By Raine Golegio in Monrovia
The Liberian Government says while it recognizes that there is always room for improvement in the allocation and disbursement of funds for essential services, the narrative expressed by Ambassador McCarthy was inaccurate.
Liberian Minister of Information, Ledgerhood Rennie stated this in a statement issued Wednesday in Liberia in a reaction to the US Ambassador’s worry over the state of health facilities in counties for which he was quoted as saying
“I was startled and deeply troubled to encounter multiple county hospitals that received not one penny of what they were promised in the 2022 budget. Hospitals on which lives depend, where outbreaks are prevented and suffering is alleviated, did not receive any portion of the US$100,000 or more appropriated by the legislature for them to operate”.
But according to the Minister, heathcare is one sector in which the government continues to expand its efforts to increase coverage in order to meet the needs of millions of Liberians, as well as hone the skills of service providers
Here Under is the Full Text of Government’s Reaction, and Followed By That of US Ambassador
Monrovia, April 26, 2023: The Government of Liberia acknowledges the concerns raised by U.S. Ambassador Michael McCarthy in a press statement released on Monday, April 24 in which he highlighted the state of some health and education centers in the rural parts of the country – as well as efforts Liberia is making to decentralise development.
The country continues to make significant progress since the end of the civil war, which tore the nation apart for more than a decade and sunk it further into poverty.
Recent efforts, including by the Weah Administration aimed at reviving critical infrastructure as it invests in heath and education, have gotten much acclaim from various bilateral and multilateral partners. These efforts are being accelerated in spite of global economic challenges which have slowed growth in many parts of the world.
While the government recognizes that there is always room for improvement, particularly in the allocation and disbursement of funds for essential services, the narrative as expressed by Ambassador McCarthy is inaccurate.
Heathcare for instance, is one sector in which the government continues to expand its efforts to increase coverage in order to meet the needs of millions of Liberians, as well as hone the skills of service providers.
This, in fact, was the central theme of the recently concluded 3rd International Symposium for Community Health Workers which was hosted in Monrovia and attended by hundreds of delegates from around the world. Many speakers, including those from the World Bank and the Global Financing Facility, cited Liberia as a “powerful example” of how crucial it is to build a health workforce.
And for this, the government remains grateful for the goodwill and support it continues to receive from all development partners, including the U.S. government, without which this feat would not have been possible. The assistance has proven vital to the giant strides the country has made over the years
It is important, however, to clarify that the U.S$60 million referenced by the Ambassador is not money coming entirely to the government of Liberia, as has understandably been skewed by politicians – with an eye on the upcoming elections. Only a small fraction in Government-to-Government support, which is disbursed only after proof of performance, goes to government.
The rest is expended through USAID’s own funding mechanisms – directly to a select project implementers.
The government remains dedicated to investing in critical health infrastructure across the country as it builds clinics and hospitals, while also prioritising human capital development. Liberia is therefore thankful to the U.S. government for its decision to complement the government’s efforts by agreeing to construct a National Reference Lab.
The government has disbursed hundreds of thousands of dollars in Resettlement Action Plan to affected residents and can assure the Americans of Liberia’s full preparedness to run the facility when it is completed in a few years.
Various initiatives are currently ongoing to train and retain healthcare professionals as a means of ensuring that all Liberians have access to quality healthcare services. As was announced by President Weah during his State of the Nation’s address, a revolving fund is also being set up to address the perennial problem of drug shortages at some facilities.
Similar efforts are being made in the educational sector as the Weah administration strengthens the free and compulsory primary education initiative, as well as the improvement of school infrastructure and the training and support of teachers. The government is also building new model schools and developing standard curriculums which have led to major improvements in students’ performance in WAEC/WASSE.
The Liberian government values the longstanding partnership it shares with the U.S., and believes that open communication between both governments is important to the sustenance of this historical tie.
Data from the Ministry of Finance and Development Planning and validated by the Ministry of Health have been attached as proof of Cash Disbursement to Health Facilities Nationwide For Year Ended FY2022.
This provides much needed explanation on the spending and disbursement pattern to health facilities within districts, towns, and villages across the 15 political subdivisions of Liberia. The summary also provides key information and clarification on actual disbursements and the mode of disbursement to health centers and the reporting requirements in order to correct the assertions made in the Ambassador’s piece that no funding was reaching healthcare centers.
Facts about Disbursement:
• Under FY2022, about US$7.2 million (Seven point two million United States Dollars) was disbursed to more than 70 hospitals, clinics health centers across Liberia. This amount represent operational activities and EXCLUDES Salaries of employees, rent, drugs, and vaccines, which are provided by the Central Government through the National Budget or with assistance of Development Partners.
• This amount includes US$4.9million United States Dollars representing about 175 USD checks cashed out of the GoL Consolidated Revenue Account, and about LRD $350 million (three hundred fifty million Liberian Dollars) representing more than148 checks cashed out of the consolidated account for FY2022.
• The health facilities include referral hospitals, hospitals, clinics, county health centers, etc.
• The disbursement report and analysis as attached show that some facilities received their operational support in both United States Dollars and Liberian Dollars while other received exclusively in Liberian dollar or United States Dollars
• The top 10 receivers in the report accounts for about US$3.8 million or 59 percent of the total US$7.2 million disbursed to the 70 plus health facilities across Liberia. The top 10 receivers include referral hospitals such Jackson F. Doe, CB Dunbar, Phebe hospital school of Medicine, Telleweyon John F. Kennedy Memorial, and Redemption hospital, etc.
