[INVESTIGATION] The Massive MDG Fraud: How the health ministry steals from the sick and dying – Premium Times

Officials continue to steal funds needed for fixing dilapidated hospitals and providing drugs
In this first part of our series on the utilisation of the yearly $1billion for Millennium Development Goals’ projects, we investigate the monumental corruption in the health ministry. We found that rather than help, the ministry is actually killing the country’s hope of achieving the MDGs

Massive corruption in various ministries, departments and agencies (MDAs) are the main reasons Nigeria will not achieve her Millennium Development Goals (MDG) targets, a PREMIUM TIMES investigation has revealed.

Between 2006 and 2008, MDAs such as the health ministry, water resources ministry and the National Primary Healthcare Development Agency (NPHCDA) mismanaged hundreds of billions of naira meant to specifically help Nigeria achieve the MDG targets.

While public officials mismanaged the MDG funds described by a senior civil servant as “free money,” President Goodluck Jonathan sits on a report indicting these officials and their collaborating contractors.

The most culpable of these MDAs is the health ministry, which according to official government investigators “is the main impediment to achieving the MDGs related to health.”

Obatunde Oladapo of the “Treatment Action Movement,” an NGO dedicated to helping people living with HIV/AIDS, is so enraged by the blatant stealing of funds meant to treat sick people and save more Nigerians from dying from treatable diseases that he only stopped short of cursing the thieves. He said they were feasting on “blood money” that will haunt them forever.

Stealing from the sick

When Aisosa Asemota was diagnosed with HIV in 2009, he believed his days on earth were numbered. He was told at the University of Benin Teaching hospital in Edo State where he was diagnosed that his immune system was weakened and that he was therefore more susceptible to other diseases.

So when his skin itched continuously in January 2012, he went to the same hospital. However, the doctors there told him that he was only entitled to free anti-retroviral drugs (ARVs). To treat his scabies, doctors prescribed other drugs, particularly 100ml benzyl benzoate for treatment. “I bought the benzyl benzoate for 180 naira. I used it with the other drugs I bought; and after a few days, I became okay,” the 34-year-old bus driver stated.

While Mr. Asemota bought his benzyl benzoate in a neighbourhood pharmacy for N180, the officials in the health ministry, which bought in bulk, quoted and bought the same drug for government hospitals at “scandalously ridiculous” amounts.

The Benzyl Benzoate fraud

As part of efforts to help in the treatment of HIV aids victims, the Federal Ministry of Health in 2008 bought benzyl benzoate to be distributed to hospitals across the country.

While the 100ml benzyl benzoate costs a maximum 200 naira in the retail market, officials in the health ministry claim they purchased each unit of the drug for N119,000, which is 59,400 per cent higher than the amount for which Mr. Asemota bought the same drug.

The drug, used in treating scabies and other skin ailments, is one of the items bought by the ministry in 2008 at a total cost of N5.4 billion.

Since a carton of the drug contains 24 bottles of 100ml benzyl benzoate, 544 cartons, which the ministry bought, could only have cost a maximum N2.6 million. The ministry however paid N64.7 million for it, with N62 million perhaps going into private pockets of officials and their collaborators.

“That is ridiculous, how can anybody buy it (benzyl benzoate) for that amount?” said Emmanuel Osigwe, a pharmacist who runs a pharmacy in Garki, Abuja.

This purchase troubled independent monitors who ordered that “the purchase of 100ml benzyl benzoate suspension at N119,000 when it costs less than N200 in the market should be flagged.”

The money used for this purchase is part of the funds meant to help Nigeria achieve the Millennium Development Goals (MDGs).

Achieving the MDGs

Although world leaders adopted the United Nations Millennium Declaration in September 2000 in New York, it was not until 2005 that the Nigerian government effectively signed on to the initiative, making a well-publicised commitment to achieving the MDGs by 2015.

In a deal negotiated by Ngozi Okonjo-Iweala, former World Bank Managing Director and Nigeria’s Finance Minister, Nigeria secured debt relief from the Paris club of creditors in 2005. Nigeria paid $12bn of the $30bn owed the Paris Club while the remaining $18bn was cancelled. The country then pledged to devote $1bn annually to achieving the MDGs. The amount was what was then being used to service the Paris club debt annually.

