Development partners, who help Malawiâ€™s health sector through Health Sector Wide Approach SWAp), have lifted a funding suspension they effected in 2011.
The suspension, lifted in July this year, worsened an already volatile drug situation in the countryâ€™s hospitals, resulting in some critically ill patients being sent back home empty-handed.
The lifting of the suspension follows progress the Anti-Corruption Bureau (ACB) has made on investigations into forensic procurement audit of 2010 as demanded by donors.
UKâ€™s Department for International Development (DfID) confirmed it has already disbursed Â£25 million (K13 billion) into the health sector strategic plan which runs from 2011 to 2016.
DfIDâ€™s programme manager for results and evaluation team Lista Amon said in an e-mailed response to a questionnaire that DfID was satisfied with governmentâ€™s commitment to respond to audit queries; hence, the SWAp funding.
Said Amon: â€œMinistry of Health has responded to forensic audit findings and developed a procurement and financial management improvement action plan.
â€œACB is investigating some of the forensic audit findings. Ministry of Health, together with development partners, have designed a Heath Sector Strategic Plan (HSSP) 2011-2016, which is a successor programme to health SWAp One, 2004/05 -2010/11 financial year.
â€œThe HSSP has been implemented for almost a year now and is due for its first annual review from October 3 to 5 2012. DfID has already disbursed Â£25 million into HSSP.â€
Norway Ambassador to Malawi said in an interview the SWAp funding suspension was lifted after government showed some commitment to deal with audit queries which worried donors.
â€œNorway resumed funding to the Health Sector Wide Approach (SWAp) in July 2012. The suspension has been lifted. Norway supports the health SWAp with NOK180 million over three years, 60 million out of which has been disbursed this year,â€ said Eidhammer.
Other donors who have agreed to support the health sector over this period include Germany, Norway, Unicef, UNFPA, the Flemish government, according to Ministry of Health spokesperson Henry Chimbali â€œbesides their support towards the emergency drug procurement project that started in January 2012 and ends June 2013.â€
ACB senior public relations officer Egrita Ndala confirmed the probe into the audit findings and gave the status of the investigations: â€œACB is conducting investigations in relation to health SWAp. The investigations are at an advanced stage. We cannot give the results of the investigation at this point as the matter is not yet concluded.â€
Chimbali said in the fiscal year 2011/2012, only DfID supported the health sector with about K4.2 billion and that Britain has signed an agreement with Malawi to provide Â£110 million (K57 billion) under the joint financing agreement over a period of five years (2011 to 2016).
He said UK has also committed to supporting family planning with an extra Â£25million pounds (K13 billion) outside the health sector.
â€œThis money is not for drugs only; it is for the entire health sector operations over this period,â€ said Chimbali.
Health SWAp agreement expired on June 30 2011 and the donors stopped providing support through government following a forensic procurement audit of 2010 conducted by SWAp donors through RSM Tenon Limited.
The donors abandoned the SWAp agreement and introduced an emergency drug kit arrangement through which drugs are distributed to health facilities excluding district and referral hospitals.
According to DfID, the emergency drug kit agreement started on November 1 2011 and will end on June 30 2013 and, so far, 7 009 kits have been distributed from January to September 2012.
Despite the resumption of SWAp and the continued emergency drug kit programme, the country continues to experience shortage of drugs. A visit to some health facilities that include Chileka, Chilomoni and Limbe revealed that the emergency drug kit contained insufficient drugs that could not last even a week. It was also reported by health officials that the kit did not contain some crucial drugs.
But Chimbali said the drug kits are for primary health care. He further said any extra drugs have to be procured by respective district health offices and so any gaps that may be observed could be attributed to other factors, â€œbut currently, the emergency drug kits are assisting hospitals to cope with the primary health care demands.â€
Malawi Health Equity Network (Mhen) executive director Martha Kwataine attested to the drug shortage.
She said: â€œThere are indeed challenges with drug shortages despite the several funding initiatives. The current shortage is not only attributed to financing challenges but also drug supply and chain management challenges that have been in existence for some time.â€
Kwataine, however, welcomed the resumption of SWAp: â€œThe fact that SWAp Two has commenced is a welcome development. Other factors constant, Mhen expects better health service delivery [while taking] on board lessons learnt from SWAp One. All stakeholders should work together closely to ensure that SWAp Two succeeds and meets its intended objectives.â€Â