U.S. COVID-19 Vaccine Contributions: USAID Should Consider Enhancing Oversight to Mitigate Risk of Fraud, Waste, and Abuse

Audit Report
Report Number
E-000-21-002-M

Why We Did This Evaluation

According to the World Health Organization (WHO), over 170 million COVID-19 cases and over 3 million deaths had been reported worldwide as of May 31, 2021. WHO reports that safe and effective vaccines are a critical tool against COVID-19. USAID, a key player in U.S. international efforts to respond to the COVID-19 pandemic and address its secondary impacts, administers U.S. government contributions to the Vaccine Alliance (Gavi) and develops strategies to respond to the pandemic.

To review the status of USAID’s effort to develop and implement a COVID-19 vaccine strategy as of May 31, 2021, we (1) determined the status of USAID’s COVID-19 vaccine strategy and reviewed the efforts of four USAID missions—Honduras, India, Nigeria and Ukraine—to assist host governments in their vaccination readiness efforts; and (2) reviewed USAID’s oversight of its contribution to Gavi for the procurement and delivery of COVID-19 vaccines.

Key Findings

We found that USAID is finalizing a COVID-19 response strategy amid challenges as missions support implementation of host-country plans. Specifically:

  • USAID developed a new COVID-19 response strategy to address shifting government priorities.
  • Systemic challenges may complicate implementation of a COVID-19 vaccination strategy.
  • USAID missions will continue to support implementation of host government vaccination strategies.

We also found that additional oversight may be needed to mitigate the risk of fraud, waste, and abuse for USAID’s contribution to Gavi, which totaled $4 billion. Gavi officials stated that the organization’s traditional oversight process was developed for vaccination programs that pose a low risk for fraud, including theft and diversion, whereas the COVID-19 program, which poses a high risk, may require more resources than Gavi has in place.

We made two recommendations to the USAID Bureau for Global Health to mitigate current and future risks of contributions to Gavi.

Recommendations

Recommendation
1

Determine whether steps can be taken to mitigate risks associated with the ongoing contribution to Gavi for COVID-19 vaccination efforts.

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

Determine whether future contributions to Gavi for COVID-19 vaccines should include additional oversight clauses to mitigate the higher risk for fraud, waste, and abuse.

Questioned Cost
0
Funds for Better Use
0
Close Date