the Global Fund to support some exemplary programs around the world.

However, some powerful Ugandans seem to have been under the impression that the Global Fund was an all-you-can-eat buffet. When I was in the country, the commission of inquiry spent one afternoon questioning the director of the Uganda Center for Accountability, which received $120,000 from the Global Fund to train community-based organizations in financial management. The director, Teddy Cheeye, is a close associate of Museveni, the Ugandan president, and a senior official in the country's main spy agency.

Bank records show that two days after the Global Fund money was transferred to the center in March 2005, Cheeye withdrew $33,000 and bought a plane ticket to China, according to the commission of inquiry. With a bemused, insouciant air, Cheeye told commissioners that he had mixed up his accounts and the plane ticket had nothing to do with the Global Fund money. When asked for evidence that he had used the money to do management training, Cheeye produced a sheaf of gas station chits to prove he had been traveling to workshops all over the country.

In Uganda, gas station attendants write the registration number of the vehicle on receipts. One of the commissioners checked with the motor vehicle registry and discovered that the vehicle Cheeye claimed to have used to drive to these workshops was a 1977 Caterpillar tractor.

All this was personally depressing to me because I love Uganda. Uganda was the first African country to see a nationwide decline in HIV rates, a success that saved perhaps 1 million lives during the 1990s. There has been much debate about whether this was mainly the result of rigorous abstinence or condom use or (my preferred explanation) pragmatic avoidance of casual sex.

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