The Court of Accounts of the Republic of Moldova (CoARM) is the only public authority that has the mandate to perform the external public audit. The audit activity is performed in strict accordance with the International Standards, developed and promoted by the International Organization of Supreme Audit Institutions INTOSAI.
The audit area of the Performance Audit "Have the competent authorities taken sufficient measures to provide citizens with vaccines and to achieve collective immunity to combat COVID-19 infection?" included an evaluation of the activities and measures taken by the decision-makers to achieve the proposed objectives, in the light of the provisions of the policies and directives in the field, as well as the examination of the issues related to the vaccination process.
The audit was performed according to the internal manuals and regulations, the national legislative and normative acts, as well as the Framework of the Professional Declarations of INTOSAI:
- ISSAI 100 "Fundamental Principles for Public Sector Auditing";
- ISSAI 300 "Fundamental Principles of Performance Auditing";
- ISSAI 3000-3899 "Performance Auditing Standards";
- GUID 3910 “Core Concepts concerning Performance Auditing”, GUID 3920 “Performance Auditing Process”.
The audit report provides the recipients with relevant information on the systemic pandemic activity management processes, which have been targeted primarily for vaccination of citizens. Thus, during the audit, the entire vaccination process was evaluated: the reception, distribution and registration of vaccine administration.
The audit evidence was obtained from the AIS Vaccine Record Registry against COVID – 19 (AIS Registry) and the records kept on paper, from primary documents obtained from various authorities involved in the process, as well as from the explanations provided by the officials within the audited entities and so on. Please note that during the audit, the audit team was not granted access to the AIS Registry during 1.5 months.
In view of the identified risks, the CoARM assessed a sample of vaccinations of approx. 31% (527 thousand) of the total of 1.6 million and the results of the evaluation served as a basis for the audit findings.
The audits of the Court of Accounts on the above sample established major differences between the data in the AIS Register and the files/lists of Health Centers (HC) and other medical institutions, which raises reasonable suspicions about the existence of 6.8 thousand cases (1.3% of total sample examined) for the administration of expired vaccines.
Thus, the date of administration of the vaccines indicated in the HC files/lists does not coincide with the date included within the AIS Register. In some cases, additional documents are inserted in the files/lists, by which the batch of the administered vaccine is modified, compared to the one initially indicated in the file and within the AIS Register. According to data from AIS Register, it was found that the 6.8 thousand doses were administered after the expiration of the vaccine.
The Court of Accounts welcomes the initiation by the Ministry of Health of a Committee of Inquiry into the findings of the audit report and expresses its openness in communicating the circumstances of the audit process, if the Committee will be interested.
We would also like to draw the attention of the Committee of Inquiry to other important findings set out in the report with reference to vaccination data from the AIS Registry, in which the audit team assessed and established over 277 thousand vaccination records that were introduced in other periods than the real ones. The analysis, in view of the identified risks, determined that over 70,000 records create suspicions regarding the veracity of the certificates issued by the institutions involved in the process.
The Court of Accounts made a number of recommendations aimed at improving and strengthening institutional management and eliminating audit deficiencies. Their implementation will contribute to streamlining the vaccination process and strengthening management control actions.
Given the importance of the issues related to the COVID-19 pandemic, the Court of Accounts will continue to carry out thematic audits in the future, which will be included in the program of audit activities for next year.