Jean Kaseya (Africa CDC): "The 700 million we are looking for are not with the government, but with the partners"

Five months after the Ebola epidemic declaration in the DRC, the Director General of Africa CDC, Dr Jean Kaseya, accuses the implementing partners of the response of not accounting for more than 700 million dollars. Mobilization of funds, financing channels, traceability, government responsibility: he answers the questions of Stanis Bujakera Tshiamala. Since the declaration of the epidemic on May 15th, how much money has been mobilized in total for the response to Ebola in the DRC? "First, we must specify what we call resource mobilization. It all starts with a government plan. From this plan, we mobilize donors, who make commitments, what we call pledges in English. The first time was on June 16th, during a meeting organized by the President of Burundi, the sitting President of the African Union, with about twenty African heads of state and all external partners. We received a total of 1.6 billion dollars in commitments. Of this amount, 962 million have been disbursed, which is nearly 58%. As we wanted more resources, we organized a meeting in September, under the leadership of the US government, the G20, expanded to other countries. The Prime Minister of the DRC made a great plea there. This allowed us to go from 1.6 billion to 3.045 billion dollars." Of this total, how much is simple promises, and how much has been actually disbursed? Which partners promised without yet paying? "The latest commitments date back to September, so the disbursements are just beginning. Of the initial commitments, 962.66 million dollars have already been disbursed by 41 donors, counting Africa as a single entity. If we count the 20 contributing African countries separately, we arrive at 69 donors. For these 69 donors, we know where the money went and which implementing partners received it. These partners were supposed to inform the government and align with its plan. Unfortunately, the government today only knows about 228 million dollars provided by some partners. Of this amount, 127 million would have already been used, and there are still a hundred million in their hands. In summary, we are looking for the gap between 962 million and 228 million, which is more than 700 million dollars. Added to this are the 100 million still available with the partners, which makes about 800 million. These funds should normally already exist. Then there are the new promises: the US government indicated that it was ready to release more than 300 million dollars in the next two weeks." When you say that you "are looking for" this money, what does that mean? "It means that we ensure that the partners who received this money come to sit with the government to say: 'I received, for example, 100 million from this donor, here is how I plan to use it.' The government can then redirect these funds to areas that do not have funding, or encourage them to continue, and the partner will report to them. The partner who refuses to give information will have their accreditation withdrawn by the government, and we will ensure that they no longer work in the DRC. At the African level, I will pass their name to all the countries on the continent, and it will be on an African blacklist. This is a big risk that these partners are taking." Is this therefore not, for the moment, embezzlement? "For the moment, I consider it a blurry management. I am not yet talking about embezzlement. It is in the coming days, when we have all the information, that we can talk about embezzlement, if applicable." How is the money distributed? Who decides the allocation between the government, the INSP, the United Nations agencies, the NGOs and Africa CDC, and according to what criteria? "When a government has solid, proven, and internationally validated management structures, the partners provide joint budgetary support: they finance the government's budget directly, which is accountable. But when there are still difficulties, and that is somewhat the case in the DRC, each donor goes through partners with whom they have always worked, in the country or elsewhere. Let's take the example of the United States. They have worked for a long time with FHI, the International Organization for Migration, or UNICEF. These agencies send proposals to the donor, who finances, for example, FHI for surveillance and UNICEF for community activities. The donor thinks that these partners will then share the information with the government. In a healthy environment, the government would say: 'For my surveillance pillar, I need 400 million. FHI has already received 100 million from the Americans, so I am looking for 300 million, and here is what FHI will do.' Unfortunately, this did not happen. This is the last time this happens in Africa. We will now make everything public, and the partners will never mock us again." Concretely, on the ground, who manages the money? Who pays the caregivers, the surveillance teams, the suppliers, and the logistics? Through what channels? "First, the state officials, doctors, nurses, and others, depend on the government. We have been very clear: partners cannot pay the salaries of civil servants. It is the responsibility of the state. Then there are the community relays, recognized and budgeted agents, who can be taken care of by the donors. There are also the programmatic activities, such as surveillance, laboratory, and supervision, which are shared between the government and the partners. Finally, there are the operations, such as the transport of large quantities of medicines and vaccines, ensured by various actors. It is therefore a multiple distribution of responsibilities, under the leadership of the government in the country and Africa CDC at the