Anatomy of a sick nation: Patients suffer amid drug, vaccine shortage in hospitals
Health CS Susan Nakhumicha and State Department for Medical Services Principal Secretary Harry Kimtai during a meeting at Argyle Grand Hotel in Nairobi last month.
What you need to know:
- A spot check in hospitals and interviews with patients, however, indicated that there are no drugs in many public hospitals.
As the hospitals report a shortage of critical drugs that are on the country’s essential list, a number are also recording shortages of children’s vaccines.
The BCG vaccine, given at birth to prevent tuberculosis, has not been procured for eight months.
The country’s public hospitals are facing a severe shortage of essential drugs and vaccines, leaving critically ill patients without access to life-saving treatment.
Some of the most affected are HIV prophylaxis for children, painkillers, antibiotics, antidepressants, anticancers as well as antidiabetic drugs.
Also lacking are medicines needed in the performance of life-saving surgical procedures, such as anaesthesia.
The Nation has also learnt that the country has no syringes to administer vaccines.
The shortage exposes a deeper problem within the country’s healthcare system — inadequate financing, irregular and delayed release of funds for drug procurement and significant debts owed to international health organisations such as the United Nations Children’s Fund (Unicef) and Global Alliance for Vaccines and Immunisation (Gavi).
This has led to empty shelves in hospital pharmacies and rising despair among patients who rely on these drugs for survival.
It is not known when supply will be revamped, but Health Cabinet Secretary Susan Nakhumicha told the Nation that the shortage had been resolved, with some of the drugs already in the country and others expected next week.
Ms Nakhumicha explained that the challenges facing Kenya’s healthcare system are a reflection of the country’s health supply chain being broken and vendor-driven.
“A responsive supply chain is based on needs and once the needs are established, then data-driven quantification and forecasting is done to determine quantities for procurement. This is why I am focused on reforms. It’s not going to be easy to change, but I am determined,” she said.
Out of stock
Ms Nakhumicha also denied that nevirapine and zidovudine drugs were out of reach for many HIV-positive mothers with newborns.
“Those saying we are out of stock should check with the National Aids and STIs Control Programme (Nascop) on service and commodity security for HIV,” she stated.
“The country’s stocks of nevirapine cover 15 months while those of zidovudine cover 14 months,” the Health CS told the Nation, adding that global best practice expects them to have a minimum stock cover of at least nine months.
A spot check in hospitals and interviews with patients, however, indicated that there are no drugs in many public hospitals.
The Nation met 26-year-old *Joy Njeri, a newborn mum, outside Thika District Hospital in Gatundu South, Kiambu County, where she had camped from morning in search of paediatric HIV drugs.
It was her third day at the hospital.
Ms Njeri, who disclosed to the Nation that she was born with HIV, was at the hospital for drugs for her two-week-old baby.
“I am here because the doctors told me that they had run out of nevirapine and zidovudine, which are usually given as prophylaxis to a baby exposed to the deadly virus at birth so that they do not contract the disease through breast milk,” she said.
“I don’t want my baby to get HIV. I have been coming to the hospital with the hope that the vital medication will be made available. I was told to keep checking and that the hospital was inquiring from other hospitals if they had supplies.”
The same drug is missing in Kibra. Ms Zipporah Achieng’, a community health promoter and HIV warrior born with the virus, said she has been approached by parents who have run out of the drug.
HIV-positive
“They come to me because I am open about my HIV-positive status and have a three-year-old child who is HIV-negative. They want the same for their babies but unfortunately, the drugs that my baby was put on are out of reach for them.”
She disclosed that the situation is dire in Kibra with mothers who were lucky to get the sought-after drugs a few months ago sharing their doses with recent newborn mothers and putting their own babies in danger.
Ms Achieng’ is concerned that the country could be ‘silently breeding’ a new generation of HIV-positive children because the government has not made the drugs available.
As the hospitals report a shortage of critical drugs that are on the country’s essential list, a number are also recording shortages of children’s vaccines.
Many children being born now are going without the vaccines hence putting their lives at risk of contracting deadly diseases in future.