In other to ensure efficiency and proper management, the President established the Office of the Senior Special Adviser to the President on MDGs (OSSAP-MDGs) whose mandate was to oversee the spending of the amount on projects that would aid the realization of the MDGs targets. This office was held by Amina Az-Zubair

To ensure probity and accountability, Mrs. Az-Zubair set up a Monitoring and Evaluation team to monitor the MDG projects executed with the funds.

What the monitoring team found is shocking and heart-rending. . Between 2007 and 2010, the team found that different ministries, departments and agencies, mismanaged a larger chunk of the N320billion allocated to achieving the MDGs between 2006 and 2008.

The Ministry of Health fraud

As part of an ongoing investigation into the (mis)management of the MDG funds, PREMIUM TIMES found that the health ministry mismanaged most of the N54billion it received between 2006 and 2008 under the MDG scheme.
Goals 4 ( Reducing child mortality), 5 (Improving maternal health), and 6 (Combating HIV/AIDS, malaria and other diseases) are directly related to health. For this reason, the Ministry of Health was allocated N21.3bn in 2006, N16.17 billion in 2007, and 16.9billion in 2008.
But rather than applying the funds for the purposes they were earmarked, officials of the Ministry and its agencies stole a large portion and then mismanaged what was left, investigations reveal. Several projects including construction of clinics, purchase of drugs and hospital equipment, and capacity building of health staff across the country, suffered as a result.
Other examples of fraud

Apart from inflation of prices which characterized the Ministry of Health’s purchases, several examples of how the ministry managed its funds abound.

Following complaints, by several (public) hospitals in Nigeria, of lack of injections, the health ministry decided to buy injections in bulk for distribution nationwide. Over N900million was released, through the National Programme on Immunization, but most of the materials purportedly bought were never supplied. Their whereabouts remain unknown.

This was confirmed in March 2008 when the M&E team submitted its report for 2006.

“Of the N1bn approved for buying syringes, N901.6mn was spent. A large quantity of syringes paid for had not been delivered. These included 2,854,000 BCG syringes; 24,000,000 1ml disposable syringes; 1,000,000 5ml reconstitution syringes; 52,092,835 0.5ml auto-disposable syringes and 49,261 safety boxes,” the report stated.

Another example of money spent without materials delivered was in the purchase of solar freezers meant to store drugs and other materials. While the ministry released N200million for 250 solar freezers in 2006, only 65 were delivered.

A senior official of the ministry told PREMIUM TIMES it was normal for contractors to under-deliver goods when they had adequately “settled” top officials.

“See, to get contract in this ministry or any other one, you must settle very well. So, if a contractor knows he has settled very well, he can choose to under-deliver since he is sure nobody will complain as everyone has been settled,” the source, who does not want to be named, for fear of being victimized, said.

A culture of misinformation

In other to hide the corruption in the expenditure of the MDG funds, the Federal Ministry of Health decided to manipulate information and forge documents of purchases given to the independent monitors.

An example of this was in the expenditure of N1.089bn meant for the Family Health Division (FHD) of the ministry. The money was to be used to purchase medical supplies including mama kits for distribution across the country

When the monitors asked for details of the purchases, the ministry told them that they had procured and supplied 45,105 mama kits. Further scrutiny of the purchase and distribution records however revealed that only 31,171 were procured and distributed.

When the M&E team sought reasons for this misinformation, the ministry was not forthcoming with any.

Frustrating investigation and monitoring

In other to ensure that the misappropriation and illegalities in the ministry are not exposed, officials decided to frustrate the activities of the M&E team, by withholding information from monitors.

This withholding of information was characteristic of the ministry in all the years its activities were monitored.

In its report for 2006, which was submitted in 2008, the M&E team stated that “the FMOH and its MDAs need to be more serious in implementing budgets they defended and more responsive to requests for information by the M&E team.”

