A total of 50 people are now in custody following one of the largest major law enforcement operations in South Texas in recent ye
- Secretary Antony J. Blinken’s Call with Iraqi Prime Minister al-Kadhimi
November 7, 2021
- Science & Tech Spotlight: Vaccine Safety
February 24, 2021Why this Matters Safe vaccines are critical to fighting diseases, from polio to COVID-19. Research shows that the protection provided by U.S. licensed vaccines outweighs their potential risks. However, misinformation and unjustified safety concerns can cause people to delay or refuse vaccination, which may increase preventable deaths and prolong negative social and economic impacts. The Science What is it? A vaccine is generally considered safe when the benefits of protecting an individual from disease outweigh the risks from potential side effects (fig. 1). The most common side effects stem from the body’s immune reaction and include swelling at the injection site, fever, and aches. Figure 1. Symptoms of polio and side effects of the polio vaccine. A vaccine is generally considered safe if its benefits (preventing disease) outweigh its risks (side effects). In rare cases, some vaccines may cause more severe side effects. For example, the vaccine for rotavirus—a childhood illness that can cause severe diarrhea, dehydration, and even death—can cause intestinal blockage in one in 100,000 recipients. However, the vaccine is still administered because this very rare side effect is outweighed by the vaccine’s benefits: it saves lives and prevents an estimated 40,000 to 50,000 childhood hospitalizations in the U.S. each year. The two messenger RNA (mRNA) vaccines authorized for COVID-19—a disease that contributed to more than 415,000 American deaths between January 2020 and January 2021—can cause severe allergic reactions. However, early safety reporting found that these reactions have been extremely rare, with only about five cases per 1 million recipients, according to data from January 2021 reports by the Centers for Disease Control and Prevention. In general, side effects from vaccines are less acceptable to the public than side effects from treatments given to people who already have a disease. What is known? Vaccine developers assess safety from early research, through laboratory and animal testing, and even after the vaccine is in use (fig. 2). Researchers may rely on previous studies to inform future vaccine trials. For example, safety information from preclinical trials of mRNA flu vaccine candidates in 2017 allowed for the acceleration of mRNA COVID-19 vaccine development. Vaccine candidates shown to be safe in these preclinical trials can proceed to clinical trials in humans. In the U.S., clinical trials generally proceed through three phases of testing involving increasing numbers of volunteers: dozens in phase 1 to thousands in phase 3. Although data may be collected over years, most common side effects are identified in the first 2 months after vaccination in clinical trials. After reviewing safety and other data from vaccine studies, the Food and Drug Administration (FDA) may license a vaccine to be marketed in the U.S. There are also programs to expedite—but not bypass—development and review processes, such as a priority review designation, which shortens FDA’s goal review time from 10 to 6 months. Safety monitoring continues after licensing. For example, health officials are required to report certain adverse events—such as heart problems—following vaccination, in order to help identify potential long-term or rare side effects that were not seen in clinical trials and may or may not be associated with the vaccine. Figure 2. Vaccine safety is assessed at every stage: development through post-licensure. Following a declared emergency, FDA can also issue emergency use authorizations (EUA) to allow temporary use of unlicensed vaccines if there is evidence that known and potential benefits of the vaccine outweigh known and potential risks, among other criteria. As of January 2021, two COVID-19 vaccines had received EUAs, after their efficacy and short-term safety were assessed through large clinical trials. However, developers must continue safety monitoring and meet other requirements if they intend to apply for FDA licensure to continue distribution of these vaccines after the emergency period has ended. What are the knowledge gaps? One knowledge gap that can remain after clinical trials is whether side effects or other adverse events may occur in certain groups. For example, because clinical trials usually exclude certain populations, such as people who are pregnant or have existing medical conditions, data on potential adverse events related to specific populations may not be understood until vaccines are widely administered. In addition, it can be difficult to determine the safety of new vaccines if outbreaks end suddenly. For example, vaccine safety studies were hindered during the 2014-2015 Ebola epidemic when a large increase in the number of cases was followed by a sharp decrease. This disrupted the clinical trials of Ebola vaccine candidates, because the trials require many infected and non-infected people. Furthermore, a lack of understanding and/or misinformation about the steps taken to ensure the safety of vaccines hinders accurate public knowledge about safety concerns, which may cause people to delay or refuse vaccination. This resulting hesitancy may, in turn, increase deaths, social harm, and economic damage. Opportunities Continuing and, where necessary, improving existing vaccine safety practices offers the following opportunities to society: Herd immunity. Widespread immunity in a population, acquired in large part through safe and effective vaccines, can slow the spread of infection and protect those most vulnerable. Health care improvements. Vaccinations can reduce the burden on the health care system by reducing severe symptoms that require individuals to seek treatment. Eradication. Safe vaccination programs, such as those