Were it not a matter of life and death, it would be funny that real action in the Eswatini’s public healthcare system is playing out outside the admission wards and outpatient departments.
While hospital dispensary shelves show no real improvement, pharmaceutical suppliers and other players are delivering one shocker after another. Medication is not being delivered – at least not up to the level the nation hoped it would reach soon after the 2023 People’s Parliament (Sibaya).
While the Ministry of Health, the Eswatini Public Procurement Regulatory Authority (ESPPRA) and suppliers engage in boardroom sparring, the patient sitting anxiously on an outpatient department (OPD) bench suffers.
So does the one admitted in a ward with a serious injury or ailment, whose family members have to find alternative and expensive means of sourcing critical medication and supplies.
This past week has been particularly dramatic.
Pharmaceutical suppliers submitted 19 objections to the ESPPRA, complaining about the handling of two government tenders with a total value of about E1 billion.
Individually and collectively, the 27 companies cited possible bias and corruption in the award of the tenders. One of the companies complained about being disqualified from participating in Tender No.1 of 2025/2026 which is for the supply and delivery of medical supplies. It had submitted a bid valued at over E123 million and alleges that its disqualification from this lucrative tender was communicated without clarity, in violation of the principles of fairness and transparency enshrined in the Procurement Act.
There is a feeling among suppliers that government’s approach towards the tendering process has changed, which raises “serious concerns regarding fairness and consistency in evaluation” of tenders. Precedents have allegedly been disregarded, as certain practices that were previously accepted, like listing two manufacturers to source the medical drugs and supplies from, are no longer allowed.
What worries me is that no matter how legitimate these concerns may be, their emergence will delay the procurement of lifesaving medication even further, seeing as there seems to be no contingency plan by the Ministry of Health to procure drugs for emergency purposes.
There was also the bombshell revelation that some audit findings from the office of the Auditor General (AG) may have been inaccurate.
Medical drugs reported as not delivered by the AG in his last report were apparently delivered.
The drugs in question were part of the consignment worth over E33 million, which the AG said had not been delivered to the Central Medical Stores (CMS).
It turns out that indeed, they were not delivered to the CMS storage facility but directly to some hospitals. I must say that this particular revelation made my head spin.
I tried to understand what it was that we had not been told and what exactly the drug procurement process entails. For now, I will not jump into conclusions but continue delving more into every legitimate documentation that comes up and thoroughly scrutinise it ,because honestly one needs to get to the bottom of this.
As I said above, my concern is that the patient on the ground is still bearing the brunt of the chaos. The shortage of drugs is real and relatives of those who are in hospital or have died bear grim testimony.
Here, I am reminded of what President of South Africa Cyril Ramaphosa said on the first day of the neighbouring country’s controversial national dialogue this past week. Ramaphosa said one of the pressing issues South Africa needed to address was why clinics ran out of medicine.
Health experts were quick with the retort that this particular question needed proper governance, not a national dialogue.
The experts told journalists that medicine shortages were caused by poor management, lack of live budgeting, unqualified Members of the Executive Council (MECs), provincial distribution failures, budget constraints and external supply chain problems.
They also cited brain drain, poor working conditions of health workers, mismanagement, and a lack of accountability and transparency in the health system.
It was stated that the MECs of health in the various provinces were not health professionals.
They also do not have to deliver to keep their positions. Sounds familiar?
In any case, that report in Newsday went on to state that the lack of essential health resources was a problem that had plagued South Africa for several years and was the leading cause of medical negligence.
Payouts for medical negligence claims reportedly increased by an average 23 per cent each year between 2014 and 2020.
Again, a report from Think Global Health revealed that clinical errors, mismanagement, lack of accountability, and inadequate facilities and equipment were primary causes of negligence in South Africa. In Eswatini, we have had a few cases of medical negligence being taken to court, with the plaintiffs complaining mostly about clinical errors.
There is not much evidence of such claims being filed on the basis of a lack of essential medical resources. Should affected emaSwati start filing such claims, for the two-decades long health crisis to be resolved once and for all?
I have said before that we have wasted acres of paper and gallons of ink on the health crisis in Eswatini and would have already stopped, were it not for the fact that we are talking about lives of taxpaying emaSwati and the lack of accountability among key players in the healthcare system.
As we speak, the very same South Africa has set aside the equivalent of E753 million to help fill the gap left by the United States of America’s decision to cut aid to developing countries. At least E268 million more will also be released in the next two years to pay researchers who lost their US grants. Here at home, we have not heard any formal announcement on how that gap would be filled. We were also affected by the aid cuts.
The last we heard was when Minister of Finance Neal Rijkenberg presented his Budget Speech in February.
He had acknowledged what was then a 90-day pause in funding from the US, saying, “Fortunately, the US government recently re-instated limited portions of its funding for urgent lifesaving HIV care and treatment services.”
The minister had promised that they would continue to work closely with the US Embassy “during this difficult time.” Isn’t it odd that even Parliament seems to have forgotten about this particular gap and has not raised any queries on how it is being filled?
Leave a comment