The organisation, which is the highest donor to Nigeria in terms of HIV and malaria, said it has disbursed more than $1.4 billion to the country since 2003.
Calling on President Muhammadu Buhari to take action, Global Fund said Nigeria has faced significant challenges around financial management, which has led to a number of investigations and recoveries of grant money in the past years.
Mark Dybul, an executive director at Global Fund, said an audit report exposed “challenges of grants not achieving impact targets, poor quality of health services, treatment disruptions and fraud, corruption and misuse of funds”.
“The audit report on Nigeria covered US$889 million of Global Fund grants, and found systemic weakness in the controls in various government entities,” he said.
“The investigation report found fraud and collusion in the amount of US$3.8 million.”
Dybul said the audit reviewed multiple grants between 2013 and 2015, and identified significant problems with internal controls relating to procurement conducted by government agencies like the National Agency for Control of AIDS (NACA) and the National Malaria Elimination Programme (NMEP).
The audit identified $20 million as expenditure for which NACA was unable to provide supporting documentation.
NACA was also accused of non-compliance with procurement policies and inadequate controls over the distribution of health commodities for HIV.
The organisation said it also observed inadequate inventory management which resulted in expired HIV commodities worth $5.4 million in the last two years.
“In addition, the audit identified a lack of documentary evidence related to human resources and payment approval processes, with $7.65 million identified as unsupported expenditures,” he said.
“Following work performed by a third party fiscal agent, US$5.1 million has now been verified, based on a review of supporting documentation that was not available during the audit; US$1.0 million requires further clarification, and US$1.5 million of expenditure that has not yet been reviewed due to timing.
“We expect to be able to provide a final, comprehensive view of these expenditures by 10 May.”
Dybul revealed that about $3.8 million of irregular spending was also uncovered at the Department of Health Planning, Research & Statistics (DPRS).
He said malaria stocks were out in all the 42 health facilities visited by the fund’s office of inspector general within eight months.