combatting smallpox, may eliminate diseases to the point where transmission no longer occurs. Challenges There are a number of challenges to ensuring safe vaccines: Public confidence. Vaccine hesitancy, in part due to misinformation or historic unethical human experimentation, decreases participation in clinical trials, impeding identification of side effects across individuals with different racial, ethnic, and socioeconomic backgrounds. Mutating viruses. Some viruses, such as those that cause the flu or COVID-19, may mutate rapidly and thus may require new or updated vaccines, for which ongoing safety monitoring is important. Long-term and rare effects. Exceedingly rare or long-term effects may not be identified until after vaccines have been widely administered. Further study is needed to detect any such effects and confirm they are truly associated with the vaccine. Policy Context & Questions What steps can policymakers take to improve public trust and understanding of the process of assessing vaccine safety? How can policymakers convey the social importance of vaccines to protect the general public and those who are most vulnerable? How can policymakers leverage available resources to support ongoing vaccine development and post-licensure safety monitoring? For more information, contact Karen Howard at (202) 512-6888 or HowardK@gao.gov.
- Behavioral Health and COVID-19: Higher-Risk Populations and Related Federal Relief Funding
December 10, 2021What GAO Found The effects of the COVID-19 pandemic and related economic crisis—such as increased social isolation, stress, and unemployment—have intensified concerns about the number of people in the U.S. affected by behavioral health conditions: mental health and substance use disorders. Based on 32 interviews with federal, state, and other stakeholders, and a review of selected research, GAO found that certain populations may be at higher risk of new or exacerbated behavioral health symptoms or conditions related to the pandemic. Six populations were cited by the most stakeholders as being at higher risk of such behavioral health effects for a range of reasons. Children and adolescents, for example, had rising rates of behavioral health conditions before the pandemic and then faced disruptions to school-based behavioral health services, stakeholders said. They also said that people may be part of multiple higher-risk populations, though not everyone at risk will develop symptoms or conditions. Stakeholders cautioned that with the COVID-19 pandemic ongoing, it will take time to determine how different populations may be affected in the long term. Populations Cited by the Most Stakeholders as Being at Higher Risk of Behavioral Health Effects As of November 2021, the federal government awarded over $8 billion in COVID-19 relief funding for behavioral health. Over 97 percent of this funding was provided to states and other recipients through six programs: one Federal Emergency Management Agency program, and five Substance Abuse and Mental Health Services Administration (SAMHSA) programs. For example, SAMHSA awarded about $5.3 billion to 50 states, Washington, D.C., eight U.S. territories and other jurisdictions, and one tribe through supplements to existing substance abuse and mental health block grants using standard statutory formulas. The Federal Emergency Management Agency also awarded about $467 million to 46 states, Washington, D.C., and four U.S. territories via the Crisis Counseling Assistance and Training Program. GAO’s review of program documentation shows that the COVID-19 relief funds for behavioral health, as awarded through the six programs, could generally serve the six higher-risk populations identified by stakeholders. Selected funding recipients in four states and Washington, D.C., reported varying ways they were using, or planned to use, relief funds to reach higher-risk populations. For example, officials in one state said they planned to use some mental health block grant funds to assist children and adolescents in the child protective services system. SAMHSA officials said that it would take time to determine who was actually served by COVID-19 relief funded programs, but said that it was important to examine grantee data to determine whether target populations were reached and identify any gaps, and the agency planned to do so. Why GAO Did This Study The COVID-19 pandemic has had repercussions for the behavioral health of the nation. During the pandemic, U.S. adults have reported higher rates of anxiety and depression symptoms and substance use. To address related concerns, the CARES Act; the Consolidated Appropriations Act, 2021; and the American Rescue Plan Act of 2021 appropriated relief funds specifically for behavioral health. The CARES Act includes a provision for GAO to report on its ongoing monitoring and oversight efforts related to the COVID-19 pandemic. This report describes (1) populations that may be at higher risk of behavioral health effects; (2) the amount and type of funding the federal government provided in COVID-19 relief to address behavioral health needs; and (3) whether COVID-19 relief funds for behavioral health could serve higher-risk populations, and how selected funding recipients plan to use these funds. GAO will continue to monitor behavioral health issues as part of ongoing COVID-19 related oversight. To conduct this work, GAO reviewed selected research on COVID-19 and behavioral health, and relevant federal funding opportunity and awards documents. GAO also interviewed stakeholders, such as federal officials, researchers, and grantees. Grantees included state officials and providers in four states and Washington, D.C., selected based on state behavioral health metrics and CARES Act-funded grants received, among other factors. GAO incorporated technical comments from the departments of Health and Human Services and Homeland Security, as appropriate. For more information, contact Alyssa M. Hundrup at (202) 512-7114 or email@example.com.
