Zambia's drugs procurement system slid deeper into chaos and confusion this month with the dismissal of the head of medical stores, Chikuta Mbewe, following the sacking of the health minister and his permanent secretary last month.
MakanDay also heard claims that government's debts to pharmaceutical suppliers have now reached US$150-million. Attempts to obtain government confirmation and comment failed this week.
Announcing Mbewe's dismissal, the medical stores board accused him of "gross negligence and professional misconduct" over expired drugs, faulty condoms and flawed pregnancy test kits supplied by Honey Bee Pharmacy.
New health minister Dr Jonas Chanda scrapped Medical Stores Limited, which Mbewe had led, and set up a new agency, the Zambia Medicines and Medical Supplies Agency (Zammsa), to handle both procurement and storage of pharmaceuticals.
Last month President Edgar Lungu fired the former health minister, Dr Chitalu Chilufya, and the permanent secretary for health, Akakulubelwa Mulalelo, following reports that the health ministry gave a contract worth US$17-million of public money to an unknown company, Honey Bee for health supplies.
Last year, the government transferred procurement of drugs from the traditional supplier, Missionpharma to Honey Bee Pharmacy.
It is understood that the procurement shift was prompted by government’s inability to settle rising debt owed to Missionpharma.
Controversy has swirled around Honey Bee for supplying expired and faulty materials. The Zambian Medicines Regulatory Authority (Zamra) cancelled the company's pharmaceutical licence on February 13 this year, accusing it of
breaching the terms of its licence and failing to take remedial action over expired drugs.
Honey Bee is seen to enjoy the favour of the health ministry. Last year some of the drugs and health equipment it had supplied were recalled and sent to Zimbabwe for testing.
Sources claimed some of the test results were available but had not been published, alleging this was an attempt to ensure the drugs were used and Honey Bee received payment for them.
It is not clear what kind of relationship exists between the ministry and the company, but according to company registration records, its directors are Zakir Husen Motala, Imran Lunat and Abdurrauf Abdurrahim Motala – all of them Zambians of Indian origin.
Some sources said the government was right to act, but wrongly blamed medical stores, and Mbewe, for the expiry of drugs. This was because MSL was not a procurement agency and had no control over the issue of expiry, which was caused by over-procurement and changes in the public health drugs regime.
Zamra, whose role is to ensure that all medicines supplied to Zambians meet quality and safety standards, did not respond to a question from MakanDay about why medical supplies were taken to a third-party laboratory in Zimbabwe without a dispute.
“Some of the results were ready in November. So why did it take so long to make a decision to do a product recall?” Asked one source.
The task of buying, storing, and distributing drugs was initially the function of MSL when an Act of parliament created it in 1976. Government decided to take over procurement so that medical stores could concentrate on storage and distribution.
New minister of health, Dr Chanda, has reverted to the old system where MSL, now Zammsa performs all functions. He also dissolved the board which was chaired by permanent secretary Mulalelo before she was fired.
On January 8, Dr Chanda was shown expired drugs at the storage facility. Angered by what he saw, he gave a 24-hour ultimatum to management to provide a comprehensive list of all expired drugs in the warehouse and their cost.
A source told MakanDay that the minister had highlighted an important problem but that Zammsa has nothing to do with expired drugs as it is not a procuring agent.
“Things expire due to over-procurement and changes in treatment protocols,” he said.
He also disclosed that government owes drug suppliers US$150 million.
“There is nothing in the pipeline for government procurement of medicines. What (Dr) Chanda found is the result of a government failure to manage resources. There’s no planning; everything is emergency supplies, buying from every Jim and Jack on the street. It’s just a mess,” he said.
An investigation by MakanDay revealed that administrative failures within the medical supply system could have led to the expiry of some medicines. These are compounded by the Ministry of Health’s heavy reliance on external donors for Zambia’s drug needs.
The donors either buy and supply drugs, make grants for drug purchases or provide budgetary support to the health ministry.
Experts say this leads to coordination challenges across procurement institutions., leading to over-supply of some drugs and shortages of others.
Shortages force the Ministry of Health, and sometimes private partners, to make emergency procurements. On occasions, donors end up supplying the country with drugs that are not even on the list of essential drugs.
Also, a major issue was the theft of HIV/Aids drugs and medical products worth over $1-million in 2016.
Investigations into that crime have not been concluded despite medical stores providing a vehicle for the police to use and weekly fuel allocation to speed up the process.
The police have failed to finalise two cases related to the theft, one involving two Congolese, and the second, 13 MSL employees on suspension awaiting the conclusion of investigations.
An MSL insider expressed frustration with the slow pace of the investigations, saying there were suspicions police are shielding suspects from prosecution.
The police are yet to respond to MakanDay’s queries about the matter.
In 2016 the former health permanent secretary, Peter Mwaba, moved Mbewe from the ministry of health to medical stores.
He was tasked with normalising irregularities and the theft of drugs.