Red tape and militancy delay health projects

Over 75% of all foreign-funded programmes face delay; some may be shut down altogether.

ISLAMABAD:

More than three-quarters of all foreign-funded projects in the health sector are facing delays, and some may be shut down altogether, threatening essential programmes designed to control diseases such as tuberculosis and AIDS.

Documents at the economic affairs division of the finance ministry, made available to The Express Tribune, show that 13 out of the 17 health projects are facing delays. Nearly all of these projects are funded by international donors, including ten by Germany.

Yet, for a variety of reasons, including bureaucratic delays, the government has not been able to utilise the funding available for these projects, many of which are meant to serve the most vulnerable segments of the population, including the militancy-hit tribal areas.

Most of the programmes are geared towards the people living in Khyber-Pakhtunkhwa, the Federally Administered Tribal Areas, Gilgit-Baltistan and Azad Jammu and Kashmir.

Of the $366.4 million available for the health sector, only about $138.7 million, or 37.8%, has been disbursed. Sometimes the issue is red tape on the part of the government, particularly in awarding contracts to vendors. Other times, the militancy gets in the way of officials being able to go over to the areas they are meant to serve, particularly in the tribal areas. Not even one project was deemed to have been satisfactorily completed.

For instance, the government received a $77.7 million subsidised loan from the World Bank for the Third Partnership for Polio Eradication project and raised another $42 million in financing for the programme in June this year. Yet Pakistan is one of only four countries in the world where polio still exists and polio cases are rapidly rising in Balochistan and Fata, raising international alarm.

A Germany-funded project, Provision of Basic Health Equipment, initiated in 2006 is going to lapse on December 30 this year but so far only 2.3% of the total cost, or $170,000, has been disbursed. Similarly, HIV/AIDS blood safety project commenced in 2006 would lapse in 2013 but no money is released against an allocation of $9.2 million.

Not all of the delays are caused by the government, however. Sometimes, the donors can be slow off the mark as well. For instance, another Germany-funded programme, the Northern Areas Health project, is also facing delays. The project agreement was signed in 2007, but has yet to even get a firm commitment of funds.

The Tuberculosis Control Programme, initiated in 2004, is likely to end in December with only 66% of the money allocated for the project actually being spent. The Health Infrastructure Project will end at the same time and has so far only received 39% of its funding. The Safe Blood Transformation Project, signed in 2009, has not received any money yet while a health care project in Fata, initiated in 2009, has got only 1.5% of its funding.

Not all may be lost, however. Officials from the World Health Organisation point out that donors can often agree to extend the dates of the projects that are facing delays.

“It should be noted that even if government agencies are not able to fully implement projects by the December deadline, donors generally agree to extend the project validity beyond this date,” said Dr Guido Sabatinelli, the WHO representative in Pakistan.

Sabatinelli, however, said that he was speaking broadly about aid projects in general.

Published in The Express Tribune, October 26^th, 2011.