- COVID-19: Brief Update on Initial Federal Response to the Pandemic
August 31, 2020As of August 20, 2020, the U.S. had over 5.5 million cumulative reported cases of COVID-19, and 158,000 reported deaths, according to federal agencies. The country also continues to experience serious economic repercussions and turmoil. Four relief laws, including the CARES Act, were enacted between March and July 2020 to provide appropriations for the response to COVID-19. The CARES Act includes a provision for GAO to report bimonthly on its ongoing monitoring and oversight efforts related to COVID-19. This second report examines federal spending on the COVID-19 response; indicators for monitoring public health and the economy; and the status of matters for congressional consideration and recommendations from GAO’s June 2020 report (GAO-20-625). GAO reviewed data through June 30, 2020 (the latest available) from USAspending.gov, a government website with data from government agencies. GAO also obtained, directly from the agencies, spending data, as of July 31, 2020, for the six largest spending areas, to the extent available. To develop the public health indicators, GAO reviewed research and federal guidance. To understand economic developments, GAO reviewed data from federal statistical agencies, the Federal Reserve, and Bloomberg Terminal, as well as economic research. To update the status of matters for congressional consideration and recommendations, GAO reviewed agency and congressional actions. In response to the national public health and economic threats caused by COVID-19, four relief laws making appropriations of about $2.6 trillion had been enacted as of July 31, 2020. Overall, federal obligations and expenditures government-wide of these COVID-19 relief funds totaled $1.5 trillion and $1.3 trillion, respectively, as of June 30, 2020. GAO also obtained preliminary data for six major spending areas as of July 31, 2020 (see table). COVID-19 Relief Appropriations, Obligations, and Expenditures for Six Major Spending Areas, as of July 2020 Spending area Appropriationsa ($ billions) Preliminary obligationsb ($ billions) Preliminary expendituresb ($ billions) Business Loan Programs 687.3 538.1 522.2c Economic Stabilization and Assistance to Distressed Sectors 500.0 30.4 19.2c Unemployment Insurance 376.4 301.1 296.8 Economic Impact Payments 282.0 273.5 273.5 Public Health and Social Services Emergency Fund 231.7 129.6 95.9 Coronavirus Relief Fund 150.0 149.5 149.5 Total for six spending areas 2,227.4 1,422.2 1,357.0 Source: GAO analysis of data from the Department of the Treasury, USAspending.gov, and applicable agencies. | GAO-20-708 aCOVID-19 relief appropriations reflect amounts appropriated under the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020, Pub. L. No. 116-123, 134 Stat. 146; Families First Coronavirus Response Act, Pub. L. No. 116-127, 134 Stat. 178 (2020); CARES Act, Pub. L. No. 116-136, 134 Stat. 281 (2020); and Paycheck Protection Program and Health Care Enhancement Act, Pub. L. No. 116-139, 134 Stat. 620 (2020). These data are based on appropriations warrant information provided by the Department of the Treasury as of July 31, 2020. These amounts could increase in the future for programs with indefinite appropriations, which are appropriations that, at the time of enactment, are for an unspecified amount. In addition, this table does not represent transfers of funds that federal agencies may make between appropriation accounts or transfers of funds they may make to other agencies. bObligations and expenditures data for July 2020 are based on preliminary data reported by applicable agencies. cThese expenditures relate to the loan subsidy costs (the loan’s estimated long-term costs to the United States government). The CARES Act included a provision for GAO to assess the impact of the federal response on public health and the economy. The following are examples of health care and economic indicators that GAO is monitoring. Health care. GAO’s indicators are intended to assess the nation’s immediate response to COVID-19 as it first took hold, gauge its recovery from the effects of the pandemic over the longer term, and determine the nation’s level of preparedness for future pandemics, involving subsequent waves of either COVID-19 or other infectious diseases. For example, to assess the sufficiency of testing—a potential indicator of the system’s response and recovery—GAO suggests monitoring the proportion of tests in a given population that are positive for infection. A higher positivity rate can indicate that testing is not sufficiently widespread to find all cases. That is higher positivity rates can indicate that testing has focused on those most likely to be infected and seeking testing because they have symptoms, and may not be detecting COVID-19 cases among individuals with no symptoms. Although there is no agreed-upon threshold for the test positivity rate, governments should target low positivity rates. The World Health Organization recommends a test positivity rate threshold of less than 5 percent over a 14-day period. As of August 12, 2020, 12 states and the District of Columbia had met this threshold (38 states had not). Resolve to Save Lives, another organization, recommends a threshold of less than 3 percent over a 7-day period, and 11 states and the District of Columbia had met this threshold (39 states had not) as of August 12, 2020. GAO also suggests monitoring mortality from all causes compared to historical norms as an indicator of the pandemic’s broad effect on health care outcomes. Mortality rates have tended to be consistent from year to year. This allows an estimation of how much mortality rose with the onset of the pandemic, and provides a baseline by which to judge a return to pre-COVID levels. According