Introduction

Our client is a Federal Health Agency responding to a growing Ebola epidemic.

Business situation

The first cases of Ebola were reported in March 2014, with 49 cases in Guinea. Within eight months, more than 15,000 cases and 5,000 Ebola-related deaths had been reported in West Africa. As a result of the rapidly growing epidemic, Congress approved $1 billion in emergency appropriations for activities to accelerate the elimination of Ebola. These activities are intended to increase infection control capabilities, improve and increase medical and laboratory response capabilities, improve surveillance, and provide training for health care workers.

A Federal Health Agency in partnership with country-based public health organizations and non-governmental organizations (NGOs), is tasked with implementing and coordinating these activities. Ebola eradication efforts are an imperative of U.S. national security and, as a result, Congress is scrutinizing the Agency’s effective execution, monitoring, and risk mitigation of all activities. Thus, it is crucial that the emergency appropriations allocated to the Agency are distributed to high priority activities that reduce the number of Ebola cases and prevent Ebola from spreading. Program activities are implemented by local public health organizations, NGOs, and for-profit agencies in collaboration with the Agency in each target country. The Agency provides funding, oversight, monitoring, and technical assistance.

Problem statement

The Agency has asked Deloitte to support the management of all financial activities related to the Ebola response. These activities include identifying programs that will receive additional funding, monitoring program implementation plans, ensuring accountable use of funds, and reporting the status of funds to the Agency Director and Congress. Funds should be allocated to programs and activities using a formula, and justified. Program funds should be spent according to plan to show efficient implementation and progress. Overspending by approximately 10% of appropriated funds is not an issue, but underspending is a red flag. Reports will go to the Senate’s Committee on Appropriations, which has jurisdiction over all discretionary spending. Congress expects reports every month.

A monthly status report on the Ebola response is due to Congress next week, and the Agency Director would like to review a draft before it is finalized. He also wants to know which programs may not be performing according to plan and the corrective actions the team will take to resolve such issues.