USAID and State Have Obligated 58 Percent and Disbursed More than One- Third of Their Appropriated Funding for Ebola Response and Preparedness Activities

As of July 1, 2016, USAID  and State had obligated  a total of almost $1.5  billion  (58 percent) and disbursed $875 million (35 percent) of the $2.5  billion  appropriated for Ebola response and preparedness activities (see  fig. 5). USAID and State used different appropriation accounts to fund Ebola  activities. In addition, USAID has not developed written  policies or procedures to guide staff on appropriate steps to take for the  reimbursement process. Twenty-One of USAID’s 271 Reimbursements Were Not Made In Accordance with the Provisions of the Act

Of 271 reimbursements that USAID made for obligations incurred prior to  the enactment of the Act, USAID made 21 reimbursements (totaling over  $60 million) that were not in accordance with the Act. These 21  reimbursements represent roughly 15 percent of the approximately $401  million that USAID obligated for reimbursements, of the almost $1.5 billion  that had been obligated as of July 1, 2016. Because USAID did not have the legal authority to make the  reimbursements that were not in accordance with the reimbursement  provisions in the Act, these 21 reimbursements represent unauthorized  transfers. Conclusions

West Africa has experienced the largest and most complex Ebola  outbreak since the virus was first discovered, resulting in more than  11,000 deaths. USAID and State have funded a range of activities to control  the outbreak and will continue to fund longer-term efforts to mitigate the  second-order effects and strengthen global health security. In particular,  USAID did not in all cases reimburse the same appropriation accounts  from which it obligated funds as required by the Act, and in several  instances it made reimbursements for obligations for which it did not  document that it incurred the obligation to prevent, prepare for, and  respond to the Ebola outbreak. 2. To help ensure that USAID complies with reimbursement provisions that  may arise in future appropriations laws, we recommend that the  Administrator of USAID develop written policies and procedures for the  agency’s reimbursement process. We  examined (1) USAID’s and State’s obligations and disbursements for  Ebola activities and (2) the extent to which USAID made reimbursements  in accordance with the requirements of the fiscal year 2015  appropriations act. We  interviewed USAID and State officials in Washington, D.C., from each  bureau and office that administers funding from accounts of the fiscal  year 2015 appropriation to discuss the status of the agencies’ obligations  and disbursements for activities to prevent, prepare for, and respond to  the Ebola outbreak in West Africa, methods for reporting the funding data,  and plans for obligating and disbursing the funds. Appendix V: USAID’s Reimbursements for Funds Obligated Prior to Enactment of the Fiscal Year 2015 Appropriations Act

The U.S. Agency for International  Development (USAID) made 271  reimbursements for the approximately $401 million total obligations that  USAID’s Bureau for Global Health; Office of Food for Peace (FFP); Office  of U.S. Foreign Disaster Assistance (OFDA); and the missions in Guinea,  Liberia, and Senegal incurred prior to the enactment of the Department of  State, Foreign Operations, and Related Programs Appropriations Act,  2015 (the Act).
Why GAO Did This Study

In March 2014, the World Health Organization reported an Ebola outbreak in West Africa and, as of June 2016, reported that the outbreak had resulted in more than 11,000 deaths in Guinea, Liberia, and Sierra Leone. USAID and State initially funded Ebola activities using funds already appropriated. In December 2014, Congress appropriated approximately $2.5 billion to USAID and State, in part, for international efforts to prevent, prepare for, and respond to an Ebola outbreak and mandated that the agencies report periodically on their use of the funds. Congress also allowed the agencies to reimburse accounts for obligations incurred for Ebola activities prior to the fiscal year 2015 appropriation.
The Act also included a provision for GAO to conduct oversight of USAID and State activities to prevent, prepare for, and respond to the Ebola outbreak. This report examines (1) USAID's and State's obligations and disbursements for Ebola activities and (2) the extent to which USAID made reimbursements in accordance with the fiscal year 2015 appropriations act. GAO analyzed USAID and State funding, reviewed documents on Ebola activities, and interviewed agency officials.

What GAO Found

As of July 1, 2016, the U.S. Agency for International Development (USAID) and the Department of State (State) had obligated 58 percent and disbursed more than one-third of the $2.5 billion appropriated for Ebola activities. In the early stages of the U.S. response in West Africa, USAID obligated $883 million to control the outbreak, and State obligated $34 million for medical evacuations, among other activities. Subsequently, the United States shifted focus to mitigating second-order impacts, such as the deterioration of health services and food insecurity, and strengthening global health security. Accordingly, USAID obligated $251 million to restore health services, among other activities, and $183 million for activities such as strengthening disease surveillance, while State obligated $5 million for biosecurity activities.
Of 271 reimbursements that USAID made for obligations incurred prior to the enactment of the Department of State, Foreign Operations, and Related Programs Appropriations Act, 2015 (the Act), USAID made 21 reimbursements, totaling over $60 million, that were not in accordance with the Act. These 21 reimbursements represent roughly 15 percent of the $401 million that USAID obligated for reimbursements, of the almost $1.5 billion that had been obligated as of July 1, 2016 (see fig.). For these 21 reimbursements, USAID did not reimburse the same appropriation accounts as the accounts from which it originally obligated the funds, and therefore it did not have legal authority to make these reimbursements. In addition, four reimbursements were for obligations that USAID did not document were for Ebola activities. In reviewing the reimbursements, GAO found that USAID does not have written policies or procedures for staff to follow in making and documenting reimbursements. As a result, USAID does not have a process that could provide reasonable assurance that it complies with reimbursement provisions of applicable appropriations laws, such as the reimbursement provisions in the Act.

What GAO Recommends

GAO is making four recommendations, including that USAID should reverse reimbursements not made in accordance with the Act and develop written policies and procedures for its reimbursement process. USAID concurred with GAO's recommendations.