African level." You assert that more than 700 million dollars have not been traced out of the 962 million disbursed. How did we get there? Where do you place the disorder? "Of the 962 million, more than 462 million comes from the United States. This is already a good proportion. The US government promised me this week the list of each partner who received each US dollar, which will already relieve us. Another donor disbursed 100 million, and we know where that money went. For certain structures, like Virunga, which works in the east of the country, we also know where the money is. We follow each partner this way. And believe me, for the first time in Africa, we will publish a report indicating where each amount went." Is this money actually missing, or do the partners simply not yet justify their expenses? Are you talking about embezzlement or a lack of transparency? "These partners have been used to not declare what they received. So I am not yet talking about embezzlement, but a lack of transparency. Some partners have understood and have started to provide information. Let the process continue: our teams will sit with all the partners in the DRC. We will have the information from the US government, the European Union, and all other donors. We can then tell you exactly what it is." What do you mean exactly by traceability? How is a dollar tracked, from the donor to the caregiver or the patient? Does this mechanism exist or is it still to be built? "We have built it. When donors make commitments, we record them in a program. For example: the United States committed to 462 million. We ask them how much they disbursed, and we record it. Then which partners benefited from it: we have the list. Then we organize a dialogue between Africa CDC, the government, and the partners. The partner tells us: 'I received so much from this donor, I used so much.' We ask them in which categories. Did you recruit personnel? Show us this personnel on the ground. Did you build treatment centers? Show us these centers. Did you organize training? Tell us where. Did you distribute food or water? Tell us which Congolese benefited. This is the mechanism that will allow us to trace every dollar." What is the government's responsibility? "Our work, as Africa CDC, is to support the government in developing solid plans, mobilizing funds, from where we organize meetings with partners, and to know what has actually been disbursed. We also provide technical support on the ground, with experts in laboratories, economics, and other fields. But it is up to the government to coordinate everything. I believe that the government has a significant share of responsibility." Can it be said that the government has failed in its responsibilities? "You know, such a mechanism has never existed, neither in the DRC nor elsewhere in the world. The partners have behaved like little kings. It is now we are putting it in place. The government was also not used to this mechanism. Therefore, it must be given a little understanding: it is also learning to manage these major operations. A colleague who spent 26 years at the United Nations in high positions told us at the beginning: 'Forget it, you will never have the information.' The last time I saw him, he told me: 'Continue what you are doing, I didn't think you would get this information.' Mindsets are changing, in the DRC and all over Africa, because what we are doing in the DRC today, we are sharing with everyone." In one word, is it up to the partners to justify these 700 million, and not the government? "In one word, the 700 million dollars we are looking for are not with the government. They are with the implementing partners." The DRC has experienced about fifteen Ebola epidemics, and the questions about money come up every time. What must change so that the next response does not experience the same deviations? "This is an important question. An epidemic is first and foremost preparation. The government must plan funds in its budget for laboratories to exist everywhere, for personnel to be trained everywhere, and for surveillance to be ensured everywhere. A disease can appear, but if it is detected quickly, it will not become an epidemic of great scope like the one we are living through. The government's first mission is therefore to finance the preparation itself. The second lesson is that in the event of an epidemic, the government must first engage the country's internal resources. It will then have the opportunity to control what the partners give. Without this, there is no transparency." What message do you address to the Congolese in the affected areas, who see hundreds of millions of dollars passing by but see few traces on the ground? "I want to say to the Congolese affected that I am not only the Director General of Africa CDC: I am Congolese. With the efforts we have made with the government and all the mobilized donors, I cannot accept that there are still doctors and nurses without protective equipment. I cannot accept that, in the affected areas, people cannot go to the hospital because caregivers are on strike, nor can they be given appropriate care. According to the indicators I have seen, maternal mortality has increased by more than 75% in some areas affected by Ebola, and vaccination has decreased by more than 38%, not to mention many other indicators. But I have a great message of hope. First, the President of the Republic is very committed: he follows what we do daily, and I speak with him very regularly. Then, we mobilize all means, including research on vaccines and medicines. What we need today is for the population to trust us and adhere to the messages addressed to them. We will fight to find all means to stop this epidemic." Interview conducted by Stanis Bujakera Tshiamala