to Centers for Disease Control and Prevention data, about 125,000 more people died from all causes January 1–June 13 than would normally be expected (see figure). CDC Data on Higher-Than-Expected Weekly Mortality, January 1 through June 13, 2020 Note: The figure shows the number of deaths from all causes in a given week that exceeded the upper bound threshold of expected deaths calculated by CDC on the basis of variation in mortality experienced in prior years. Changes in the observed numbers of deaths in recent weeks should be interpreted cautiously as this figure relies on provisional data that are generally less complete in recent weeks. Data were accessed on July 16, 2020. Economy. GAO updated information on a number of indicators to facilitate ongoing and consistent monitoring of areas of the economy supported by the federal pandemic response, in particular the COVID-19 relief laws. These indicators suggest that economic conditions—including for workers, small businesses, and corporations—have improved modestly in recent months but remain much weaker than prior to the pandemic. In June and July initial regular unemployment insurance (UI) claims filed weekly averaged roughly 1.4 million (see figure), which was six and a half times higher than average weekly claims in 2019, but claims have decreased substantially since mid-March, falling to 971,000 in the week ending August 8, 2020. Increasing infections in some states and orders to once again close or limit certain businesses are likely to pose additional challenges for potentially fragile economic improvements, especially in affected sectors, such as the leisure and hospitality sector. National Weekly Initial Unemployment Insurance Claims, January 2019–July 2020 Note: See figure 5 in the report. As GAO reported in June, consistent with the urgency of responding to serious and widespread health issues and economic disruptions, federal agencies gave priority to moving swiftly where possible to distribute funds and implement new programs designed to help small businesses and the newly unemployed, for example. However, such urgency required certain tradeoffs in achieving transparency and accountability goals. To make mid-course corrections, GAO made three recommendations to federal agencies: To reduce the potential for duplicate payments from the Paycheck Protection Program (PPP)—a program that provides guaranteed loans through lenders to small businesses—and unemployment insurance, GAO recommended that the Department of Labor (DOL), in consultation with the Small Business Administration (SBA) and the Department of the Treasury (Treasury), immediately provide information to state unemployment agencies that specifically addresses PPP loans, and the risk of improper unemployment insurance payments. DOL issued guidance on August 12, 2020, that, among other things, clarified that individuals working full-time and being paid through PPP are not eligible for UI. To recoup economic impact payments totaling more than $1.6 billion sent to decedents, GAO recommended that the Internal Revenue Service (IRS) consider cost-effective options for notifying ineligible recipients of economic impact payments how to return payments. IRS has taken steps to address this recommendation. According to a Treasury official, nearly 70 percent of the payments sent to decedents have been recovered. However, GAO was unable to verify that amount before finalizing work on this report. GAO is working with Treasury to determine the number of payments sent to decedents that have been recovered. Treasury was considering sending letters to request the return of remaining outstanding payments but has not moved forward with this effort because, according to Treasury, Congress is considering legislation that would clarify or change payment eligibility requirements. To reduce the potential for fraud and ensure program integrity, GAO recommended that SBA develop and implement plans to identify and respond to risks in PPP to ensure program integrity, achieve program effectiveness, and address potential fraud. SBA has begun developing oversight plans for PPP but has not yet finalized or implemented them. In addition, to improve the government’s response efforts, GAO suggested three matters for congressional consideration: GAO urged Congress to take legislative action to require the Department of Transportation (DOT) to work with relevant agencies and stakeholders, such as HHS, the Department of Homeland Security (DHS), and international organizations, to develop a national aviation-preparedness plan to ensure safeguards are in place to limit the spread of communicable disease threats from abroad, while also minimizing any unnecessary interference with travel and trade. In early July 2020, DOT collaborated with HHS and DHS to issue guidance to airports and airlines for implementing measures to mitigate the public health risks associated with COVID-19, but it has not developed a preparedness plan for future communicable disease threats. DOT has maintained that HHS and DHS should lead such planning efforts as they are responsible for communicable disease response and preparedness planning, respectively. In June 2020, HHS stated that it is not in a position to develop a national aviation-preparedness plan as it does not have primary jurisdiction over the entire aviation sector or the relevant transportation expertise. In May 2020, DHS stated that it had reviewed its existing plans for pandemic preparedness and response activities and determined it is not best situated to develop a national aviation-preparedness plan. Without such a plan, the U.S. will not be as prepared to minimize and quickly respond to future communicable disease events. GAO also urged Congress to amend the Social Security Act to explicitly allow the Social