Malawi doctors blame drug crisis on systems

Medical doctors on Monday blamed the drug crisis in Malawi on inadequate funding, long and bureaucratic procurement processes, the centralised health system and use of intermediaries to buy drugs.

The doctors expressed these sentiments during their crisis meeting with President Joyce Banda in Lilongwe soon after the President arrived from South Korea.

Minister of Health Catherine Gotani-Hara last week said the current drug crisis has left the country with an almost 95 percent stock-out of essential drugs, especially in district and central hospitals.

In Monday’s meeting, Dr Ronald Mataya of the University of Malawi’s College of Medicine described the country’s situation as a shame in letting people die due to lack of basic drugs. He said the drug budget should be reviewed and matched with the actual cost of treatment if the country is to do away with persistent drug shortages.

Mataya also said government should consider decentralising the health system to allow more ownership and easy supervision of the country’s public medical facilities.

“A centralised system is the most inefficient system of running a health system. We are told that it takes two years to procure drugs, I think that is total negligence,” he said.

Giving an overview of the situation in district hospitals, Nsanje district health officer Dr Medson Matchaya said the situation in referral hospitals was a reflection of what is happening in district hospitals as most patients are referred to central hospitals because there are also no drugs at district level.

Ministry of Health Principal Secretary Dr Charles Mwansambo confirmed that the situation is at a crisis level, especially in referral hospitals. However, he expressed hope that the situation would soon stabilise as the tender process for both emergency and normal drugs has been finalised.

Mwansambo agreed that use of intermediaries by the Central Medical Stores Trust (CMST) and the bureaucracy in the system were a problem.

Director for Kamuzu Central Hospital (KCH) Dr Noor Alide said the other problem was the budget allocation system which is based on a set formula rather than the actual costing of the needs of individual hospitals.

In her response to the issues, the President observed that despite the problems, there is need to put systems that would check drug theft in hospitals which many of the officials attributed to lenient punishments from the courts on those who are caught stealing the drugs.

She promised that government will work on the issues raised and also that the meeting has given her several pointers that would assist her to draw up an agenda on how to deal with the problem with the help of the experts in the health sector itself.

Two weeks ago, doctors from KCH published an open letter to the President and the public to draw attention to the acute shortage of basic medical provisions at the referral hospital.