The ministry however continued to withhold information from the monitors up till 2010 when the report for the 2008 expenditure was submitted. This made the M&E team to state in its report for 2008 that “the major challenge in the 2008 M&E exercise as in 2006 and 2007 was accessing timely information to verify implementation and assess outcomes.”

“The M&E team inevitably concluded that MDAs (Health Ministry and departments under it) refused to give information either because they were hiding something, or because they had got away with withholding information in previous years (of M&E).”

Health ministry an impediment

In a public document whose forward was written by President Goodluck Jonathan and titled “Nigeria Millennium Development Goals Report 2010,” the Federal Government admitted that “None of the MDGs are certain to be achieved.” The report also showed that the MDGs related to health had an average or weak potential of being achieved by 2010.

Although the Federal Government failed to elaborate on who is to blame for the potential non-achievement of the health-related MDGs, the scale of mismanagement and inefficiency at the Federal Ministry of Health caused independent monitors to conclude that the ministry is the greatest impediment to achieving the MDGs.

“The most important lesson learnt was that the projects and programmes implemented by the FMoH procurement division performed poorly. This has been a consistent finding of the M&E since 2006.” The M&E team stated as part of its conclusion in the 2008 report.

“The FMoH is the main impediment to achieving the MDGs related to health,” it concluded while recommending that funds should be halted to the ministry while health-related projects should be funded through a different scheme and agency.

Blame the President

Despite the mismanagement of MDG funds in the health ministry, no official of the ministry or project contractor has been questioned or prosecuted.

Jibrin Ibrahim, the national coordinator of the Centre for Democracy and Development believes the president is to blame for the continuous mismanagement and non-performance of projects associated with the MDGs, as official reports of the mismanagement have been sent to the President.

“What we expect the government to do is to follow up on this non-performance. Our own position is that this report goes to the President. The president is the person who has final authority to follow up on these issues, and what should happen is that those that are not performing should be investigated,” he said.

“I don’t see why the anti-corruption agencies shouldn’t investigate these people,” said Mr. Ibrahim, whose organisation was part of the M&E team.

Apart from the official M&E report, the Bureau for Public Procurement, which monitors purchases by MDAs also carried out its own investigations and found some ministries culpable of misappropriation.

“The Bureau did a Procurement Audit in 2008 and forwarded the report to the Economic and Financial Crimes Commission for investigation,” said Segun Imohiosen, the Bureau’s spokesman.

The Senior Special Adviser to the President on MDG, Precious Gbeneol wouldn’t respond to PREMIUM TIMES enquiry, even though it was her office that disbursed the stolen funds, and should render account.

After several calls and text messages to Mrs. Gbeneol, her spokesperson, Kene Offie requested a formal letter of enquiry. Several weeks after the letter was sent and despite repeated visits, phone calls and text messages, we got no written response. Mr. Offie, later explained that the office had stopped giving funds to indicted MDAS.

“When MDAs have been found to have performed abysmally in implementation of budgets, OSSAP MDGs has stopped such MDAs of any further budgetary provision until the issues leading to poor performance are resolved,” she said.

Ministry keeps mum

Despite repeated request for information and clarification from the Ministry of Health, its officials refused to comment.

Yusuf Isiaka, the Deputy Director Media in the ministry is yet to respond to our enquiry several months after they were submitted to him in the format he requested. Mr. Isiaka requested a formal letter of our questions after listening to them.

Although the letter was sent to the Ministry through him in November last year, several visits to the ministry and repeated phone calls yielded no results as Mr. Isiaka kept saying “you know we are very busy.”

While the billions of naira spent on purchase of drugs and other medical supplies by the health ministry remain unaccounted for, and its officials refuse to comment, Nigerians like Mr. Asemota still find it difficult to get basic medical supplies such as injections and drugs from public hospitals.

“Since I was diagnosed of HIV, I always go to them (University of Benin Teaching hospital) for any sickness. Most times however, I still buy my injections and drugs from chemist outside the hospital,” Mr. Asemota said.

***Funding for this story was provided by the FUND FOR INVESTIGATIVE JOURNALISM (FIJ).

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