•Global Fund also fingers the Kenya Red Cross Society for malpractice.
•Kemsa chairperson Mary Mwadime admits the authority has been grossly underperforming and unable to meet its clients' urgent needs.
Image: MAGDALINE SAYA
In 2018, Kenya was the only country in Africa that Global Fund commended for its excellent drugs supply system.
The Fund said the Kenya Medical Supplies Authority was doing such an excellent job that other countries should come and learn from it.
"Procurement processes are able to get medicines at cheaper prices than the Global Fund’s pooled procurement mechanism," the fund's Office of Inspector General said in its 2018 audit report, covering 2016 and 2017.
Four years later, the Fund says Kemsa has become so inefficient that, after payment, it takes 406 days to deliver malaria drugs and in some cases delivers nothing.
What changed? Kemsa chairperson Mary Mwadime admits the authority has been grossly underperforming and unable to meet its clients' urgent needs.
"This state of affairs had endangered the lives of Kenyans and gravely threatened the realisation of Universal Health Coverage (UHC), which is critically predicated on a successful and optimally operating Kemsa," she said in a statement.
However, Mwadime, whose board was appointed April year, says they are already reforming the authority.
"We wish to confirm that commendable progress has already been made," she said in a statement.
"Within the last six months, critical reforms have been achieved and the board evaluation matrix confirms that we have achieved a 65 per cent progress rate against the targets set to be achieved by mid this year," she added.
Last week, in its 2018-2021 audit, Global Fund complained after Kemsa took about 406 days after receiving funds in 2020 to finally deliver malaria medicines in Kenya last year.
This resulted in a year-long stockout of some malaria drugs in many hospitals, with some facilities receiving no drugs for more than 480 days.
The investigation by Global Fund also shows the authority also took about 348 days after receiving funds, to deliver TB drugs and related supplies.
The supplies were meant to boost Kenya’s capacity to withstand Covid-19 shocks in 2020.
TB drugs have the worst stockouts with 38 per cent of facilities telling Global Fund investigators they have not had TB treatment RHZE (received rifampin, isoniazid, pyrazinamide, and ethambutol) for two years now.
The Fund said delivery of HIV drugs took about 278 days.
“Due to gaps noted in advanced planning and turnaround timelines, long procurement delays are impacting program implementation and leading to stock-outs and non-availability of Kemsa commodities at almost all health facilities visited,” Global Fund’s Office of Inspector General said in the 2021 audit for Kenya.
The Fund had allocated Kenya about Sh4 billion in 2020 to help the country mitigate the Covid-19’s impact on HIV, malaria and TB programmes.
Due to the delays, only half of the Covid-19 response funds were spent by the end of the grant in June 2021.
GF executive director Peter Sands said they are taking a keen interest in the concerns raised by the audit regarding Kemsa.
He said the fund is already involved in reforms at Kemsa following the corruption allegations in 2020, known in Kenya as the Covid billionaires scandal.
“Implementation of the Kemsa reforms action plan is ongoing under the leadership of the new Kemsa board and acting CEO, with support from the Global Fund and partners,” Sands said.
Kenya is one of a few countries not using the Global Fund’s Pooled Procurement Mechanism, instead procuring health commodities using its own country systems.
Warehousing and distribution of Global Fund-financed commodities is performed by Kemsa on behalf of the grant principal recipient, the National Treasury.
The report also notes the two other principal recipients, Amref and Kenya Red Cross, have delays procuring Covid-19 commodities: up to 182 days for Amref and over 180 for Kenya Red Cross.
In total, Kenya has received grants of over Sh44 billion for the 2020-2022 allocation cycle (including the Covid response funds), with approximately 60 per cent of grant funds going towards procuring medicines and health products.
Global Fund also fingered the Kenya Red Cross Society for malpractice.
Between 2018 and June 2021, the Kenya Red Cross Society awarded 69 per cent of procurements for conference facilities (valued at Sh95.5 million) to Boma Inn Hotel, a subsidiary of KRCS, without a competitive procurement process.
“Furthermore, a framework agreement for the provision of conferencing facilities was only issued to Boma Inn, rather than to the three lowest bidders, as stipulated in the KRCS procurement manual,” Global Fund says.