Security Administration (SSA) to share its full death data with Treasury for data matching to help prevent payments to ineligible individuals. In June 2020, the Senate passed S.4104, referred to as the Stopping Improper Payments to Deceased People Act. If enacted, the bill would allow SSA to share these data with Treasury’s Bureau of the Fiscal Service to avoid paying deceased individuals. Finally, GAO urged Congress to use GAO’s Federal Medical Assistance Percentage (FMAP) formula for any future changes to the FMAP—the statutory formula according to which the federal government matches states’ spending for Medicaid services—during the current or any future economic downturn. Congress has taken no action thus far on this issue. GAO incorporated technical comments received the Departments of Labor, Commerce, Health and Human Services, Transportation, and the Treasury; the Federal Reserve; Office of Management and Budget; and Internal Revenue Service. The Small Business Administration commented that GAO did not include information on actions taken and controls related to its loan forgiveness program or its plans for loan reviews. GAO plans to provide more information on these topics in its next CARES Act report. For more information, contact A. Nicole Clowers at (202) 512-7114 or firstname.lastname@example.org.
- Information Technology: DOD Software Development Approaches and Cybersecurity Practices May Impact Cost and Schedule
December 23, 2020GAO reported in June 2020 that, of the 15 major Department of Defense (DOD) information technology (IT) programs selected for review, 11 had decreased their cost estimates as of December 2019. The decreases in cost estimates ranged from a .03 percent decrease to a 33.8 percent decrease. In contrast, the remaining four programs experienced increases in their life-cycle cost estimates—–two with increases exceeding 20 percent. Program officials reported several reasons for the increases, including testing delays and development challenges. Ten of the 15 programs had schedule delays when compared to their original acquisition program baselines. Schedule delays ranged from a delay of 1 month to a delay of 5 years. Program officials reported a variety of reasons for significant delays (delays of over 1 year) in their planned schedules, including cyber and performance issues. Regarding software development, officials from the 15 selected major IT programs that GAO reviewed reported using software development approaches that may help to limit risks to cost and schedule outcomes. For example, 10 of the 15 programs reported using commercial off-the-shelf software, which is consistent with DOD guidance to use this software to the extent practicable. Such software can help reduce software development time, allow for faster delivery, and lower life-cycle costs. In addition, 14 of the 15 programs reported using an iterative software development approach which, according to leading practices, may help reduce cost growth and deliver better results to the customer. However, programs also reported using an older approach to software development, known as waterfall, which could introduce risk for program cost growth because of its linear and sequential phases of development that may be implemented over a longer period of time. Specifically, two programs reported using a waterfall approach in conjunction with an iterative approach, while one was solely using a waterfall approach. With respect to cybersecurity, programs reported mixed implementation of specific practices, contributing to program risks that might impact cost and schedule outcomes. For example, all 15 programs reported developing cybersecurity strategies, which are intended to help ensure that programs are planning for and documenting cybersecurity risk management efforts. In contrast, only eight of the 15 programs reported conducting cybersecurity vulnerability assessments—systematic examinations of an information system or product intended to, among other things, determine the adequacy of security measures and identify security deficiencies. These eight programs experienced fewer increases in planned program costs and fewer schedule delays relative to the programs that did not report using cybersecurity vulnerability assessments. For fiscal year 2020, DOD requested approximately $36.1 billion for IT investments. Those investments included major IT programs, which are intended to help the department sustain key operations. The National Defense Authorization Act for Fiscal Year 2019 included a provision for GAO to assess selected IT programs annually through March 2023. GAO’s objectives for this review were to, among other things, (1) describe the extent to which selected major IT programs have changed their planned costs and schedules since the programs’ initial baselines; and (2) describe what selected software development and cybersecurity risks or challenges, if any, may impact major IT programs’ acquisition outcomes. GAO selected programs based on DOD’s list of major IT programs, as of April 10, 2019. From this list, GAO identified 15 major IT programs that had established an initial acquisition program baseline and that were not fully deployed by December 31, 2019. GAO compared the 15 programs’ initial cost and schedule baselines to current acquisition program estimates. In addition, GAO aggregated DOD program office responses to a GAO questionnaire about software development approaches and cybersecurity practices used by the 15 programs. GAO compared this information to leading practices to identify risks and challenges affecting cost, schedule, and performance outcomes. This report is a public version of a “for official use only” report issued in June 2020. For more information, contact Kevin Walsh at (202) 512-6151 or email@example.com.
