Review of the Problems Noted in the AIDS Prevention Program

10/24/2002 | 12:00 AM

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TALLINN, 24 October 2002 - The State Audit Office audited the utilization of funds allocated from the state budget to the national development plans for the prevention of HIV/AIDS and other sexually transmitted diseases, administrated by the Ministry of Social Affairs, Health Protection Inspectorate and Estonian AIDS Prevention Center, being one of the departments of the said Inspectorate.

Planning and Management

As the result of the audit it was found that the program planning left a lot to be desired: action plan for 2001, devised by the Estonian AIDS Prevention Center, provided neither explicit guidelines nor the expected results. Instead, the plan listed technical activities, the time schedule for the achievement of the objectives was missing altogether. One of the main reasons for that was the fact that the National Development Plan for the Prevention of AIDS was very general altogether, stating a goal to deal with as many areas as possible while failing to establish explicit objectives, target groups and performance indicators related to the implementation of the plans. The lack of thereof eliminated the opportunities for providing adequate feedback necessary for the planning of further activities.

The program management scheme was illogical: the Health Protection Inspectorate and the Estonian AIDS Prevention Center were appointed to act as program implementing institutions while they were not able to fulfill the task of supervision, supposedly resting with the Inspectorate, as this was given to the Health Education Center within the administrative area of the Ministry of Social Affairs, lacking the competence essential for that purpose.

Utilization of Funds

The program is funded from the state budget: in 2001, 7.85 million kroons were allocated from the main and supplementary budget, in 2002 the respective amount totaled to 8.85 million kroons. The main problem with the utilization is the fact that all the funds intended for the preventative activities were given to the Estonian AIDS Prevention Center, that is, for funding of the activities with permanent character. It is the opinion of the State Audit Office that the project-based preventative activities should be implemented.

In addition, the Estonian AIDS Prevention Center has helped the non-profit organizations involved in the preventative activities to apply for funds from domestic and foreign funds and private sponsors. Neither the Health Protection Inspectorate nor the Health Education Center have no idea whatsoever of the utilization of funds obtained from another channels. The State Audit Office decided that the utilization of all the funds allocated for the prevention of AIDS should be transparent. Lack of adequate review also creates problems with elaboration of plans used to apply funding from the state budget.

Treatment

The State Audit Office is not convinced that it is correct to use the funds of the program for the purchase of the medicines. The purchase of medicines shouldn’t be dependent upon the allocations made for the program.

Large share of the HIV-positive patients have no health insurance. Many of them have passed the initial analysis; after that they have not returned to the doctor and have not been made subject to immunological analysis. Therefore, it is not possible to give the indicative number of people needing treatment. At the same time, the program had made no allocation for the treatment of people without valid health insurance.

Operations performed by the Estonian AIDS Prevention Center

The Estonian AIDS Prevention Center proceeded in accordance with the priorities established with the program and action plan devised for the specific year while focusing on the main risk groups – young people and drug addicts injecting into vein. The public has been informed actively of the threat of AIDS through different media channels.

In larger cities, the Estonian AIDS Prevention Center directed the work done by non-profit organizations of similar character, helping them to obtain money and assets outside the framework of the program. In addition, the staff of the Estonian AIDS Prevention Center belongs into the management bodies of several non-profit organizations or coordinate projects implemented by such organizations. At the same time, the Center has not cooperated with Estonia’s Center for Family Planning and with the Estonian Red Cross, having regional offices involved with preventative activities in each county.

The nature and character of the Estonian AIDS Prevention Center is similar to non-government organizations that could apply project schemes when search for additional funding. The State Audit Office considers too close relations with non-profit organizations to be denunciatory. The consequence is a situation where there will be no opportunities for giving anonymous evaluation to the performance of a state agency or determining its scope of accountability.

The Audit Manager Mr. Maidu Lääne stresses that he is not making any reproaches to the preventative activities implemented so far: "As the result of the work done by the Estonian AIDS Prevention Center the public awareness of AIDS and other sexually transmitted diseases has increased considerably. The Ministry of Social Affairs and the Health Protection Inspectorate have provided the basis for the implementation of the program; there is a review of the main prevalence areas of the disease and the risk groups and in most cases the preventative activities do coincide with the project strategies and goals. Major share of the expenditures incurred within the framework of the program are justified, The audit report drawn up by the State Audit Office is intended to point out the areas for improvement that are being already handled by the Ministry and its subordinates."


Sven Soiver
Press Representative of State Audit Office
Telephone: (372) 640 0787
GSM: (372) 53 414464
E-mail: Sven.Soiver@riigikontroll.ee

  • Posted: 10/24/2002 12:00 AM
  • Last Update: 10/15/2015 9:41 AM
  • Last Review: 10/15/2015 9:41 AM

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