Despite
NatPharm’s substantial stockpiles of essential medicines, bureaucratic
obstacles have impeded the efficient distribution of these resources to
healthcare facilities, leading to patients experiencing significant difficulty
accessing them.
In response to
one of the issues that came out of President Mnangagwa’s impromptu visit to
NatPharm, Parirenyatwa Group of Hospitals and Sally Mugabe Central Hospital
last week, the Ministry said it was now focused on identifying and addressing
the root causes of the challenges within the supply chain.
The goal being
to establish an effective and streamlined distribution system that can better
meet the needs of public hospitals and their patients.
Health and
Child Care Permanent Secretary, Dr Aspect Maunganidze, said in an interview
that they were now rolling out reforms, including an electronic logistics
management information system (eLMIS) to track deliveries and improve
coordination.
The eLMIS is a
software-based system designed to automate the process of capturing, managing
and analysing supply chain data.
It is a digital
evolution of traditional paper-based systems and is crucial for efficient
logistics operations, particularly in healthcare and other sectors where
managing the flow of goods is critical.
Dr Maunganidze
said plans were underway to decentralise distribution hubs and streamline
financial flows for medicine procurement and delivery from NatPharm.
“The ministry
is in active discussion with Treasury to stabilise and prioritise these
essential health disbursements,” he said.
“In parallel,
we are advocating for increased support for non-communicable diseases
medicines, which are often in short supply due to the lack of donor funding.
Sustaining NatPharm’s revolving fund and improving last-mile distribution
requires both consistent funding and accountability across all levels of the
health system.”
Dr Maunganidze
said public hospitals depended on both Treasury allocations and the Health
Services Fund (HSF) to pay NatPharm.
When those
funds are delayed, hospitals cannot procure medicines, even when they are
available, he said.
“Public health
institutions are expected to use part of their HSF and Treasury disbursements
to pay NatPharm for supplied medicines,” said Dr Maunganidze.
“The ministry
has reinforced this policy through circulars and monitoring systems.”
He added:
“However, the effectiveness of this arrangement depends on how regularly and
promptly those funds are received. When disbursements are delayed, so too are
payments to NatPharm and, in turn, the delivery of medicines. This is
particularly problematic for non-donor-supported medicines, such as those for
non-communicable diseases (NCDs like hypertension, diabetes and asthma), which
are often the first to be affected.”
Additionally,
Dr Maunganidze said, transport and logistical operations (such as fuel, vehicle
maintenance and delivery scheduling) were directly affected by funding
constraints.
Ideally, funds
are disbursed by Treasury quarterly, but according to Dr Maunganidze, delays
sometimes occurred due to fiscal pressures and competing priorities.
He said these
delays affected the facilities’ ability to purchase medicines and pay for
associated logistics costs such as fuel and vehicle support, which are
essential for last-mile delivery.
“As a result,
even when medicines are in stock at NatPharm, patients may still experience
shortages at the facility level,” he said.
NatPharm is
mandated by the Government to procure, store and distribute medicines and
medical supplies to public health institutions across the country.
The company has
six warehouses, one in each of the following areas: Harare, Bulawayo, Chinhoyi,
Gweru, Masvingo and Mutare.
NatPharm
managing director Mr Newman Madzikwa said while the company holds various
medicines in stock, dispatch to facilities was delayed due to payment lags and
logistical hurdles.
“Once medicines
are received into NatPharm warehouses, they undergo a rigorous quality
assurance and verification process to ensure compliance with regulatory
standards of the Medicines Control Authority of Zimbabwe (MCAZ),” he said.
“Following
this, orders are processed based on requisitions (or orders) from public health
institutions under a pull system on a quarterly basis with delivery run
conducted by NatPharm to all public health facilities across the country within
30 days of placing the order.
“While various
factors influence exact timelines, efforts are made to ensure most medicines
are dispatched within six to eight months of arrival.”
Other orders
outside of this schedule, including emergency orders, were accepted and
fulfilled ideally within 72 hours depending on the size.
Mr Madzikwa
emphasised that NatPharm’s commercialised model depended entirely on payment
for services to remain operational.
“The public
health facilities under the budget of the Ministry of Health and Child Care are
the main customers and thus their ability to pay for products and services that
we offer will ensure sustainability of the entity,” he said.
“Delayed
payments by these public health facilities significantly impact NatPharm’s
operations and subsequently its ability to replenish stocks.” Sunday Mail
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