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- Deputy Attorney General Lisa O. Monaco Delivers Remarks at the 33rd Pan Am 103 Memorial Service
December 21, 2021Thank you for that warm welcome. It is my honor to join you today, and a privilege to return to this memorial. I want to thank President Kara Weipz and the Victims of Pan Am Flight 103 organization for inviting me back this year – and for all the work you do year-round to lift up the legacies of the 270 lives we lost – far too suddenly and far too soon.
- Priority Open Recommendations: Office of Science and Technology Policy
July 15, 2021What GAO Found As of June 2021, the Office of Science and Technology Policy (OSTP) had 11 open recommendations. We are identifying three recommendations from our prior work as priorities for implementation by OSTP. These three recommendations relate to strengthening interagency collaboration on science and technology issues. As the challenges of the 21st century grow, it is increasingly important for executive agencies to consider how the federal government can maximize performance and results through improved collaboration. Our prior work has shown that many issues, including those in science and technology, cut across multiple agencies. In this regard, OSTP plays a critical role in bringing agencies together under the committees and subcommittees of the National Science and Technology Council. This mechanism provides a valuable opportunity for agencies to coordinate on implementing an administration’s research and development priorities and to address cross-cutting science and technology issues, such as scientific integrity, public access to federally funded research results, reliability of research results, supply chains for critical materials, and others. Strengthening interagency coordination in these areas could help amplify the synergistic effects of related research conducted by different agencies, avoid unnecessary overlapping or duplicative research and development efforts, and share lessons learned or coordinate actions to address science and technology issues. Why GAO Did This Study Priority open recommendations are the GAO recommendations that warrant priority attention from heads of key departments or agencies because their implementation could save large amounts of money; improve congressional and/or executive branch decision-making on major issues; eliminate mismanagement, fraud, and abuse; or ensure that programs comply with laws and funds are legally spent, among other benefits. Since 2015 GAO has sent letters to selected agencies to highlight the importance of implementing such recommendations. This is the first year that we are providing a priority recommendation letter to OSTP. For more information, contact John Neumann at (202) 512-6888 or firstname.lastname@example.org.
