Kyrgyzstan & Tajikistan: Are Health Donors Bailing Because of Rampant Graft?

Kyrgyzstan and Tajikistan are the two Central Asian countries most in need of outside support to help prop up crumbling healthcare systems. Yet amid rising evidence that officials are stealing international aid, donors are increasingly wary of extending assistance.

Lately Kyrgyzstan and Tajikistan have been on the radar of the Global Fund to Fight AIDS, Tuberculosis and Malaria for all the wrong reasons. In April, the Global Fund sent a letter to Kyrgyzstan's Health Minister demanding the return over $120,000 that an audit identified as stolen through fraudulent procurement. In Tajikistan in March, the Global Fund blacklisted a government committee for misappropriating over $100,000.

According to the World Health Organization, both Kyrgyzstan and Tajikistan face high rates of multidrug-resistant tuberculosis, with incidences increasing each year. HIV infections are also on the rise: both countries lie on major narcotics trafficking routes and migrant workers bring the virus back from Russia, where the infection rate is exploding.

But overall funding is drying up. In January, Kyrgyz Deputy Prime Minister Damira Niyazalieva claimed the Fund would not support programs in the country beyond 2017. Kyrgyzstan is already borrowing from the Global Fund against a future grant to provide tuberculosis treatments.

It is unclear how much the corruption allegations have influenced the Global Fund's decision to scale back in the two graft-prone countries. Representatives of the Geneva-based organization refused to comment on future activities. But Ibon Villelabeitia, a spokesman, said the Fund "operates with the highest degree of transparency and takes the issue of fraud or missing funds very seriously," adding that the audits, which the Fund published online, "speak for themselves."

In the past, the Global Fund took steps to reduce grant misuse in Tajikistan and Kyrgyzstan by channeling funds through the United Nations Development Program, rather than via government agencies. The move was not without a cost - the UNDP takes a 7 percent commission on the procurement process - but UN officials claim it has eliminated some of the more eye-popping fraud.

The Tajikistan audit, carried out by the US Department of Justice's Office of the Inspector General, suggests there is still plenty of room for theft by sub-recipients, including government bodies such as Tajikistan's Committee of Youth Affairs, Sports and Tourism.

Specifically, the audit looks at the procurement of "stationery, small electrical goods, and sports equipment" in 2011 and 2012. While the purchases were admissible under the terms of the Global Fund program, the audit found the Committee overpaid a local company, LLC Komyob, more than $116,000 for the supplies. Nevertheless, Komyob became a favored Committee supplier, winning six tenders, five of which were not advertised.

The audit makes Komyob sound like a company set up to steal money: "The address of Komyob listed on the bid submission document […] is a residential address. The inhabitant at the address had no knowledge of Komyob, despite living at this location for many years."

The Global Fund blacklisted Tajikistan's Committee of Youth Affairs, Sports and Tourism.

Critics say official responses to Fund investigations are unsatisfactory. Responding to the allegations, Tajikistan's Minister of Health - who like many highly placed officials hails from President Emomali Rahmon's home district of Dangara - criticized the Global Fund for not warning the government that an audit would take place. He did not address the alleged theft.

Kyrgyz Health Minister Talantbek Batyraliev claimed not to have known about the Global Fund letter addressed to him until journalists informed him of it 11 days after it was written. While stressing that the alleged infractions - also related to procurement - did not occur on his watch, he said he would "do everything to fulfill the Global Fund's requirements" and acknowledged that his predecessors had risked future funding.

Representatives of Kyrgyzstan's Health Ministry and Tajikistan's Committee of Youth Affairs, Sports and Tourism both declined to speak to EurasiaNet.org about the audits.

Officials in the two countries have a history of allegedly misappropriating Global Fund dollars. A 2013 review of programs in Tajikistan hinted at the Komyob phenomenon, noting "fundamental weaknesses in procurement and supplies management […] exposing the grant to risk." A Kyrgyz audit covering the period when the government was the main funding recipient - from 2003 to 2009 - alleged that a government official had passed money to family members through NGOs set up for just that purpose.

The alleged thefts in Kyrgyzstan and Tajikistan pale in comparison to revelations from Kazakhstan, where Fund officials said in January that local officials swindled over $5 million from its tuberculosis program from 2005 to 2012.

Without guarantees of future cash from the Global Fund, the situation in Kyrgyzstan looks "pretty dire," said a senior international aid worker based in Bishkek.

"If there is a funding shortfall for AIDS and tuberculosis over the coming years - and it looks like there might be - they [Kyrgyzstan and Tajikistan] will both have to get good at writing grant proposals, something they have not been in the past," said the aid worker, who declined to give his name for fear of official reprisals.

The director of an NGO that partners with the Global Fund on HIV programs fears the worst. "Due to funding shortages, many organizations will not be able to run shelters for HIV sufferers and other services," the director told EurasiaNet.org. "Vulnerable sections of the population are becoming exposed to risk again."