Cancer patients to wait for local treatment

Cancer patients will have to wait a little longer for local specialised treatment as the building of an oncology (cancer) centre, initially scheduled to start early in 2016 has been delayed.

Principal Secretary for Health Macphail Magwira said in an interview this week that the delay is due to the need to work out cost escalations following depreciation of the Malawi kwacha.

But there are indications that political posturing also shoulders part of the blame.

The kwacha was at about K415 to the dollar at the time Parliament approved a loan for the project in October 2014. Now it is at about K650, a   depreciation by nearly 56 percent, raising the cost of building materials.

The approved loan worth $13.15 million (about K8.5 billion) from the Organisation for Petroleum Exporting Countries (Opec), was for a cancer facility in Lilongwe.

But Magwira now says government has decided to also have another centre in Blantyre.

When authorising the loan, Parliament said the cancer facility would be built in Lilongwe in the Central Region—the political stronghold of   Malawi Congress Party (MCP).

The Lilongwe location was a reversal of President Peter Mutharika administration’s earlier plan-as proposed in the bankable proposal—to build it in Blantyre in the Southern Region, the ruling Democratic Progressive Party’s (DPP) home stronghold.

In fact, the bill authorising the loan was almost shot down in the House over the cancer centre location question and only passed when government gave in to the largely opposition pressure that it should be built in Lilongwe, not Blantyre as tabled.

At the time, Finance Minister Goodall Gondwe argued that government chose the Blantyre location because the cancer centre has to be built near a medical training institution; (probably near College of Medicine) while the opposition said it wanted Lilongwe because it is at the centre of the country, thus easing access by patients from any region.

Finance spokesperson Nations Msowoya said yesterday the Blantyre facility will be built with a grant from the Chinese government and will cost about $20 million.

Magwira said the ministry has already identified three contractors who are expected to bid for the construction of the cancer centres in Lilongwe and Blantyre.

He said the project would be implemented in stages and that money for the initial phase is available.

The PS said government was doing all it could to speed up the project, which includes training of specialised doctors who will take charge of the centres.

Some interested group also questioned the costing of the building and use of a single source format to hire a building contractor as well as supply equipment.

They argued this was against the Public Procurement Act which stipulates that any contract management project of a large sum of money should be subjected to open tendering and that two or three interested bidders are supposed to bid.

They advised the ministry to review the current planning and cost estimates for the development of the country’s first ever comprehensive oncology services.

They cited lack of competitive pricing as their major area of concern for single sourcing.

They also asked the ministry to split the bidding process into two parts—one for building and the other for supply of equipment.

The group also queried the ministry why the public organisation involved in the procurement process has authorised one contractor for both the building and the supply of equipment instead of splitting the tender into two segments.

They further asked MoH why it awarded such an important and specialised project to a building contractor to supply equipment rather than a medical equipment specialised company.

Parliamentary Health Committee chairperson Juliana Lunguzi said she was surprised that construction of the centre will be delayed because of recosting the works, as the loan was acquired in US dollars, which has not depreciated.

MoH spokesperson Adrian Chikumbe said the ministry had not been communicated to about any queries regarding the tendering of the cancer centre.

He also said the ministry followed all necessary procurement protocols.

Said Chikumbe: ‘‘It advertised the tenders accordingly, and prospective contractors submitted their bids.’’

But the delays will hit the poor harder than the politicians and technocrats who can either afford or easily get tax-payer funded cancer treatment abroad such as in South Africa, Tanzania and Zimbabwe; leaving the poor on a long waiting list.

The delay is also a cost to government because, according to MoH, on average, Capital Hill spends around $12 000 (around K7.8 million) per patient to get cancer treatment abroad. n