- Afghanistan: Actions Needed to Improve Accountability of U.S. Assistance to Afghanistan Government
August 23, 2021The U.S. Agency for International Development (USAID) and the Department of Defense (DOD) award direct assistance to Afghanistan, using bilateral agreements and multilateral trust funds that provide funds through the Afghan national budget. GAO assessed (1) the extent to which the United States, through USAID and DOD, has increased direct assistance, (2) USAID and DOD steps to ensure accountability for bilateral direct assistance, and (3) USAID and DOD steps to ensure accountability for direct assistance via multilateral trust funds for Afghanistan. GAO reviewed USAID, DOD, and multilateral documents and met with U.S. officials and staffs of multilateral trust funds in Washington, D.C., and Afghanistan.The United States more than tripled its awards of direct assistance to Afghanistan in fiscal year 2010 compared with fiscal year 2009. USAID awards of direct assistance grew from over $470 million in fiscal year 2009 to over $1.4 billion in fiscal year 2010. USAID awarded $1.3 billion to the World Bank-administered Afghanistan Reconstruction Trust Fund (ARTF) in fiscal year 2010, of which the bank has received $265 million as of July 2011. DOD direct assistance to two ministries grew from about $195 million in fiscal year 2009 to about $576 million in fiscal year 2010, including contributions to fund police salaries through the United Nations Development Program-administered (UNDP) Law and Order Trust Fund for Afghanistan (LOTFA). USAID and DOD have taken steps to help ensure the accountability of their bilateral direct assistance to Afghan ministries, but USAID has not required risk assessments in all cases before awarding these funds. For example, USAID did not complete preaward risk assessments in two of the eight cases GAO identified. Although current USAID policy does not require preaward risk assessments in all cases, these two awards were made after the USAID Administrator’s July 2010 commitment to Congress that USAID would not proceed with direct assistance to an Afghan public institution before assessing its capabilities. In these two cases, USAID awarded $46 million to institutions whose financial management capacity were later assessed as “high risk.” USAID has established various financial and other controls in its bilateral direct assistance agreements, such as requiring separate bank accounts and audits of the funds. USAID has generally complied with these controls, but GAO identified instances in which it did not. For example, in only 3 of 19 cases did USAID document that it had approved one ministry’s prefinancing contract documents. DOD personnel in Afghanistan assess the risk of providing funds to two security ministries through quarterly reviews of each ministry’s capacity. DOD officials also review records of ministry expenditures to assess whether ministries have used funds as intended. DOD established formal risk assessment procedures in June 2011, following GAO discussions with DOD about initial findings. USAID and DOD generally rely on the World Bank and UNDP to ensure accountability over U.S. direct assistance provided multilaterally through ARTF and LOTFA, but USAID has not consistently complied with its risk assessment policies in awarding funds to ARTF. During GAO’s review, DOD established procedures in June 2011 requiring that it assess risks before contributing funds to LOTFA. The World Bank and UNDP use ARTF and LOTFA monitoring agents to help ensure that ministries use contributions as intended. However, security conditions and weaknesses in Afghan ministries pose challenges to their oversight. For example, the ARTF monitoring agent recently resigned due to security concerns. The World Bank is now seeking a new monitoring agent and does not anticipate a gap in monitoring. In addition, weaknesses in the Ministry of Interior’s systems for paying wages to police challenge UNDP efforts to ensure that the ministry is using LOTFA funds as intended. GAO recommends that USAID (1) establish and implement policy requiring risk assessments in all cases before awarding bilateral direct assistance funds, (2) take additional steps to help ensure it implements controls for bilateral direct assistance, and (3) ensure adherence to its risk assessment policies for ARTF. In commenting on the first recommendation, USAID stated that its existing policies call for some form of risk assessment for all awards and that it has taken new steps to ensure risk assessment. GAO retained its recommendation because existing USAID policies do not require preaward risk assessments in all cases. USAID concurred with GAO’s other recommendations.
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- VA Real Property: Preliminary Observations on Challenges Limiting VA’s Ability to Effectively Manage Its Assets
June 10, 2021What GAO Found GAO has identified key characteristics of an asset management framework designed to optimize funding and decision-making related to capital assets. The Department of Veterans Affairs (VA) continues to have challenges meeting at least three of these key characteristics. Staffing resources. This key characteristic calls for organizational leadership to provide the necessary resources for asset management to succeed. Previously, VA officials described problems resulting from low levels of staffing resources, including project delays and difficulties in managing projects. VA has taken some actions to improve staffing levels, such as establishing special salary rates for engineers, and VA’s vacancy rate for general engineers has improved, decreasing from 17.2 percent in fiscal year 2019 to 12.6 percent in fiscal year 2020. VA officials, however, continue to describe staffing difficulties in planning and executing projects and limits on the number of projects that facilities can undertake. Communication and collaboration. This key characteristic calls for organizations to promote a culture of information-sharing across traditional agency boundaries to help ensure that agencies make effective, enterprise-wide decisions regarding their assets. VA has taken steps to improve communication among offices with asset management responsibilities, such as by issuing an asset management directive that VA officials said would help to facilitate such collaboration. However, in current work GAO has found instances of insufficient communication, such as lack of (1) collaboration early in project development between local offices and the Office of Construction and Facilities Management and (2) coordination between construction offices and the Office of Information and Technology when bringing facilities online. Measurement and evaluation. This key characteristic calls for agencies to continuously evaluate the performance of their asset management systems and implement necessary improvements to optimize the assets’ value and ensure the assets reflect the organization’s current goals. VA previously developed goals and measures for its program of inspections to identify maintenance and repair needs in health care settings. However, currently VA lacks goals with related measures that would evaluate its asset management processes and point the way to necessary improvements. Why GAO Did This Study VA manages a vast portfolio of real property assets, including a healthcare system that provides care at 171 VA medical centers and 1,112 outpatient sites to over 9 million veterans enrolled in the VA health care program. VA has pressing infrastructure needs, including adapting to changes in veterans’ demographics and maintaining or replacing aging facilities. GAO’s key characteristics of an asset management framework state that effectively managing assets requires, among other things, maintaining leadership support that provides the necessary resources; a collaborative organizational culture; and a system for evaluating and improving asset management performance. However, GAO’s previous and ongoing work has found that VA continues to face challenges on these fronts. Although VA has implemented some GAO recommendations, several priority recommendations remain outstanding in areas related to asset management, such as staffing and capital planning. GAO was asked to testify about VA’s management of its capital asset portfolio. This statement summarizes GAO’s findings from prior reports and preliminary observations from ongoing work examining VA’s capital asset management. In ongoing work, GAO reviewed VA documentation and interviewed officials from VA headquarters offices involved in asset management. GAO also interviewed personnel at a selection of eight VA medical centers and seven regional offices and from four Veterans Service Organizations about VA’s asset management. For more information, contact Andrew Von Ah at (202) 512-2834 or email@example.com.
