World Bank faults health sector supply chain
The World Bank has faulted Malawi’s health sector supply chain, describing it as disintegrated with a lot of parallel systems.
In an aide-memoire dated April 10 2015 whose findings were compiled by a World Bank mission on procurement for health sector under the Nutrition and HIV and Aids Project addressed to Secretary to the Treasury Ronald Mangani, World Bank country manager for Malawi, Laura Kullenberg, said the current set up is failing.
She said: “The Government of Malawi established the Central Medical Stores Trust [CMST] as a trust to manage all the supply chain activities for health sector commodities with a view to integrating existing parallel supply chain systems for the various programmes in the country. However, there has been limited progress recorded so far in integrating the parallel supply chain systems.”
The bank also said it felt recapitalisation of CMST is imperative as accountability and transparency were identified as major items for the trust to be restored in the national health supply chain system.
Reads in part the memo: “Capitalisation of CMST will enable it to carry out its mandate as a national supply chain agent for health sector commodities.
“This would entail improving physical infrastructure such as warehouses, replenishment of the transporting fleet, security and inventory and logistics information systems, among others.”
According to the communication, the mission, which was tasked to look into the recapitalisation of CMST, also found that it would be a major issue as funds to procure drugs are not only inadequate but not made available on time.
“Payments for drugs supplied to service delivery points are not honoured, not on time and in full, leading to debt accumulation with various supplies of goods and services. There is a huge gap between estimated drug budget based on actual quantification and budget approved by government,” reads the report.
However, Ministry of Health spokesperson Adrian Chikumbe differed with the bank and said it was not fair to say the current parallel supply chain system is disintegrated.
Said Chikumbe: “The parallel supply chain system was introduced to complement Central Medical Stores Trust’s efforts in supplying medicines for priority areas such as family planning, malaria and HIV and Aids which at the time required an enormous amount of resources within a short period. Several partners, therefore, had to come in with their support. We would not say the parallel system is problematic, but rather complementary.
“As for recapitalisation of CMST, we do not think it would have a direct effect on the supply chain. Actually, this was important when we were setting up the trust to enable it to stand on its own.”
On his part, Ministry of Finance spokesperson Nations Msowoya said government was aware of the challenges outlined in the memo, but said it planned to strengthen the capacity of CMST to enable it fully execute its mandate of procurement, storage and distribution of drugs and other medical supplies.
He said: “Some of the fixed assets of the CMST may need replacement, buildings maintained etc. At the same time, its working capital [needs to be] increased given the increased needs of the population.”
CMST is a public trust that sources medical supplies for public hospitals nationwide. Initially, CMST was operating as Cnetral Medical Stores, a fully fledged government department, before it was restructured and turned into a trust in 2010 to enhance efficiency. n
