swaziland times

BABAN – Is the investigation into drug shortages fair?

This is because the government hired more than 100 companies to supply medicines to public health institutions between 2021 and 2023. However, it is not clear whether there is reason to single out one supplier for defamation. Evidence shows that more than 100 companies were paid 1.21 billion euros for the supply of medicines and drugs in the 2021-2023 financial year. In fact, the government made about 122 payments. This is not to say that these companies did not supply medicines after the Ministry of Health paid them. But it must be pointed out that all audit documents seen and analyzed by this newspaper indicate that these companies may also assist in investigating drug shortages.

Ten suppliers were paid high amounts, of which EGP 609.6 million was shared by eight companies not linked to the current center of controversy. The audit sample covers the years 2021 to 2023. In 2021, the selected entities were paid EGP 137 million and EGP 128.17 million, and in 2022 EGP 84.3 million. In 2023, EGP 300.7 million and EGP 100.2 million were paid to other companies for the supply of medicines. Two other entities shared EGP 57 million. In 2021, three companies also shared EGP 53.6 million. In 2022, three suppliers were paid EGP 90 million for the procurement and delivery of medicines to the government.

There were 15 payments made to the list of 10 high-paying suppliers. Five of the payments went to the most criticized companies and their subsidiaries. Ten payments went to eight companies that made the list of high-paying suppliers. On average, the more than 100 companies received payments between €50,000 and €10 million. It is not clear why one of the companies did not make the list of high-paying suppliers, as it received a payment of €25 million. The one with the least payment among the 10 high-paying suppliers received €11 million.

Reliable sources said the drug shortage issue was complex and difficult to attribute to the inability to supply or deliver drugs. They said that at some point, delivered drugs were allegedly stolen from the central pharmacy and there were also rumors that officials from certain public health institutions instilled a culture of selling drugs and medicines to some pharmacies. “Ultimately, the problem must be viewed as a whole, rather than adopting narratives that narrow the problem down to one factor,” the source said.

A senior government technocrat said the issue of drug shortages must be understood in the context of the Proposal and Audit of Forensic Investigation of Procurement, Distribution and Management of Medicines, which was prepared by Auditor-General Timothy Matsebula and tabled by Neal Rijkenberg in March 2023. At the time, the technocrat said emaSwati was preoccupied with civil unrest and the assassination of Thulani Maseko and never bothered to focus on drug shortages.

“Many of the issues raised at the time went unnoticed by us because the unprecedented and shocking factors distracted us from the civil unrest,” the source said. In the published report, Matsebula stated Medicines worth EGP 151.6 million are missing or unaccounted for. Medicines worth €9,308,963.02 are missing from Mbabane Government Hospital, while medicines worth €2,283,688.91 are also missing from Piggs Peak Government Hospital.

“This clearly shows that some medicines were stolen after arriving at the hospital,” the source said. The Siphofaneni clinic did not record medicines worth €111,089.08 and the Mpolonjeni clinic had medical medicines worth €45,990.19 unaccounted for. It was observed that the total amount of missing and/or unaccounted for medicines in the 2021 and 2022 financial years was €18,793,823.99. It must be noted that the Ministry of Health admitted to the loss of medical medicines worth €5,848,589.89. This was reported in the medical medicines trading account for the financial year ending March 31, 2022.

Attorney General Matt Cebula found in his own investigation that the main reasons for drug shortages in the country are as follows:

• Weak information management systems;
• The artificial control environment is weak;
• cash flow constraints;
• There is a shortage of human resources due to a hiring freeze and fuel shortages.

Medicine theft is an old problem. In October 2018, medicines were stolen from the Central Medical Store (CMS) and a police investigation resulted in the arrest of two civil servants. They appeared in the Matsapha Magistrate’s Court and were charged with stealing government medicines. Medical sterile gloves were also stolen from CMS, leading to the arrest of three other civil servants. Two other men were also arrested and charged with stealing government medicines from CMS. Our sister publication Eswatini News reported in June 2023 that an internal report from the Ministry of Health revealed how some employees stole medicines from CMS.

The ministry acknowledged that drug theft did lead to shortages. In an investigation launched by the Department of Health, two former CMS employees recounted how they stole drugs from shelves without anyone noticing. The health ministry has tasked a three-member panel to look into the matter under the provisions of Section 41 of the Public Service Commission (CSC) Act 1963 and Government General Order A944.

The police raided a staffer’s rented apartment in Matsapha and arrested him after finding him in possession of government medical drugs from CMS. He allegedly revealed during police investigation that he had stolen the drugs in collaboration with others from CMS. “We cannot ignore the problem of drug theft either. It is another serious cause of drug shortage. The drugs are in sufficient supply but are stolen,” the source said.at the same time, The more than 100 companies and the 10 highest-paying suppliers cannot be named because the audit documents do not show any wrongdoing, simply showing taxpayers where his money was spent.

