By Nokunceda Magagula
The government has acknowledged the current shortage of some medical drugs in public health facilities and it has assured the nation will normalise around November. In a statement issued by Government spokesperson Alpheous Nxumalo on Thursday.
Nxumalo said in June 2023, the government established a Cabinet sub-committee, composed of four key ministers, the Minister of Finance, Agriculture, Health, and Commerce, Industry, and Trade. This committee’s primary purpose was to address the persistent issue of medicine shortages in the country.
One of the primary findings of this sub-committee was the insufficiency of the Ministry of Health’s budget to meet the growing health demands. This budgetary shortfall had led to accumulating arrears over extended financial periods, severely affecting the healthcare system’s ability to function effectively.
To address this situation, the sub-committee recommended an increase in budget allocation to clear the arrears and enable the Ministry of Health to operate within its budgetary constraints. Furthermore, the sub-committee suggested extending existing tenders from the previous financial year to cover the period from June to September 2023.
This extension allowed for the delivery of medicines and medical supplies to the Central Medical Stores (CMS), resulting in a noticeable increase in the supply of medicines to healthcare facilities across the country. Despite this progress, the supplies remain below the anticipated quantities, resulting in some facilities receiving less medication than needed.
Currently, the CMS can only deliver an estimated 50 per cent of the required medicines per facility, with significant gaps in essential medicines, including those related to family planning, malaria, and non-communicable diseases. The new tender for the current financial year started on 1st October 2023, with expected supplies arriving in late October or November.
To improve relationships with suppliers and address outstanding payments, the government, through the Ministry of Health, has maintained continuous communication with suppliers. This has resulted in over E127 million being paid to suppliers, with ongoing discussions aimed at clearing all remaining outstanding debts. Since the administration’s term has ended, the Principal Secretaries in relevant ministries, led by the Secretary to the Cabinet, have assumed oversight responsibilities.
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Weekly feedback meetings continue, with a particular emphasis on prioritizing payments to suppliers.
Additionally, significant efforts have been made to enhance the operations of the CMS warehouse. Working in collaboration with the USAID Global Health Supply Chain – Procurement and Supply Management, the CMS has invested time and resources to improve the efficiency of its operations. A mission is currently ongoing to address key interventions that will further enhance the CMS’s operations.
One of the noteworthy decisions made by the Cabinet in August 2023 was the approval, in principle, for the transformation of the CMS from a department within the Ministry of Health to a semi-autonomous parastatal under the Ministry. To establish this new entity and comprehensively define its functions, a legal instrument is in development in collaboration with key stakeholders.
The government has constituted a task team to oversee this transformation, with support from international organizations like the World Bank, Global Fund, and USAID. In addressing the challenges, the statement also recognized the vital role played by The Luke Commission (TLC) in the health sector and expressed appreciation for their longstanding support. However, due to financial reasons, TLC has indicated a reduction in their support.
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The government, led by the Acting Prime Minister, has held multiple meetings with TLC’s management to explore potential government and donor support. The parties are actively seeking ways to form partnerships, which may include the utilization of The Luke Commission’s Oxygen plant.
To address issues of mismanagement related to medicines and medical supplies, the government has initiated a forensic audit. However, the statement also included a clear warning against casting aspersions on the suspended CMS employees who have recently been charged following the drug shortage issue.
As of now, none of these employees have been found guilty, as disciplinary processes are still pending. It is essential to refrain from making assumptions until the necessary proceedings have been carried out, allowing these employees to present their side of the story.
The government urged the nation to remain calm and await the outcomes of these proceedings and any other legal actions related to the drug shortage issue. As of now, the government is actively addressing the critical health matters facing Eswatini with a comprehensive plan to improve healthcare services, supply chains, and budgetary support.
