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CMS blames suppliers for drug shortage

Publishing Date : 03 September, 2018

Author : KETUMILE RAMATITI

Central Medical Stores (CMS) manager, Keletso Israel has blamed contracted suppliers for the current shortage of medicinal drugs in public health facilities, including at Princess Marina Hospital. The beleaguered health sector is currently grappling with a number of challenges, chief among them being shortage of drugs in clinics and hospitals alike.


While the CMS has been on the receiving end for drug shortages, the manager has however shifted the blame, saying that companies that benefited from the outsourcing exercise are the ones to blame. CMS is mandated to procure, store and distribute medicines and medical consumables to health facilities in accordance with its customers’ needs.


Israel has revealed to this publication that the centre ran open domestic tenders for framework contracts that run for 2-3 years. “Medicines supply chain is a global challenge. Procurement of medicines is complex with very high costs.  Active Pharmaceutical Ingredients (API) are produced in few countries leading to the complexity of the supply chain as countries across the globe compete for supply from the same manufacturers,” she told WeekendPost.


As of June 23, availability of medications at CMS stood at 62%. This is mainly for vital, essential and other non-drug commodities. This is despite the department’s P1.6 billion budget plus the P5 million on standby for emergency drugs at both Marina and Nyangabgwe hospitals.
It has been revealed that normal delivery time of medicine is between 4-6 months with short supply of required quantities. “Suppliers fail to deliver for different reasons some could be beyond their control, non-availability of APIs, refurbishment of factories or just downtime for general cleaning especially for primary manufacturing and lack of relationship with manufacturers,” Israel highlighted.


INTERVENTIONS

Faced with plethora of challenges CMS has decided to communicate with manufacturers of ordered commodities where possible.  “Suppliers are now being given the forecasted quantities before placement of orders as indication of requirements.” It is envisaged that this would be improved going forward to provide such details before the end of the calendar year for manufacturers to include Botswana requirements in their production pipeline for the following year.


Israel has conceded that there is need to improve end-to-end visibility within the supply chain from the manufacturer to patient Framework contracts. However, not firm orders but facilitation of procurement as and when products are needed. Hence this does not reduce delivery period. CMS continues to strive to provide commodities as needed to ensure availability of commodities. CMS orders in accordance with requirements from facilities to avoid over/under stocking in line with approved essential drug list. The Ministry continues to work hard to address the internal inefficiencies to improve service delivery


OUTSOURCING

In 2014, the Ministry outsourced its warehouse management and distribution services to improve services and availability at facility level. This was done to address challenges of unavailability of transport and long lead delivery times which created uncertainties at the facilities and lack of tracking of orders and deliveries.


“Outsourcing resulted with great improvement, where orders are logged through a call center operated by the third party service provider,” she said. Israel says the distribution turnaround time has improved from 3 months to 72 hours with 24 hours within Gaborone region.
Emergency orders are delivered within 24 hours; outsourcing has also improved systems hence daily receipts reports. The Ministry strives to provide commodities as much as possible especially based on disease burdens.  


The CMS manager said they procure approved medicines which are categorized according to vital, essential and non-essential. “Vital and essential are lifesaving products. These are prioritized for procurement; non-medical commodities include laboratory and other consumables. Medicines and non-medical commodities are acquired through the recurrent budget,” she explained. CMS orders in accordance with requirements from facilities to avoid over/under stocking in line with approved essential drug list.

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