The United Nations Development Programme (UNDP) Pakistan has temporarily suspended its HIV effective prevention and treatment programme in Sindh, leaving around 18,000 HIV-positive transgender persons in the lurch.
The programme — Accelerated Response to HIV Through Effective Prevention, Treatment, Care and Support — was being implemented in the province through the Gender Interactive Alliance (GIA), a transgender NGO.
Without naming GIA, the UNDP said that some of their sub-recipients are under investigation by its independent Office of Audit and Investigations (OAI) in New York, and they cannot comment on the investigation.
The OAI is the UNDP’s principal channel for addressing non-compliance with the UN’s Standards of Conduct, and is mandated to investigate all reports of alleged wrongdoing involving UNDP staff members, and allegations of fraud and corruption against UNDP whether committed by UNDP staff members or other persons, parties or entities where the wrongdoing is to the UNDP’s detriment.
Meanwhile, the federal and provincial health departments have criticised the UNDP’s decision to unilaterally suspend the programme overnight, arguing that no one knows what the investigation is about.
Around 18,000 HIV-positive transgender persons are the programme’s beneficiaries in Sindh’s four divisions: Karachi, Hyderabad, Sukkur and Larkana. The programme is funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, an international financing and partnership organisation that aims to invest additional resources to end the above-mentioned epidemics.
As the principal recipient of the Global Fund HIV Grant, UNDP Pakistan is legally responsible for its programme management, financial accountability, procurement of goods and services, along with monitoring and evaluation.
The grant is for six key population segments. In Sindh the programme was being implemented for the transgender population through GIA. Until 2018 the principal recipient of the Global Fund was the federal government’s National Aids Control Programme.However, in 2021 UNDP Pakistan became the principal recipient of the programme for three years, until December 2023, with a lot of UN protocols, such as helping the transgender community through a banking channel.
GIA’s programme manager Zehrish Khanzadi told The News how difficult it was for them to have a transgender person registered with Nadra, then opening a bank account, but they still complied with their protocols.
She said that in Karachi they operate in two districts: District Central (near Gol Market in Nazimabad) and District East (Mehmoodabad). Their District East office caters to the transgender population of Keamari, South, Malir and Korangi districts, and the District Central office caters to those living in the Central And West districts.
Khanzadi said that in October 2022 UNDP Pakistan opened a procurement process for the enhancement of their HIV programme in Hyderabad, Sukkur and Larkana, which they won. “Had we not been following their protocols earlier, how could we have won the competitive bid?”
GIA said in their statement that their operations, which have consistently adhered to a data-driven community outreach and hotspot detection strategy, successfully scaled up this January with the establishment of two additional clinics in Karachi and Hyderabad. They said that as of this April, they have expanded their services to Sukkur and Larkana.This scale-up resulted in a significant discovery. GIA found a validated HIV-positivity rate above the five per cent threshold in four new sites, a clear indication of an active community-based epidemic of HIV in Sindh. The positivity ratios are 8.6 per cent in Hyderabad, six per cent in Karachi, five per cent in Sukkur, and 4.15 per cent in Larkana. “This discovery underscores the urgent need for GIA’s services.”GIA argues that their operations have been “repeatedly and unjustifiably disrupted by UNDP. Our services were initially suspended in July 2022, leading to numerous detrimental effects on the community, such as leaving HIV-positive persons without our community support, causing job losses among our staff, and pushing many of our outreach workers to resume sex work due to the lack of a stable income source”.
In July 2022 the allegation was against GIA’s outreach coordinator Shahzadi Rai, who is also currently the Karachi Metropolitan Corporation’s city council member on one of the seats reserved for transgender persons.
An investigation conducted by CDC Sindh’s senior staff did not find them guilty of any misconduct. The OAI visited GIA’s office this January, then on July 18. GIA received a notification from UNDP Pakistan declaring an “interim suspension” of their vendor status based on an ongoing investigation under their policy clauses (66-68).
GIA says they are forced to suspend critical HIV services across all of their five sites. “This action was taken without providing GIA any clarity about the nature of the alleged violations or the progress of the investigation.” “If there is a charge against us, we should be told about it,” says Khanzadi. After The News emailed UNDP’s project coordinator Heather Doyle, their communication head unit replied that UNDP is aware that some sub-recipients of the Global Fund HIV Grant are under investigation by OAI, whose findings are not privy to UNDP Pakistan management. “Thus, UNDP Pakistan management cannot comment on any investigation carried out by OAI.”
Federal Joint Secretary Health Jamal Kazi told The News that not even UNDP officials in Pakistan know what is in the investigation. “If there was something wrong, they could have closed one office; how could they close operations in all five offices?”The National Aids Control Programme’s Sindh head Dr Naeem said UNDP Pakistan could not suspend their service overnight. “We have sent them a strongly worded email,” he said, adding that they hope for resolution.
This story was originally published in The News