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Ministry, Medical Stores tussle over drug supplies

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MALAWIANS should brace for a persistent health crisis following a protracted disagreement between the Ministry of Health (MOH) and Central Medical Stores Trust (CMST) over stocks of medical supplies including drugs.

Amid reports of shortage of essential drugs in most district hospitals across the country, the ministry has accused CMST of under stocking, despite government approving the three months front loading funding arrangement for the trust.

But sources at the CMST have hit back at the ministry saying its quantification figures always surpass its budget, and have thus asked the ministry to work on raising its annual budget.

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The ministry’s spokesperson Adrian Chikumbe made the accusation in an interview recently when asked to explain a persistent drug shortage in public health facilities despite an upward adjustment of the annual drug budget from K8, 956.77 billion in the 2016/2017 national budget to K9, 258.54 in the current financial year.

For instance, at Chitipa District Hospital three people have died of rabies in the last three weeks due to lack of medical drugs. “Due to devolution of some of our functions the onus is on the District Health Offices (DHOs) to have a priority list of drugs. But there are concerns that the CMST usually does not have some of the drugs on such lists and antirabies vaccines could be among them,” said Chikumbe.

He disclosed that the ministry just increased its priority list of medical drugs from 944 to 945 with an addition of sunscreen lotion for People with Albinism (PWA). According to Chikumbe, CMST is expected to stock all the items on the list, especially now that DHOs were banned from procuring drugs from other private suppliers.

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“Front loading was approved for CMST alone to beat fluctuation of the Kwacha and also ensure that they have enough money to procure all the necessary medicines. Needless to mention that the liberal procurement provided leeway for abuse among DHOs,” Chikumbe added.

When contacted, spokesperson for CMST Herbert Chandilanga asked for a questionnaire which he has not yet responded to, for three weeks, despite several reminders.

But another source within the trust confided in us that there have been meetings between the two parties in an attempt to address the crisis but contrary to expectations, the must-have list has been trimmed from 945 to about 700.

“The CMST barely has money to meet the demand; with the current budget lines, obviously the trust cannot afford to order all the 3,440 items in the catalogue. The ministry was asked to prioritise the items and the conversation is ongoing,” said the source.

Adding: “Imagine a situation where we procure K10 billion drugs, and yet the drug budget is at K8 billion; obviously the hospitals can’t order more than their budget bracket, what would we do with the remaining stock? Remember the trust is in business.”

Commenting on the development, health rights activist George Jobe of Malawi Health Equity Network (MHEN) has asked government to recapitalise the CMST if it’s to remain the sole supplier of drugs, arguing that lives of thousands of patients across the country are at stake.

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