Drug shortages persist despite recent supplies 

District health officers in Rubanda, Rukiga, Kabale, Kisoro, and Kanungu all reveal that they last received drug supplies from the National Medical Stores(NMS) in November, resulting in absenteeism of some health workers from their work stations.

“We are experiencing serious drug stock -outs in Kisoro District because the last supplies we got were in November. Patients who visit our health facilities are only diagnosed and referred to private pharmacies to buy the drugs. Those that cannot afford have been telling us that they use herbs,” Dr Stephen Nsabiyunva, the Kisoro District health officer, says.

When drug stock-outs were first reported in various hospitals across the country in January this year, the government attributed the crisis to financial bottlenecks that had crippled its operations across the country this financial year. 

This scenario, which was later addressed, saw some of the patients who entirely depend on government drugs, miss between two and three cycles of supplies.  Despite the persistent drug stock-outs, the Kanungu District Health Officer, Dr Birungi Mutahunga, insists health workers have to report to their work stations daily to provide other health services.

“I have directed all the health workers to remain at their work stations to offer other health services such as screening patients, guidance and counselling services to HIV/Aids patients since their drugs are available. Patients that require laboratory services should be attended to, since the reagents to use are also available,” Dr Birungi says.

In Bugiri District, health centres are also still waiting to get supplies from NMS.
Mr Yassin Mwase, the chairperson of health management unit at Nanderema Health Centre II in Kapyanga Sub-county, says the facility received some drugs late last month after waiting for three months.

Mr Mwase adds that the facility registers more than 50 patients daily from the neighbouring Bugiri Primary School and Nakavule Primary School, with most of them suffering from malaria and skin diseases, however, the scarcity of drugs remains a problem, prompting some patients to be referred to Bugiri Hospital.

In Jinja District, the chairperson, Mr Moses Batwala, says health centres received drugs, but the quantity was a quarter of the usual disbursement.
“I can confirm that all the health centres in my district received drugs, but it was very little compared to what we were expecting,’’ Mr Batwala says.

Mr Batwala, however, reveals that there are promises that more drugs will be dispatched to the health facilities.
In Mbale, at Namanyonyi Health Centre III in Mbale Northern City Division, staff say they have taken three months without drugs.

Mr Juma Mafabi, who took his daughter to the facility for treatment on Tuesday, says the health centre is the only nearby facility in the area.

“Whenever we visit the facility the health workers either refer us to Mbale Regional Referral Hospital or advise us to go and buy drugs from private pharmacies,  which are expensive,”  he says.
The health centre serves a population of more than 40,000 and it receives between 150 and 200 patients daily.

Dr Albert Kalyebi, the officer-in-charge of Namanyonyi Health Centre III, acknowledges the problem of the lack of drugs.  
“We have indeed spent three months without getting any supply and currently we don’t have all essential drugs, including Panadol,” Dr Kalyebi says.

The Resident District Commissioner of Mayuge, Mr Elijah Madoi, says all health centres received drugs, however, there is no “transparency” in the distribution of medical supplies. “It is very complicated to know whether the supply [of drugs] is worth the money that has been allocated to health centres. I call for an automated system to show where the balance of the money allocated for the supply of the drugs is in order to build trust with the public,” he said.

In some instances, NMS attributes the drug stock-outs to supply chain issues where it receives orders for medicine deliveries from the administrators of healthcare facilities on papers, which sometimes go missing.

In order to resolve the issue, NMS and United States Agency for International Development (USAID) recently collaborated to develop the NMS+ enterprise resource planning (ERP) system as a way of digitising the healthcare supply chain. With this innovation, the daily operations of purchasing, accounting, and ordering medications from NMS have since been digitalised.

In Kaliro, the RDC, Mr Aggrey Fred Bangu, says the district received drugs a week ago, adding: “Although we recently had a drug stock-out countrywide, it is no longer a challenge because we got some drugs, which were sent to facilities.”

Mr John Lukoki Magezi, the Ngora deputy RDC, says he has not received any reports of a shortage of drugs, but the only reports suggest delays from the NMS to supply the drugs for up to two weeks.

