Mutahi Kagwe's scorecard

When Mutahi Kagwe took his oath of office as Cabinet secretary for Health on Friday, February 28, 2020, he could not foresee that in a month, he would be Kenya’s proverbial Moses, a frontline soldier leading 52 million Kenyans in the fight against the  Covid-19 pandemic. 

And when the dreaded virus finally crept into our midst, Mr Kagwe had found his footing on the slippery floors of Afya House and everyone looked up to the son of Mukurweini to quell fears of impending death that had been witnessed in nations such as Italy.

Armed with documents and flanked by Health ministry officials, he appeared daily on national televisions, untiringly reminding Kenyans to wear masks, wash their hands and maintain social distance. Sometimes he would scold those who he deemed careless about their wellbeing and his “I can get it, you can get it” slogan spread across social media at a time when the country entered into full lockdown and employees started working from home. With each announcement, he detailed how many had gotten infected, been discharged, succumbed to the disease, and his visage became the new normal and representation of announcements and precautionary measures. He became the face of hope amidst despair for thousands of Kenyans who caught the virus. By training more health workers to support Covid-19 response, and enlightening county level leaders to share knowledge of Covid-19 testing, he taught Kenyans how to prevent the spread of the disease in their homes. He mandated that all 47 counties identify and designate at least one 
Covid-19 hospital, about three weeks after the announcement of the primary case, and asked retired health workers to return to work to lend a hand. 

However, his reign was also notably marked by the Kenya Medical and Supplies Authority (Kemsa) scandal in which 908,000 mosquito nets, 1.1 million condoms and tuberculosis drugs worth Sh10 million disappeared from its warehouse.

Global Fund, which finances the fight against HIV/Aids, tuberculosis and malaria, has also raised the red flag over suspected fake suppliers demanding Sh1.66 billion from Kemsa.

The lost medicines are believed to have been stolen and resold on the black market and to private chemists, shining a spotlight once again on Kemsa over its graft record.

Kemsa is also accused of overstating the value of medicines by Sh640 million, with some types of drugs having been inflated 100 times, says an audit by Global Fund. Some of the drugs, which were bought by cash from Global Fund, expired amid a shortfall in government hospitals.

This was preceded by revelations that Kemsa had been involved in a tender fraud over procurement of Covid-19 materials worth Sh7.8 billion in 2020. 

As a result, health workers lacked protection, which exposed them to infection, trauma and death, risks which were avoidable. Due to lack of support, health workers from at least five out of 47 counties went on a strike from June 2020 followed by doctors and clinical officers in August 2020. 

Human Rights Watch reported that health workers were not provided with risk allowances, nor did they have access to quality and affordable healthcare in case they got infected with Covid-19. Coverage of burial expenses in case they lost their lives was also thrown out of the window. Healthcare workers also complained that they were understaffed despite the government having a pool of trained but unemployed health workers to manage the demanding health sector, which resulted in overworked and stressed health workers, some of whom also complained of being underpaid. 

In his defence, the CS said there had been no inflated prices of Covid-19 products and that his ministry had done a lot of work at Kemsa to ensure things were done transparently. He added that he had dealt with cartels and that they would not dictate what he had to do at the ministry. In June 2020, the Pharmaceutical Society of Kenya released a report showing that health facilities were experiencing both drug shortages and drug expiries, with 75 per cent having a drug fill rate of between 50per cent and 70 per cent.  Supplier evaluations pointed to gaps in inadequate funds, delays in fund disbursement, staffing shortages and bureaucratic bottlenecks.

During research, eight sub-counties within Nairobi County were sampled, and 22 participants from departments concerned with management of medicines-including pharmacy, finance and procurement departments were recruited. The hiring was then questioned. 

The World Health Organization notes that drug shortage is multifaceted and is a global problem, affecting developed and developing countries. Medicines are a crucial part of healthcare and their availability is important to ensure patient’s access to quality and affordable services.  

Mr Kagwe’s era, however, shone a positive light on the sprouting of telemedicine apps and online doctors ,who offered services at a patient’s touch of a button. Consulting a health care provider over phone, video or text has become the new normal for many non-urgent medical needs, only requiring patients with urgent medical care to visit hospitals. The virus, it seemed, birthed the mushrooming of various online telehealth services that brought down the cost of access to medicare from the rural areas.

An analysis done by McKinsey and Company in July 2020 showed that over 40 per cent of patients were willing to continue using telehealth services, showing the possibility that virtual health would grow at record levels , as traditional healthcare providers also receive pressure to innovate. However, it is unknown whether the CS will retain his position in the next government as no presidential aspirant has listed his name as part of their potential cabinets. He will be remembered for his medicare rhetoric that helped Kenyans swim in catastrophic Covid-19 waters; but taxpayers will want to forget him for the mess at Kemsa where their millions of shillings were misappropriated under his watch. 

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