Audit of USAID/Ethiopia's HIV Care and Treatment Activities

USAID/Ethiopia determine, in writing, whether International Relief and Development must reimburse USAID for its costs caused by the delayed completion of the first five health centers constructed under the Ethiopia Health Infrastructure Program.

USAID/Ethiopia determine, in writing, whether to include electricity and water connections in the scope of work for constructing new health centers.

USAID/Ethiopia determine whether the fixed fee in the task order with Tetra Tech under the Ethiopia Health Infrastructure Program can be reduced because the scope of work will not be completed as planned, document this determination, and recover the excess amount from Tetra Tech.

USAID/Ethiopia meet with the Ethiopian Government's Federal Ministry of Health, determine which type of construction activity is most needed, and document this determination.

USAID/Ethiopia reassess decisions about the type of new health centers to construct, the dollar value of renovations, and the budget allocation between renovations and new health centers, and revise the plan for future construction and renovation activities to best address current needs in Ethiopia.

USAID/Ethiopia determine, in writing, whether health center prototype activities that Tetra Tech conducted were within its scope of work, and, if not, take necessary corrective action.

USAID/Ethiopia determine the allowability of costs incurred to design the prototype health center, and recover from Tetra Tech the amount determined to be unallowable.

USAID/Ethiopia implement written procedures to document technical direction provided by contracting officer's representatives, and communicate these directions to contracting officers.

USAID/Ethiopia implement policies and procedures to confirm that health facilities that manage USAID-funded commodities maintain and periodically reconcile their inventory records.

USAID/Ethiopia require Save the Children to include documented reviews of storage conditions and recordkeeping in its periodic site visits.

USAID/Ethiopia ask Ethiopia's Federal Ministry of Health to issue explicit guidance about the proper, safe storage of all commodities (especially food and medicines) to all health facilities that manage USAID-funded commodities.

USAID/Ethiopia determine the allowability of $66,663 of ineligible questioned costs related to the reimbursement of value-added tax to Tetra Tech in contravention to the terms of the contract, and recover from Tetra Tech any amount determined to be unallowable.

USAID/Ethiopia contract with an independent accounting firm to conduct an agreed-upon procedures engagement to determine the full amount of value-added tax claimed by Tetra Tech under Task Order AID-663-TO-11-00001.

USAID/Ethiopia implement procedures to prevent or detect ineligible costs related to the reimbursement of value-added tax.

USAID/Ethiopia implement a monitoring plan for its HIV activities that includes documented periodic site visits.

USAID/Ethiopia require Save the Children to correct its reporting system to provide reliable data about the number of patients assessed for malnutrition, counseled, and provided with therapeutic food, and document the resolution.