The below table summarizes the disbursements of resources to health facilities referenced and discussed in the preceding paragraphs.
Signed:____________
Ledgerhood J. Rennie
Minister of Information
What Did The US Ambassador Say About Health Care Facilities In Liberia?
Embassy of the United States of America, Monrovia
502 Benson Street, Monrovia Phone: 077-677-405
April 24, 2023
Questions and Priorities
A Press Statement by U.S. Ambassador to Liberia Michael A. McCarthy
In the past three weeks I visited Bomi, Gbarpolu, and four counties in the Southeast, and I have now been to every county in Liberia. This fulfills my promise to the U.S. Congress to be an Ambassador to all Liberia, not just Monrovia. I am happy to report that each capital city has its own unique bundle of trade and cultural ties, and that Liberians throughout the country share a warm, welcoming spirit!
Unfortunately, on the trip I was startled and deeply troubled to encounter multiple county hospitals that received not one penny of what they were promised in the 2022 budget. Hospitals on which lives depend, where outbreaks are prevented and suffering is alleviated, did not receive any portion of the US$100,000 or more appropriated by the legislature for them to operate. As reported in the press last week with Tellowoyan Memorial Hospital in Lofa County, these facilities currently survive on the backs of incredibly dedicated health professionals, making do with whatever they can scrape together. Lest you think this is the work of one political party, that notion was quickly dispelled by Liberians I talked to. The blocking of resources is so complete that it must be institutional: and the lack of any alarm being raised indicates a syndicate involving players at the legislature, the Ministry of Health, and the Ministry of Internal Affairs. In one town, administrators look with anticipation mixed with fear at the brand-new, modern hospital that sits vacant, knowing that they can barely keep the existing makeshift facility going, and running the new one will require ten times the resources. The United States Government is about to spend a total of over US$40 million constructing Liberia’s state-of-the-art National Reference Laboratory (NRL) that, when completed, will require US$3 million to US$4 million a year from the Government of Liberia to operate. If the Government is failing to deliver statutory appropriations of only US$100,000 to existing hospitals, why would we ever trust annual pledges of US$3 million for the future NRL?
I also visited most of the County Service Centers, and in 2022, NONE had received any of their budget allocation (usually around US$13,333). One Center has not printed marriage certificates for four years because the printer broke, and their last allocation was received five years ago. Virtually all of them, beautifully electrified over the past two years with UNDP-supplied solar power systems (costing around $35,000 – $40,000 each), and amply staffed by (mostly) salaried employees in tidy buildings, are reduced to the job of middlemen. Limited to forwarding paperwork to Monrovia periodically for time-consuming processing, their plight makes a mockery of decentralization efforts. The one functioning office in every center, the Liberia
Revenue Authority (LRA), has representatives who collect duties and regularly forward funds to Monrovia – apparently a one-way street.
It was striking that the further I went from Monrovia, the more elaborate and explicit were the reasons given for the lack of funding from the central government. “Oh, it is challenging for the government these days.” “Oh, Putin’s war has made everything more difficult.” “Prices have dried up the budgets.” “You donor partners must fill the gaps.” I wonder if these people are aware that, much to their credit, the LRA has surpassed projections and increased revenues for the past four years, climbing from US$435,682 million in 2019 to US$605,005 million in 2022? I suspect the country folk don’t know that the Liberian economy grew by 3.7% in 2022. And I am quite sure they have not been told that the legislature has spent more every year for the past three years buttering their own bread, allocating over US$65 million in 2022 for salaries and operations. That’s correct – while hospitals went without, and service centers withered on the vine, the 30 senators and the 73 representatives spent sixty-five million U.S. dollars feathering their own nests.
We withhold 25% of the salaries of our Liberian employees at the Residence and at the Embassy to pay their legally mandated income tax to the LRA. Why are the much better-paid representatives and senators not paying a full 25% of their salaries? Why are legislators and ministers, those living on the top of the heap, given annual duty-free imports that deny the LRA much-needed additional revenue? Is there any reason other than the perverted version of the Golden Rule – “those that have the gold, make the rules”?
U.S. taxpayers spend around US$60 million a year on health care in Liberia, and another US$23 million on education. The same legislature that spent US$65 million on itself in 2022 appropriated around US$7.1 million for grants and subsidies to county health facilities and US$2.76 million for operations at basic and secondary education (although, as we saw, that doesn’t mean the funds reached their intended destinations). But if the legislature could just appropriate an additional US$10 million a year to primary education (for a country that is tied in last place for average days of school attendance), and an additional US$10 million a year for county hospitals, even the greatest cynics concede that it would make a big difference. Just US$500,000 each per year of actual maintenance (not make-believe budgeted funds) on four unpaved roads (Zorzor – Voinjama; Zwedru – Fishtown; Greenville – Barclayville City; and Greenville – Buchanan) would dramatically improve the lives of more than a million of Liberia’s poorest citizens, lowering food costs, revolutionizing farm to market access, and eliminating seasonal shortages of life-saving medicines and equipment. The legislature would still have US$43 million a year to somehow get by. Anyone interested in a pro-poor agenda?
As for me, should the U.S. Congress ask how the elite in Monrovia are treating destitute citizens in the leeward counties, my honest response would have to be, “those citizens are treated with a neglect that borders on contempt.” Is this the best that Liberia can do?
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Please contact MonroviaPD@state.gov with press inquiries.
