OVER 28 DRUGS OUT OF STOCK AT RFM

MANZINI – Over 28 drugs are out of stock at the Raleigh Fitkin Memorial (RFM) Hospital.

The drug shortage at RFM Hospital comes against the backdrop of this publication reporting that the Auditor General (AG), Timothy Matsebula, was investigating the shortage of medicines. The shortage of medical supplies and drugs has been a constant challenge in the public health sector in the kingdom for time immemorial, despite interventions by the Ministry of Health to strengthen its stock controls. This constant issue has seen health practitioners petitioning government in various instances wherein they raised their concerns and outlined that, among other things, they were now issuing prescription letters instead of affording the citizenry adequate care, as per their oath of service. The shortage of medication is said to be rife at RFM Hospital and has seen healthcare workers issuing prescription letters to patients so that they could get the drugs at retail pharmacies.

Medication

According to impeccable sources within the health facility, the shortage of medication has escalated in recent weeks. The sources said the medication cut across a number of ailments, which non-communicable diseases (NCDs). The impeccable sources claimed that the issue had been ongoing and had been reported to the management of the hospital. They claimed that patients with hypertension always had to buy drugs like Atenolol, Slow K, Digoxin and Furosemide. The sources claimed that in fact, almost all ailments had a drug shortage including syrups for minors. On the list of drugs that are not available is medication for treating pain (Diclofenac and Tramadol) and severe infections (Cefazolin). Chief Executive Officer (CEO) of the Eswatini Nazarene Health Institutions (ENHI) Benjamin Simelane, referred questions related to the drug shortage to the Ministry of Health. He had been asked about the drug shortage at RFM Hospital.

Subsequent to Simelane’s response, the Director of Health Services in the Ministry of Health, Dr Vusi Magagula, was asked what was the cause of this drug shortage and if other health facilities were also affected. He said they (ministry) were working on the issue and his office was working on ensuring that it was addressed. In the interim, he said they were waiting for the list of the drugs that were in a stock-out.

A fortnight ago, Principal Secretary (PS) in the Ministry of Health, Dr Simon Zwane, was sought by this publication to establish the state of the healthcare system in Eswatini. Dr Zwane was asked if the ministry had investigated the cause of the shortage of medication in hospitals and if yes, what the causes were. He was also asked why the ministry was always facing a shortage of medication yet it was procured frequently. The PS was also sought to establish how much the ministry was losing, in terms of the supposed theft of pharmaceutical and medical supplies upon delivery in hospitals. Dr Zwane said the AG’s office was carrying out an investigation to establish the challenges which resulted in the shortage of medication in public health facilities. He said some of the known causes were the inaccurate forecasting of commodities leading to over or under supply, the shrinking supplier base due to a number of reasons including payment tendencies (United States of America Dollar (USD) against the local currency Lilangeni (SZL).

Unfavourable

The PS said there was also the issue of unfavourable economies of scale. In explaining this, he said the Kingdom of Eswatini’s quantities of commodities were very small compared to other countries.  Dr Zwane said: “As a result (of quantities of commodities being very small when compared to other countries) manufacturers have to wait for other countries to place orders so as to form reasonable batches.” He said Eswatini was unable to form a complete batch for production; hence some delays were bound to happen (in the delivery of orders).
The PS said they (Ministry of Health and government) had investigated the cause of the frequent stock-out of medicines in the public health facilities. He said this was done in 2017 through a commission led by the deceased former PS in the Ministry of Information, Communication and Technolgy (ICT) Prince Sikelela. The outcome of this investigation, Dr Zwane said, culminated to a report which highlighted a number of gaps, as well as, specific recommendations. He said a number of the recommendations had been implemented while others had not.

On the other hand, despite the constant outcry due to the shortage of medical supplies and drugs, the AG in his Financial Audit Report for the year ended March 31, 2021, reported an over-expenditure on medical drugs amounting to E13 072 215.85. This amount, he said, was incurred by the Mental Hospital, Special Medical Care Unit, Central Laboratory, Manzini Region Clinics, Shiselweni Region Clinics, Matsenjeni Health Centre, Lubombo Region Clinics, Dvokolwako Health Centre, and Pigg’s Peak Public Health Unit in the period under review.

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