Mildmay Uganda Did Not Always Manage the President's Emergency Plan for AIDS Relief Funds in Accordance With Award Requirements

Congress authorized the President's Emergency Plan for AIDS Relief (PEPFAR) to receive $48 billion in funding for the 5-year period beginning October 1, 2008, to assist foreign countries in combating HIV/AIDS, tuberculosis, and malaria. Congress authorized additional funds to be appropriated through 2018.

CDC awarded PEPFAR funds of $40.7 million for September 30, 2010, through March 31, 2016, to Mildmay Uganda (Mildmay). We reviewed 61 financial transactions totaling $4.3 million and found 2 unallowable transactions totaling $36,000. These transactions were unallowable because Mildmay did not provide sufficient supporting documentation for the expenditures. Mildmay also used PEPFAR funds to pay for unallowable staff meals, wedding costs, gifts, and value-added tax to the Ugandan Government.

We recommended that Mildmay (1) refund to CDC $36,000 for transactions that were not adequately supported; (2) maintain adequate supporting documentation for expenditures; (3) refund to CDC $173,000 for unallowable meals, wedding costs, and gifts; (4) work with CDC to determine the allowability of $14,000 in gifts, and (5) work with CDC to obtain $191,000 of VAT reimbursement from the Ugandan Government. We also made procedural recommendations to Mildmay.

Mildmay agreed to refund unallowable wedding costs and generally agreed with our procedural recommendations and described some of the actions it has taken or plans to take to address them. Mildmay generally disagreed with our recommendations to refund amounts for transactions that were not adequately supported and transactions for staff meals and gifts. However, it did not address our recommendation to maintain adequate supporting documentation for expenditures.