General Hospitals run out of drugs as NMS stops deliveries
Many Ugandans seeking health services in General Hospitals countrywide and can’t afford private facilities will continue to suffer and die in silence due to shortage of medical supplies.
This is the role of National Medical Stores (NMS) headed by Moses Kamabare.
We have learnt that many General Hospitals have gone months without receiving supplies from NMS.
For instance the General Hospitals have not received the 5th and 6th cycles of supplies for this financial year 2023-2024 which was supposed to have been done in March and April.
However, following an outcry from these General Hospitals, NMS is promising to deliver them at the end of June.
“This is to inform you that we intend to execute the delivery of FY2023/24 cycles 5 and 6 by the end of June 2024.
Since these quantities will be for multiple cycles, kindly have your team prepare to receive and manage this stock adequately.
The details of the cycle delivered to your facility shall be referenced in the delivery documents accompanying the consignment at delivery time,” reads an April 2024 letter by NMS to one of General Hospitals’ administrators.
This means patients who can’t afford private services have to wait up to June or resign to fate.
“The medicines were supposed to be delivered in April and May but they have now told us they will be delivered at the end of June. We wonder what will happen to some Ugandans who depend on these government supplied drugs. If NMS leaders have failed, let them resign and competent people take over,” said an administrator in one of General hospitals.
NMS has always attributed the late drugs delivery and consequent shortage to delays in receiving funds from the Ministry of Finance, an excuse the latter denies.
IS NMS FAILING HER MANDATE?
The National Medical Stores (NMS) is one of those critical departments the Government of Uganda (GoU) relies on to ensure the well being of its people health wise.
This requires NMS to always be on top of her game in terms of delivering its mandate to guarantee bragging rights for the NRM government whenever it is seeking a re-election.
Moses Kamabare calls shots there as the General Manager.
However, if findings by the 2022/23 Auditor General report are to go by, a quick intervention is required there even if it means changing leadership because someone there is sleeping on the job.
Why? It has been observed that NMS is slowly going to the dogs and Ugandans keep losing confidence in it every day that passes—and that implies a vote of no confidence in the NRM government. These are things that annoy Gen. Museveni with the 2026 presidential elections around the corner.
The role of NMS is stipulated in the mandate that is provided for in the NMS Act, that is, to procure, store and distribute essential medicines and medical supplies of good quality primarily to public health facilities.
These among others include; Antiretrovirals (ARV’s), essential medicines, essential medical supplies, laboratory supplies including HIV test kits and basic equipment like stethoscopes, BP machines and thermometers.
However, auditors have discovered NMS is no longer delivering medicine on time if at all it does and even if it does it is sometimes less. The auditors also talk of expired vaccines, understaffing, drug stock outs, lack of storage facilities and among others.
Whereas NMS as usual always blame all these on the mother Ministry of Health, Finance bosses and others, watchers say they must accept responsibility and find ways to stop this mess rather than whining.
EXPIRED VACCINES AND DRUGS
According to auditors, out of 12,595,920 doses of COVID-19 vaccines in the NMS store, 5,619,120 doses had expired. The expired COVID-19 value of the vaccines as at reporting date was worth Sh28.159bn.
To make matters worse, more expired COVID vaccines still lie in various health facilities across the country and the total combined loss to be incurred this year is estimated at Sh300bn. These are vaccines procured out of the World Bank loan advanced for CoviD-19 support.
Such reports are coming at a time when some Ugandans continue to die of Covid-19 to date.
According to NMS, with cases of Covid going down, the low uptake and demand of these vaccines ultimately led to the expiry.
Furthermore, it was observed that NMS has non-viable /expired stock of drugs worth Sh33bn which was a 153% increase from Sh13.4bn of the previous year (2021/20122).
These majorly include Anti-retro Viral Medication (ARVs).
However, NMS will have you believe that these expired due to mainly changes in the recommended treatment guidelines by the World Health Organization which they say was inevitable clarifying that “NMS could not continue distributing ARVs which were no longer considered effective in the treatment of HIV and the HIV patients in need were put on the new ARVs.”
“Regarding the expiry of drugs the Accounting Officer NMS was advised to appropriately align the budget for the EMHS with the demand so as to avoid over stocking of these drugs and ensure adequate and timely distribution and delivery of drugs and health supplies to the respective health facilities,” the AG advised.
DELAYS AND UNDER-DELIVERY
The AG also observed that there is always late delivery and under delivery of Drugs and Medical Supplies to the various health facilities by NMS.
It was discovered that out of the 3,254 health facilities, a total of 3,183 health facilities had under deliveries of drugs and medicine supplies worth Sh26.403bn.
In addition, the deliveries were not following the cycles which meant delayed deliveries that caused disruptions in patient treatment.
“Under-delivery of expected supplies caused drug stock-outs and treatment disruptions in the affected Health facilities across the country. The Under deliveries impact the effectiveness of these hospitals in delivering on their mandate,” the AG noted, and attributed it to failure by NMS to adhere to the approved budgets for these hospitals.
“The Accounting Officer NMS was advised to appropriately align the budget for the EMHS with the demand to ensure adequate and timely distribution and delivery of drugs and medical supplies to the respective health facilities” the AG report further reads.
The report also faults NMS for not following up to find out whether there are enough storage facilities and skilled staff to manage the little drugs and health equipment they always deliver. They simply just dump and go away.
DRUG STOCK OUTS
Due to NMS’s incompetence, the AG reported drug stock-outs for long periods that significantly affected service delivery. Some of the Significant drugs out of stock include; Quetiapine, FLUANXOL 20MG, SEVOFLURANE 100% V/V, TRIFLUOPERAZINE TABLETS 5mg, ORAL MORPHINE 250ML 5MG/5ML among others.
“The stock-outs erode patient confidence in the health sector which leads patients to explore inappropriate and expensive alternatives of health care. I advised the Accounting Officers to continuously engage National Medical Stores to deliver drugs as per the requests/orders,” the AG report points out.
NMS bosses are not remorseful about delays and under-deliveries issues saying it’s beyond them.
To NMS, Finance and MoH bosses have clear answers.
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