However, sources and analysts said that if all audit documents are carefully read and analyzed, it becomes clear that the problem of drug shortages is complex and needs to be addressed fairly and comprehensively. For example, the source mentioned in The Sunday Times the query raised by Auditor General Timothy Sifo Matsebula to the Ministry of Health in the report submitted to Parliament. Matsebula said that in the fiscal year ending March 31, 2023, the Ministry of Health transferred funds of EGP 281,162,369.68 from the Consolidated Fund to the National Emergency Response Committee for HIV/AIDS (NERCHA) for the procurement of medical drugs (antiretroviral drugs).

A foreign company called iPlusSolutions delayed the delivery of medical drugs (antiretroviral drugs) for which it had been fully paid. “Do you see the problem now? A foreign company is also involved. It delayed the delivery of drugs despite having been paid,” the high-ranking source raised this concern. In order to make this issue known to our newspaper, our source tried to solve the mystery and now gave a sum of 138 million euros. Matesbula pointed out that the National Emergency Response Committee for HIV/AIDS (NERCHA) paid three advance payments totaling 221.8 million euros to the above-mentioned foreign supplier.

The crux of the matter is the undelivered medical drugs (antiretrovirals) amounting to 138 611 473.70 euros. “The lack of coverage of these issues in the media is worrying. Audit inquiries have revealed that some purchase orders PO7278 were under-delivered by up to 6 245 679.00 euros,” the source said. Other orders were under-delivered by up to 48 million euros. “We never hear the media and civil critics calling on all companies to be responsible for drugs, but only hear you point to one or two of them,” the source said.

At one point, Attorney General Matsebula raised concerns, for example, that NERCHA had left 138.6 million Egyptian pounds in the hands of foreign suppliers. Expired and dumped medicines were also found in several institutions, including the King Sobhuza Clinic, Lobamba Clinic and Mbabane Government Hospital. In an interview, Thembinkosi Dlamini, executive director of the Conference of Coordinating Non-Governmental Organizations (CANGO), said forensic audits typically “don’t go after the person doing the transaction, they go after the transaction itself.”

He suggested that the starting point should be deciding what is a reasonable sample, such as 10%, 15% or 20% of all transactions? “Once the sample is drawn, all transactions in the sample are scrutinized whether they follow the established procedures and reasonableness, that is, whether the prices are not superficially inflated. If the answer is yes, then the secondary investigation will look at the relationship between the role players, who may include company owners and government officials,” Dlamini said. It is based on the sample and the discovery of “hard evidence” that the audit results are reached, he said.

The Executive Director mentioned that the conclusion of the sampling audit may be to conduct a larger sample audit or to conduct an overall audit. “It may be a race against time with scarce resources. It is therefore not possible to draft the terms of reference with a 100 per cent sample size. What if after two years of auditing and spending €2 billion you find nothing actionable? ” Dlamini said the audits risked becoming, like the South African State Capture Commission, another wasteful and futile expenditure that would not provide any return on investment or value for money to the exchequer.

Health Ministry Secretary General Khanya Mabuza did not respond to our questionnaire, but this newspaper can reveal that the ministry has suspended nine officials over drug procurement issues. The employees have appealed to the courts. The Office of the Auditor General issued a statement clarifying its work. It said that as the supreme audit institution, it was deeply concerned about the continued unfounded allegations against the office. The Office of the Auditor General said its audits were intended to provide credibility The Auditor General said accountability, transparency, efficiency and effectiveness in the use of public funds are all tested and validated by audits.

South African police arrest four for suspected drug theft

Not long ago, four suspects were arrested in the Eastern Cape Province of South Africa for the theft and trafficking of public medicines worth about 200,000 euros. Police arrested three women and one man. According to reports, some of the stolen medicines were allegedly found in their homes. The police launched an investigation with the help of the provincial health department when they received information that the medicines that were originally intended for distribution to public hospitals and clinics were sold by officials for personal gain. The medicines were allegedly stolen from the warehouse of the provincial health department and sold to private doctors and pharmacies.

A 32-year-old male On 9 February 2023, a suspect was arrested in Bergman Square near Bloemfontein for carrying suspected stolen antiretroviral drugs. Using BroadCast Unitedligence, members of the Mangaung Metro Tactical Response Team identified a suspect in possession of antiretroviral drugs with the intent to sell them illegally. The team arrived at the designated house and conducted a search. Three boxes containing bottles of Adco Lamivudine, Zidovudine, Aluvia and Euthyrox were found under the bed and confiscated. The drugs were labeled with the name of the pharmacy and prescription details. The street value of these antiretroviral drugs is estimated to be 40,000.00 Egyptian pounds. The 32-year-old suspect was arrested and a case was opened at Bromspruit Police Station for possession of suspected stolen property and violation of the Drugs and Related Substances Act.