Patients have been forced to buy medicine from private pharmacies due to shortage in public health facilities.

The shortage was flaged out by the Auditor-General’s office, which revealed that for about four years Medical Procurement and Production Division (MPPD), supplied overall essential medicine below the demand.

According to Obadiah Biraro’s report, between July 2016 and September 2019, MPPD supplied only 29 per cent of the overall needed essential medicine in the country.

The report added that the low supply of essential drugs undermines existence of MPPD to serve public health facilities.

The Rwanda Biomedical Centre (RBC) central store experienced stock out of essential medicines in the range between 54 per cent and 71 per cent over a period of three years, reads the report.

Interviews by Rwanda Today with over 10 directors of referral, district and health centres in the country found that the facilities acknowledged the shortage, saying they had to devise ways of getting drugs for poor patients who cannot afford to buy them from private pharmacies.

Rwanda Today learnt that the department served only one-third of the orders of essential medicine received from the district pharmacies.

The Auditor-General’s report further indicates that placed orders including Drugs shortage now pushes patients to private pharmacies emergency for some medicines were not available in the stock.

Delays

This affected distribution and availability of essential medicines in health facilities and impacted negatively on the quality of healthcare services provided to the population.

Dr Pascal Nkubito, director general of Muhima Hospital said medicine stockouts are a result of delays in procurement, which is handled by Medical Procurement and Production Division.

“The process involves us sending a list of drugs to MPPD, which then requests bids from suppliers.

“However, MPPD tells us that because district pharmacies delays to provide the list of required drugs, that is why there are also delays in procurement hence delaying the acquisition of drugs,” he said.

“I don’t think it is the reason behind the low supply of drugs by the procurement division because the analysis indicates that public hospitals use the system at above 70 per cent," he said, adding "this implies that we are doing well complying with the use of the system," says Dr Nkubito.

Dr Nkubito said though the shortage may result from hospitals failure to use the Electronic Logistics Management Information System, the supply chain need to be well harmonised.

“Inadequate management of the medicines supply chain is a major contributing factor to the countrywide shortage of drugs especially by district hospitals and health centres,” said Dr Nkubito.

Dr Uwizeye Marcel, director general of Masaka Hospital said the tender and procurement process takes between 90 and 120 days, but can sometimes take up to six months.

“It is clear MPPD cannot just do the replenishment of the drugs without having orders from district pharmacies, which later supplies the district hospital and health centres.

Without having a well-harmonised supply chain of drugs, the country will continue to experience a shortage of essential drugs,” said Dr Uwizeye.

Celsa Muzayire Gaju, head of medical procurement and production division at RBC, said the agency relies on electronic logistics management information system (e-LMIS) data from all district pharmacies and hospitals to order for them to procure a new stock of drugs.

“Hospitals failure to indicates the required type and quantity of essential drugs needed before the stock-out it’s what is causing the shortage,” said Ms Muzayire.