Feds deny funding to UW health project in Mozambique

The Obama Administration says it wants to re-invent foreign aid and one of its mantras is to increase “country ownership” of the programs it funds for improving health and welfare in poor countries.

Given this, it came as a shock to Dr. Stephen Gloyd and others at the UW’s Health Alliance International (HAI) when the government basically pulled the plug on a long-running AIDS health care project in Mozambique that is, or was anyway, widely regarded as a model of doing just that.

“It’s ironic given their goal of wanting to strengthen local governance,” said Gloyd, director at HAI.

The U.S. Agency for International Development’s (USAID) recently denied HAI its request for continued funding of the project — a $100 million, 5-year grant. As a result of losing its bid for the grant, the non-profit organization affiliated with the UW Global Health Department had to lay-off nearly 900 health workers in Mozambique and cut its Seattle staffing by half, from more than 40 down to 22 people.

“It’s been wrenching,” said Gloyd, who is also associate chairman of the UW Global Health Department.

As the Seattle Times reported this week, the non-profit health services organization had expanded greatly over the past five years to assist with the global efforts aimed at improving access to HIV treatment in Africa. Gloyd said they fully expected to continue doing this work.

But USAID didn’t approve the new funding, he said, apparently due to HAI discovering some of the community-based organizations it works with in Mozambique may have been engaging in fraud, or at least financial improprieties. Hmnm, this reminds me of another killing the messenger story

Stephen Gloyd

“We identified these problems and are now in the process of taking some of these organizations to court,” Gloyd said. “Also ironically, most of them were the kinds of local and faith-based organizations USAID had encouraged us to work with.”

Gloyd said he’s not so sure most of these cases are actual fraud. Some, he said, may just be messy bookkeeping or based on misunderstandings. Mozambique is a poor country lacking in all sorts of infrastructure, he noted. If we want to give these poorly resourced governments and organizations more “ownership” of health programs, he said we need to accept that some aspects of management will fail.

Gloyd accepts responsibility for failing to provide enough financial oversight. But he questioned the wisdom of USAID simply pulling the plug on his organization’s decades of work in Mozambique and then handing it over to a DC-based firm Abt Associates that has had little expertise in running such a project.

I asked USAID for its position on denying HAI the grant, but all agency spokesman Lars Anderson could get for me was an unattributed (no identifiable person) and somewhat unintelligible statement: “We determined that HAI was not responsible, at that time, to receive U.S. taxpayer funds.”

Huh? What’s that mean?

So much for the Obama Administration’s vaunted new effort to be transparent and publicly accountable.

Gloyd said he still has received little explanation as to why the feds thought it reasonable to dismantle HAI’s Mozambique project because of financial problems with local groups.

Here’s what the USAID chief says he is doing:

Rajiv Shah, director USAID

“We must seek to do our work in a way that allows us to be replaced over time by efficient local governments, by thriving civil societies and by a vibrant private sector,” said Dr. Rajiv Shah, director of USAID for the Obama Administration and a former agriculture and health guy for the Gates Foundation.

Shah has also said he is on a bent to root out fraud and corruption. That’s good, and perhaps it’s become even more politically urgent given all those Republican members of Congress looking to slash foreign aid (at least the kind that goes to poor people, not the kind we’ve been giving to Egypt).

Gloyd wasn’t too keen to talk about losing the USAID grant, but he does think there needs to be more attention given to the on-the-ground effect on the poor — in Mozambique and elsewhere — of what we mean we talk about “re-invention” and improving “efficiency” in foreign aid.

I think what he means is that it’s easy to reshuffle the deck chairs and slap some heads in order to show you’re taking action. But just reshuffling and slapping isn’t actually a good measure of whether or not the changes are actually helping those most in need.

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Tom Paulson

Tom Paulson is founder and lead journalist at Humanosphere. Prior to operating this online news site, he reported on science,  medicine, health policy, aid and development for the Seattle Post-Intelligencer. Contact him at tom[at]humanosphere.org or follow him on Twitter @tompaulson.