“There are also no doses of childhood vaccines like Bacillus Calmette-Guérin (BCG). My baby has not received any jab. I am concerned about where I can get the vaccine. I have been to many health facilities in Kibra and Mathare,” Ms Lucy Atieno from Dagoretti revealed.
The shortage will see at least 1.6 million infants, a similar number of pregnant women as well as 750,000 girls under the age of 10 who need the human papillomavirus (HPV) vaccine, fail to get them.
About 15,000 fewer children were vaccinated in April when the country started recording the shortages, but the number could be higher since the issue has not been resolved.
The HPV vaccine is given to girls under 10, who number about 750,000 every year. The remaining stock in some hospitals may not last a month.
A Ministry of Health insider told the Nation that the government has up to July 1 to clear a Sh1.5 billion debt for the last financial year to Unicef and Gavi so that Gavi can release their co-financing portion of Sh8 billion for this financial year.
Kenya, too, has to put Sh3.6 billion of its own into the scheme. This is because Kenya must submit its 20 per cent contribution to Gavi before the organisation releases its 80 per cent funding.
This is to put the country on a trajectory of self-sustainability and prepare it for the phasing out of Gavi backing.
“Last week, the government paid Sh1.25 billion to the international organisation and this opened the door for emergency procurement. The government has since requested Unicef to expedite delivery. We are expecting the first batch next week. But should the government fail to pay the Sh1.5 billion, then Gavi will withdraw its support, including equipment,” said the official.
According to documents seen by the Nation, Kenya has not procured the DTP (Diphtheria, Tetanus, and Pertussis) vaccine for 10 months, with public hospitals reporting shortages.
The BCG vaccine, given at birth to prevent tuberculosis, has not been procured for eight months.
Already, TB, polio, measles, rubella, pneumococcal conjugate vaccine (PCV), rotavirus, inactivated polio vaccine (IPV), measles-rubella (MR), human papillomavirus (HPV), yellow fever vaccine and malaria vaccines are out of stock.
It is recommended that a country has at least eight months’ stock of every vaccine in its supply chain.
Kenya’s current stocks of these vaccines may be exhausted in two months. This year, the government reduced the budget for vaccines from Sh2.6 billion to Sh1.2 billion, leading to unpaid bills and a shortage of Gavi-supplied vaccines.
Last week, a spot check by Nation in public health facilities around the country established that over 27 counties had run out of stock and were in dire need of key drugs and medicines on Kenya’s Essential Medicines List.
In an exclusive interview in the same week, Kenya Medical Supplies Authority (Kemsa) CEO Dr Andrew Mulwa disclosed that the authority was operating from hand to mouth given that as of May 29, all 47 counties owed it a total of Sh3 billion.
Kemsa gets 90 per cent of its business from counties and supplies drugs and medical equipment, giving counties a 45-day credit period.
“We are stocked up to 70 per cent,” Dr Mulwa said.
Therapeutic foods
He said that ready-to-use therapeutic foods, TB, HIV, malaria, Covid-19, cancer, blood transfusion as well as family planning/reproductive products are the most affected.
Kemsa also procures medical supplies on behalf of the health and development partners, this is then followed up with a distribution list for delivery to various targeted populations across the country.
Council of Governors Health committee chair Muthomi Njuki, however, told Nation that the allegations that counties owe Kemsa a lot of money hence affecting the delivery of drugs is a fresh plot to return the health function to the national government through a calculated smear campaign painting the devolved units as inept.
“As it stands now, counties have not received their equitable share from the national government for three months, including June, yet, the IFMIS system reportedly slowed down from mid-June, this is why we as governors cannot pay Kemsa the Sh3billion we owe them,” the Tharaka Nithi governor said.
He accused the national government of denying counties their equitable share of about Sh100 billion, adding that had the national government stuck to the law and disbursed resources on the 15th of every month, no county would be having a debt at Kemsa.
“A debt is not bad. The agreement we have with Kemsa gives counties a repayment grace period. Counties would not hesitate to clear debts owed if they receive money from Treasury,” Mr Muthomi said.
“The national government should also prioritise settling the Sh2billion pledge to Kemsa,” he added
