Devolution of health services opens new battlefront in drugs procurement

By JACKSON OKOTH

KENYA: County governments will no longer have to buy their drugs and other essential medical supplies from state-controlled Kenya Medical Supplies Authority (Kemsa).

This unfolding scenario will open up the lucrative drugs procurement space to competition, pitting the authority against private players.

With the March 2014 deadline to use up their stocks fast approaching, many counties are already considering a future without Kemsa.

Disease burden

“We have already mapped the region’s disease burden as well as patterns. What we are doing now is pre-qualifying those who tendered to supply drugs. What Kemsa offers will be compared with what competing suppliers present,” said Dr Charles Githua Githinji, the Nyeri County executive officer in charge of health.

At present, all public health facilities in the country have a special arrangement with Kemsa, which receives payment for deliveries from the ministry of Health.

“The procurement process is now open, and we can order for supplies from any source. This is as long as the prices are competitive, supplies meet quality standards and public procurement rules that prohibit single sourcing are followed,” said Dr Githinji.

But even as county governments plan to go it alone, it is acknowledged that Kemsa enjoys economies of scale due to its large network, and quality assurance from its high-tech laboratories.

The other big player in the drugs supplies business that county governments are likely to consider is the Mission for Essential Drugs and Supplies (MEDS).

Kemsa has been accused of not being sensitive to the unique needs of the counties.

“While Nyeri has more cases of diabetes than Kisumu, which has more malaria patients, both these counties are given the same medical supplies kit,” said Githinji.

Public health facilities

But with the devolution of health services, each county can now create its own drugs list, depending on requests it receives from public health facilities.

This arrangement is expected to eliminate frequent reports of expired drugs as each county procures only what it needs.

Kemsa, however, has denied knowledge that there are counties intending to break away, and warned of the dangers ahead if they do so.

The agency insists that it has over the years built structures and systems that guarantee quality and safety of its medical commodities. These include a well-equipped laboratory, experienced personnel, storage facilities, post-distribution surveillance systems and suppliers’ audit mechanisms in line with World Health Organisation guidelines.

“It has taken us time and resources to build these systems and structures to the current levels. In the absence of the above, there are real dangers of sub-standard products and even counterfeits penetrating the public health supply, endangering the lives of Kenyans,” said Dr John Munyu, Kemsa’s CEO.

So far, 20 county governments have made a deal with the supply agency to support delivery of healthcare products to their respective regions.

The agency says it is currently accredited as a procurement and supply agent by several international agencies, donors and development partners.

“Loss of this strategic position could have adverse consequences. For instance, without a central supply system, response to emergencies, national disasters and disease epidemics will be compromised,” Dr Munyu added.

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