In Sembabule District, at Mateete Health Centre III, local leaders say drug shortages have paralysed operations.
Mr Jude Mubiru, the officer-in-charge of the health centre, says the facility currently serves more than 32,000 patients yet the drugs they receive can only cater for 2,000 patients.

“The facility is now serving a big number of people, the medicine supplied to us is supposed to last two months, but we find ourselves finishing it within a month and our patients have to buy from outside,” he says. 

Mr Ssenyonga Baker Byayi, the chairperson of Miteete Sub-county, wonders why the government has failed to provide adequate medical supplies to public health facilities in the countryside.

“This is something I am going to address to the State minister for Health in-charge of General Duties, Ms Hanifa Kawooya. It is good she comes from this district,” he says.  
Ms Sheila Nduhukire, the NMS spokesperson, has reportedly been on leave and both her known telephone contacts could not be reached by press time.

The Ministry of Health Spokesperson, Mr Emmanuel Ainebyoona, yesterday declined to comment on the matter, referring the Monitor to Mr Moses Kamabare, the general manager of NMS, but all repeated phone calls to his known telephone contacts went unanswered since Tuesday. 

Obongi
In Obongi District, Mr Dominic Lomurechu, the acting health officer, says they are experiencing a drug stock-out in the health centre IVs.  He reveals that the district has not yet received both their third and fourth cycle of supply from NMS.
“We have run out of injectables and some essential medicines. We only have anti-malarial drugs and we have been depending on partners such as Medical Teams International (MTI),’’ he adds.

He says they had made a request from MTI through the UNHCR to consider supplying drugs to health centre IVs, which is the most affected. “The demand for drugs is high due to the influx of the refugees in the area,” Mr Lomurechu says. 

In Adjumani District, Dr Dominic Drametu, the district health officer, says the district only received drugs from NMS in the first and second circles, but has not yet received circle three and four.
“Due to the high number of refugees and the nationals, the drugs supplied in the first circle and second circle are all utilised,” Dr Drametu says.

In Terego District, the officer-in-charge of Ogua Health Centre II,  Ms Sauda Tuku, says the health facility has been without drugs for two consecutive months. 

“We serve a total of more than 5,000 residents and currently have run short of drugs. We only have some small tins of anti-malarial drugs which will take us for a few days,’’ she says.
In Bukomansimbi, officers-in-charge of Kitanda Health Centre III, Butenga Health Centre IV and Bigasa Health Centre III – all say they last received drugs on December 12.

“We currently offer only counselling services,” Mr Julius Musibula, the clinical officer at Kitanda Health Centre III,” says.

Western region
The officer-in-charge of Bwizibwera Health Centre IV in Mbarara District, Dr Richard Atuhairwe, says they last received a supply in December last year.

“We have been promised to receive [drugs] this month, so we are hopeful that by the end of this month, we will get them. It is not easy, patients have to buy drugs from the nearest pharmacy,” he says.

Dr Atuhairwe asserts that as a health centre, they are managing the situation by purchasing essential drugs, especially for expectant mothers, from nearby pharmacies to save lives.

Dr Vian Namanya, the in-charge of Bushenyi Health Centre IV, says: “We last received drugs from NMS on December 20, 2022, and we are supposed to get them after every two months. We expected another batch last month, but we never received it. Nowadays, we prescribe and patients buy drugs from private clinics.” 

The in-charge of Kinoni Health Centre IV in Rwampara District, Dr Rashid Mugabe, says: “We restored getting drugs from lower facilities in the district like health centre IIs and IIIs which have excess, but even though we go there, most of them do not have drugs.”

“The number of patients being admitted to the facility reduced because they travel for long distances and they don’t find drugs at the hospital,” he adds.

Compiled by Al-Mahdi Ssenkabirwa, Philip Wafula, Abubaker Kirunda, Tausi Nakato, Denis Edema & Asuman Musobya Fred Wambede, Robert Muhereza, Naume Biira, Felix Warom, Marko Taibot, Ronald Acema, Felix Ainebyoona, Coslin Nakayiira, Milton Bandiho, Gertrude Mutyaba & Brian A Kesiime.

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