BY KWANELE TSABEDZE
MBABANE – Central Medical Stores (CMS), cabinet’s decision, the forensic audit report, and supplier payments.
These are just some of the topics covered in a statement by the Government of Eswatini, giving “an update on critical health matters currently confronting the Nation.”
The statement was released earlier today by Government Spokesperson Alpheous Nxumalo to update the public on the status of findings and recommendations by the Cabinet sub-committee which was established in June 2023 to address the issues in the health sector. The sub-committee was instituted following public outcry on medicine shortages, and it consisted of the Ministers of Finance, Agriculture, Health and Commerce, Industry and Trade.
The sub-committee instituted a Forensic Audit, among other things, and they uncovered various issues such as supplier payment delays and budget limitations among other things.
The full statement from the Government updating the public on the subcommittee’s progress reads as follows:
GOVERNMENT STATEMENT
UPDATE ON CRITICAL HEALTH MATTERS AFFECTING THE COUNTRY
Following a public outcry on medicine shortages, the Nation will recall that a cabinet sub-committee was established in June 2023, which constituted of four ministers – Minister of Finance, Agriculture, Health and Commerce and Industry and Trade to address this issue.
Among its findings, the sub-committee found that the Ministry of Health’s budget was not sufficient to meet the health demands, resulting in accruing arrears over longer financial periods. To redress the situation, it would require an increased budget allocation to clear the arrears and allow the ministry to operate within budget.
Secondly, the sub-committee recommended that the existing tenders from the previous financial year be extended for the period from June to September 2023, which allowed for the delivery of medicines and medical supplies to the Central Medical Stores (CMS). This resulted in increased supply of medicines to all facilities.
However, even though significant progress has been made, the supplies are still below the forecasted quantities; resulting in facilities receiving less than required medicines. Currently, the CMS is able to deliver an estimated 50% of the needed medicines per facility. There are still major gaps in some essential medicines, including family planning, malaria and non-communicable diseases medicines. The new tender for the financial year started on the 1st of October 2023 and the expected time of arrival of supplies is late October/November 2023.
Thirdly, the sub-committee further sought to improve relationships with suppliers by addressing the outstanding payments to suppliers. The government, through the Ministry of Health, is in constant communication with suppliers on payments and the situation has improved with over E127 million paid to suppliers. The outstanding amounts are known between suppliers and the Ministry of Health and discussions are ongoing to clear all outstanding debt.
Following the end of term of the administration, the Principal Secretaries in the relevant ministries, led by the Secretary to Cabinet, have taken over this oversight role and the meetings for feedback continue to be held on a weekly basis. The payment to suppliers remains a priority intervention.
Improvements in the operation of the CMS Warehouse
The CMS, working with the USAID Global Health Supply Chain – Procurement and Supply Management, has invested effort in improving the operations of the CMS warehouse. A mission is currently with the CMS to address key interventions which will bring about efficiencies in the operations of the CMS.
Cabinet Decision on Parastatilisation of the CMS
In August 2023, Cabinet approved, in principle, the transformation of the CMS from a department within the Ministry of Health to a semi-autonomous parastatal under the Ministry. A legal instrument establishing the new entity, and comprehensively defining the functions of the new entity, will be developed in collaboration with key stakeholders. The Government constituted a task team to oversee the transformation of the CMS. The World Bank, Global Fund and USAID have committed to support the transformation process.
The Luke Commission (TLC)
The Luke Commission is a critical service provider in the health sector. Government appreciates the long-standing support from TLC. The Luke Commission has indicated that due to financial reasons, they will scale down their support. Government, through the leadership of the Acting Prime Minister, has met with the Management of TLC several times to explore possible support from Government and donors. The country is aware of the challenges faced by The Luke Commission and is exploring ways for a possible partnership, including the Oxygen plant owned by The Luke Commission.
Forensic Audit report
Government is doing everything possible to address issues around the mismanagement of medicines and medical supplies. This will be conducted without any malaise or victimization.
Government, however, wishes to warn the public against casting aspersions on the suspended CMS employees who have recently been charged following the drug shortage issue. At this point, none of the employees are guilty as disciplinary processes are yet to be instituted. It is, therefore, malicious to assume they are until the necessary proceedings have taken place and they have been given a chance to present their side of the story. We wish to therefore urge the Nation to remain calm and await the outcome of these proceedings and any other legal proceedings that may be instituted by Government in the drug shortage matter.
ALPHEOUS NXUMALO
Government Spokesperson
19 October 2023
