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Cloudy numbers

So far, $127 million has been spent, and SIGAR said it’s difficult to know how much of that money might have been lost to corruption. Some $63 million has been authorized for Afghanistan but has not been spent, and SIGAR wants that returned. Plus, the auditors want to stop the last bit of $46 million from being spent on the program, stating USAID needs to stop its funding until problems at MoPH are fixed.

USAID officials disagreed that funding should be stopped, stating that their cost estimates for the PCH program were accurate and oversight is rigorous. Plus, cutting off funds immediately would deprive millions of Afghans of needed medical services.

The 2012 third-party investigation by an accounting firm found a couple of troubling issues at MoPH, the inspector general said. Salaries for some officials were paid in cash, with little recordkeeping. External audits were not being performed and MoPH’s internal auditors weren’t qualified for their jobs. Plus there were few budget procedures in place, and few explanations when something went over budget.

This isn’t the first time SIGAR has targeted USAID’s medical assistance to Afghanistan. In April, the IG criticized the construction of two hospitals that it said the Afghans wouldn’t have the resources to maintain after U.S. funds stopped coming in. One hospital built was twelve times larger than the facility it was replacing, with an upkeep cost estimated at $3.2 million.

The U.S. has spent nearly $100 billion on rebuilding Afghanistan since the start of military action in 2002. Federal officials have faced a daunting task of trying to get the nation to support itself by building infrastructure — including public health — from the ground up.