Drug supply hit amid MSD budget squeeze

Dar es Salaam. The supply of drugs to public hospitals is being hampered by serious shortage of funds after the government provided only 32 per cent of the money that the Medical Stores Department (MSD) needs for quarter ending September 30.

A drugs supply monitoring undertaken by the health NGO, Sikika, shows that the government has only released Sh20 billion to MSD for the purchase of essential medicine and medical supplies by September 16, out of the Sh62.5 billion that should have been released for the July-September quarter.

The Parliament approved for the MSD an annual budget of Sh250 billion for the 2016/17 fiscal year.

Underfunding has immensely weakened MSD’s ability to procure supplies for use in public hospitals, health centres and dispensaries, leading to a countrywide shortage of medicine.

By September 16, the monitoring of essential medicines indicates, MSD warehouses in the country had only 170 units of Paracetamol tablets with one unit containing 1,000 tablets.

That is to say Tanzania was had in its stocks only 170,000 Paracetamol tablets, the most commonly prescribed painkiller. Worse still, the stock was found in the Mbeya warehouse, while storerooms elsewhere in the country had run out of stock.

Efforts to reach MSD managing director, Mr Laurean Bwanakunu and Minister of Health, Community Development, Gender, seniors and Children, Ms Ummy Mwalimu, to shed light on the worrisome situation proved futile.

But the Sikika monitoring shows that the sampling of the seven key drugs indicates that the country had 21,536 units of 1,000 capsules each of Amoxicillin capsules, one unit of Co-trimoxazole tablets 400 mg/mg which is important in providing relief to people living with HIV/Aids.

The trend of availability of sampled medicines and medical supplies further shows that the country is running out of Delivery Kits (midwife kits), Oxytocin Injections, Amoxicillin Granules, Diarrhoea Treatment Kit (Oral Rehydration Salts [ORS] and Zinc) and Atenolol tablets in its stocks.

Generally, observations have shown that 521 items, equivalent to 47.32 per cent of the total 1,200 essential medicine and medical supplies, were found to be out of stock in the MSD warehouses as compared to 502 items (43.3 per cent) recorded in July this year. Statistics show on May 499 items (43.8 per cent) were out of stock, while 444 items (38.4 per cent) were out stock in March.

Speaking at a media workshop yesterday, Sikika executive director, Mr Irenei Kiria, said while the current government is commended for increasing funds allocation to MSD this fiscal year compared to 2015/16 where only Sh29 billion was budgeted and Sh20 billion eventually released, much needs to be done to improve issuance of funds in order to stabilise supply of essential medicine and medical supplies in the country.

“While Sh70.5 billion was allocated in 2014/15 Budget, Sh64 billion was set aside in 2013/14 and Sh80.5 billion was assigned in the 2012/13. In the 2011/12 Budget, MSD basket was allocated Sh123.4 billion, with only Sh63.9 billion set aside in the 2010/11 Budget,” he said.

According to available statistics, it was only in the 2012/13 financial year that the government met its allocation commitment by 100 per cent when it provided MSD with Sh80.5 billion as allocated by the Parliament. In all other years, it fell short.

One of the ways to make medical supplies more reliable should be to allow MSD to operate as a profit making parastatal competing with wholesalers in the medical supplies sector.

Also, the government should repay or replenish MSD working capital to a reasonable level to allow it to compete with private vendors and wholesalers, according to recommendations given out by Sikika.

The Medical Stores Department should also decentralise its procurement system to make it work more efficiently.

This means that funds allocated centrally for the purchase of drugs and other medical supplies should be sent directly to the district councils and municipality or health facilities.

The ministry of Health and the President’s Office—Regional Administrations and Local Government (PO-RALG) should focus on strengthening facility management.

The government’s debt to MSD should be paid. The debt now stands at Sh142 billion, an indication that President John Magufuli’s administration was making little efforts to clear the debt.