Correction: An earlier version of this article stated incorrectly that the Office of the Special Inspector General for Afghanistan Reconstruction, or SIGAR, was established in July 2012. SIGAR was created by Congress in 2008 and began its work in 2009.The article has been updated.

In its latest report sharply criticizing U.S. government aid programs, the Office of the Special Inspector General for Afghanistan Reconstruction charged Thursday that millions of U.S. dollars being spent on public health programs is “at risk of waste, fraud and abuse” and that there is “little assurance” the funds are being used as intended.

The report, made available here by officials of the U.S. Agency for International Development, recommended that no further U.S. funding be provided to Afghanistan’s Public Health Ministry for basic services “until program costs are validated as legitimate.” It called for aid officials to address 55 “deficiencies” found in a previous review of the ministry’s financial practices before spending any more money.

The criticism was focused on a $236 million USAID program called Partnership Contracts for Health, which provides, among other things, immunizations, prenatal exams, hospital equipment and salaries in 13 Afghan prov­inces. Most of the services are delivered through local nonprofit groups, reaching hundreds of thousands of people who have little means to pay for them.

USAID officials here, in a hastily arranged briefing Thursday for American journalists, strongly rejected the accusations made by the special inspector general, known as SIGAR. They said that no U.S. funds were being provided directly to the ministry and that they had set up a special unit inside the ministry, along with other foreign donors, to monitor all grants and contracts.

“The report provides no evidence that the extensive measures taken by US AID to safeguard taxpayer resources have resulted in high risk of misuse of funds,” William Hammink, the agency’s mission director in Kabul, said in a written response. He said that ­SIGAR also had found no evidence of waste, fraud or abuse in the health service program and that its recommendations for stronger financial oversight were already being carried out.

“We are very careful before we spend a dollar,” said one USAID official here, speaking on the condition of anonymity because of his agency’s restrictions on public comments. “We do not provide direct assistance to the ministry, and we do have full assurance on how it is used.”

USAID officials here said they objected to the alarmist tone of the SIGAR report, which declared that financial management deficiencies at the ministry had “put millions of taxpayer dollars at risk.” They said they did not know of a single instance in which fraud or abuse had been detected in the health program’s finances.

The “deficiencies” listed by ­SIGAR, the officials said, were problems they had flagged in their own 2012 review and have since been working to correct. According to the SIGAR report, those problems included some salaries being paid in cash, no double-
entry accounting system, a lack of external audits, poorly prepared internal auditors and inadequate transaction procedures.

The report is the latest in a series of hard-hitting critiques of U.S. aid management and prac­tices issued by SIGAR in recent months. The Afghanistan aid mission is one of the largest in the world, and Congress has appropriated more than $95 billion for Afghan reconstruction since the Islamist Taliban regime was toppled by a U.S.-led invasion in 2001.

SIGAR, which was created by Congress in 2008 and began work in 2009, is headed by John Sopko, an aggressive former federal prosecutor. His investigations have found waste, delays and mismanagement in a variety of programs and facilities.

Recent reports by SIGAR have described aid funds being wasted on conferences and meetings, a program to create “stability” in troubled provinces that spent $47 million in preparations but none on field projects, and a $34 million military facility built for the Marine Corps in southern Afghanistan, though Marine officials said it was not needed and would probably never be used.