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Drug crisis

DHOs express frustration as CMST fails to supply required drugs

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George Jobe

By Deogratias Mmana:

District health facilities across the country are down on their knees as the Central Medical Stores Trust (CMST) is failing to supply the required quantities of medical commodities they need in service of Malawians, Malawi News has established.

As a result, the district health facilities are being forced to refer patients to private pharmacies to buy the drugs.

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In government arrangement, district health offices can only procure medical commodities from CMST.

But with the medical stores trust unable to meet their demands, they are now fighting for at least 10 percent waiver to be able to procure medical commodities from other markets, in addition to CMST.

Malawi News investigations have established that many of the country’s district health offices have been receiving below 50 percent of the commodities they require from CMST.

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For example, CMST failed to supply 90 of 122 commodities requested by Ntchisi district health office for this month, putting the percentage of commodities not supplied at 73.77.

Some of the drugs not supplied include Amitriptyline, Azithromycin, Benzhexol, Bisacodyl, Captopril, Carbamazepine needle disposable dental, Gauze swabs, masks face disposable, syringe insulin 100 IU with needle, and bags urine drainage 2,000ml with outlet.

Director of Health and Social Services for Ntchisi, Lumbani Munthali, described his situation as sad and added that the challenge is that CMST is the only supplier for their requirements.

“We do not have anywhere else to procure the commodities. It is only the CMST. If we do not have drugs, clients are forced to go and buy wherever they may get them.

“But the big challenge is for people in the villages that may not have money to buy the drugs,” Munthali said Friday.

He blamed this on the central management arrangement for the procurement of essential drugs.

Statistics at Nsanje district health office shows the following percentage of supplies that were received from CMST: November 2020, 33 percent; December, 37 percent; January 2021, 58 percent; February, 40 percent; March, 31 percent; April, 36 percent and 40 percent for July emergency order.

Nsanje Director of Health and Social Services Dr. Gilbert Chapweteka confirmed the statistics.

He described the CMST situation as pathetic as district hospitals are forced to return patients without helping them.

“If we cannot get anything, we tell patients to go and buy from pharmacies which is not ideal for people who cannot manage,” said Chapweteka adding that “Sometimes we press an emergency order and get partial supplies.”

Chapweteka said sometimes district hospitals seek help from one another or partners to fill gaps.

In Chitipa, Director of Health and Social Services for the district, Wilson Ching’ani, said CMST’s failure to supply medical items as required by health facilities has been a challenge for some time now to all hospitals across the country.

Ching’ani said district hospitals are in discussion with authorities to be allowed to procure drugs from other suppliers, instead of being limited to CMST.

He said central hospitals have a waiver of five percent of their budgets which they use to procure drugs from other suppliers.

“Discussions are under way to have a waiver to be able to buy drugs from elsewhere too. We want to follow suit with the central hospitals. We want a percentage from five to 10 percent,” Ching’ani said.

The shortage of drugs forces medical personnel to devise ways of solving the situation among themselves, Director of Health and Social Services for Karonga David Sibale said.

“We swap the drugs,” Sibale said. He said for example, they may provide Aspirin instead of Panado if Panado is not available.

Apart from swapping drugs, Sibale said health facilities do request from other facilities to fill the gaps.

“Those who have more, may share with their colleagues,” he said.

Malawi Health Equity Network (Mhen) Executive Director George Jobe said CMST is in a crisis which is forcing poor people into a helpless situation.

“We have people who rely on public health facilities. If such people are returned because of drug stock-out, they will go home and wait for luck or fate. We need an explanation from CMST,” said Jobe.

Jobe asked CMST to give an explanation and justification for their situation.

He further said CMST should be proactive in its operations and update the public frequently on the availability of drugs.

CMST spokesperson Herbert Chandilanga said his seniors were preparing the response to our questionnaire and he promised to send it before our deadlines yesterday. We had not yet received by the time we went to press.

In the 2021/22 budget, government allocated K187.2 billion to the Ministry of Health.

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