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- Stabilizing Iraq: DOD Cannot Ensure That U.S.-Funded Equipment Has Reached Iraqi Security Forces
August 25, 2021Since 2003, the United States has provided about $19.2 billion to develop Iraqi security forces. The Department of Defense (DOD) recently requested an additional $2 billion to continue this effort. Components of the Multinational Force-Iraq (MNF-I), including the Multinational Security Transition Command-Iraq (MNSTC-I), are responsible for implementing the U.S. program to train and equip Iraqi forces. This report (1) examines the property accountability procedures DOD and MNF-I applied to the U.S. train-and-equip program for Iraq and (2) assesses whether DOD and MNF-I can account for the U.S.-funded equipment issued to the Iraqi security forces. To accomplish these objectives, GAO reviewed MNSTC-I property books as of January 2007 and interviewed current and former officials from DOD and MNF-I.As of July 2007, DOD and MNF-I had not specified which DOD accountability procedures, if any, apply to the train-and-equip program for Iraq. Congress funded the train-and-equip program for Iraq outside traditional security assistance programs, providing DOD a large degree of flexibility in managing the program, according to DOD officials. These officials stated that since the funding did not go through traditional security assistance programs, the DOD accountability requirements normally applicable to these programs did not apply. Further, MNF-I does not currently have orders that comprehensively specify accountability procedures for equipment distributed to the Iraqi forces. DOD and MNF-I cannot fully account for Iraqi forces’ receipt of U.S.-funded equipment. Two factors led to this lapse in accountability. First, MNSTC-I did not maintain a centralized record of all equipment distributed to Iraqi forces before December 2005. At that time, MNSTC-I established a property book system to track issuance of equipment to the Iraqi forces and attempted to recover past records. GAO found a discrepancy of at least 190,000 weapons between data reported by the former MNSTC-I commander and the property books. Former MNSTC-I officials stated that this lapse was due to insufficient staff and the lack of a fully operational distribution network, among other reasons. Second, since the beginning of the program, MNSTC-I has not consistently collected supporting records confirming the dates the equipment was received, the quantities of equipment delivered, or the Iraqi units receiving the items. Since June 2006, the command has placed greater emphasis on collecting the supporting documents. However, GAO’s review of the January 2007 property books found continuing problems with missing and incomplete records. Further, the property books consist of extensive electronic spreadsheets, which are an inefficient management tool given the large amount of data and limited personnel to maintain the system.
- WWII Nazi Concentration Camp Guard Removed to Germany
February 20, 2021Today a Tennessee resident with German citizenship was removed to Germany for participating in Nazi-sponsored acts of persecution while serving as an armed guard at a Nazi concentration camp in 1945.
- Equatorial Guinea National Day
October 12, 2021
- Chair’s Statement by U.S. Secretary of State Antony Blinken following the COVID-19 Ministerial
November 10, 2021
- Attorney General Garland and Civil Rights Division Assistant Attorney General Clarke Commemorate the 31st Anniversary of the Americans with Disabilities Act
July 26, 2021Today, Attorney General Merrick B. Garland and Assistant Attorney General for the Civil Rights Division Kristen Clarke issued the following statements to mark the 31st Anniversary of the Americans with Disabilities Act (ADA), the nation’s preeminent civil rights law that provides equal opportunity for people with disabilities.