PEPFAR in Africa: USAID Can Take Additional Steps to Improve Controls Over Data Quality

Audit Report
Report Number
4-936-22-002-P

High quality data helps support effective, impactful programs combatting HIV/AIDS funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), according to the U.S. Department of State’s Office of the U.S. Global AIDS Coordinator and Health Diplomacy, which leads and manages PEPFAR in coordination with several U.S. government agencies, including USAID. USAID implemented $2.3 billion in PEPFAR-funded activities in Africa during fiscal year 2019, a share of the more than $100 billion invested by PEPFAR in the fight against HIV/AIDS since 2003, the largest commitment to address a single disease in the history of U.S. foreign assistance. Data’s central role in informing decision-making for PEPFAR-funded programs and sustaining U.S.-funded development generally underscores the need for proper data quality monitoring.

Our audit objective was to assess the extent to which USAID designed and implemented internal controls to provide reasonable assurance of quality PEPFAR data in selected Africa missions.

Key Findings

Beginning in fiscal year 2017, PEPFAR data quality criteria for agencies became more rigorous, reinforcing the need for the design and implementation of strong internal controls to ensure quality data. Although selected USAID Africa missions—Kenya, Malawi, and South Africa—generally adhered to controls, reasonable assurance was lacking. We noted weaknesses in quality control measures in PEPFAR’s official data system, data quality assessments, and the adoption of recommended best practices for validating results.

We made three recommendations to enhance USAID’s efforts to produce quality data in its PEPFAR programs. USAID agreed with all three recommendations.

Recommendations

Recommendation
1

We recommend that USAID's Bureau for Global Health develop detailed guidance to ensure that PEPFAR DATIM quality control measures at missions are well-documented and applied consistently.

Questioned Cost
0
Funds for Better Use
0
Close Date
Recommendation
2

We recommend that USAID's Bureau for Global Health develop detailed guidance to ensure that Missions document compliance with Agency requirements on how to respond when PEPFAR interagency DQAs are not performed, or reports are not received.

Questioned Cost
0
Funds for Better Use
0
Close Date
Recommendation
3

We recommend that USAID's Bureau for Global Health develop detailed guidance to ensure that PEPFAR RDQAs conducted by implementing partners at missions cross-reference databases to other sources, are provided to the appropriate USAID officials, and include controls for oversight of the process.

Questioned Cost
0
Funds for Better Use
0
Close Date