Here’s what we know, don’t know
A Sthe medical drugs shortage investigation continues and as more facts come to light, there appears to be a widening of the circle of players involved in the unfolding saga. Let’s look more closely at who the players might be and what role they may have played and continue to play in this sordid tale.
The protagonists
These are all those involved, past and present, who played active or passive roles in facilitating the medical drugs theft, right from its genesis to the present.
It was shocking to learn recently that the medical drugs shortage problem in the country has, in fact been around, going back six ministers of Health. In other words, six previous ministers of Health had to navigate their way through the morass that is the shortage of medical drugs in the country without resolving the problem.
However, in truth, it is possible that the problem is much older. It is just that it only was recognised and acknowledged as recently as six or so Health ministers ago.
The question we now need to ask ourselves is the following:
How did we get here?
At this point let’s embark on a speculative journey going back many years to try to piece together how this whole racket may have started and evolved. In the process we may learn more about ourselves as human beings and the forces that propel us many times to act in less than honourable ways.
1. Like most problems that start small and snowball into near unmanageable proportions, the pilfering of drugs most probably started at the consumer end of the medical drugs supply chain management continuum.
2. Initially the pilfering may have started by way of a healthcare worker stealing a few headache tablets for a friend, family member, lover, neighbour or casual acquaintance. This was probably, a once-in-a-while occurrence where the perpetrator was in some cases overcome by a feeling of remorse or guilt for their act. The practice, nevertheless, continued.
3. With the passage of time, not only did the pilferage become easier but the variety of pilfered drugs expanded from headache tablets to incontinence to sexually transmitted infections medications, etc.
4. At some point, one of the regular recipients of the pilfered medications, being endowed with the spirit of entrepreneurship, recognised the opportunity to make a few Emalangeni extra cash out of selling painkillers to a neighbour/s who suffered from chronic pain and one or two of the other ailments mentioned above. It probably was at this point that our entrepreneur made a proposition to the healthcare worker to make available a regular supply of medications for a cut in proceeds from sales to clients seeking relief from all types of pain and some of the ailments mentioned earlier.
5. It was not long before the healthcare worker at the hospital or clinic realised that there was money to be made selling medication directly to clients outside the hospital or clinic setting.
6. Also, the hospital healthcare worker came to the realisation that there was a big demand for certain types of medication, in particular painkillers.
7. At this point, greed set in when the healthcare worker came to the conclusion that more money could be made if he/she set up a distribution network of individuals who would make themselves known as discrete suppliers of several types of medications for a fee. Of course, the whole operation was to be completely hush-hush.
8. Setting up this medication distributorship was made all the easier because of poor controls at the point of dispensing medication to patients at the hospital or clinic, as has been revealed in a preliminary forensic audit report.
At some point the demand exceeded supply at hospital or clinic level. In other words, since the distributorship was growing exponentially, the needed drugs had to be sourced elsewhere other than the hospital or clinic.
9. And so it was that after making a few discrete inquiries here and there, the healthcare worker established contact with one or two individuals, a friend of a friend or relatives at the main government medical drugs supply centre, in this case Central Medical Stores (CMS), whereby an arrangement was subsequently arrived at for deliveries to be made to various well selected spots and out-of-theway locations.
Everyone involved in the diversion and delivery of drugs to unauthorised destinations received a cut from the proceeds of the illegal sales of these drugs. As such, nobody was tempted to blow the whistle on anybody.
It would not be long before one or two retailers of pharmaceutical products (pharmacies) made one or two senior managers of CMS an offer they could not refuse: Sell to us the drugs we need, we resell the drugs at inflated prices, you and I make a hefty profit, and everyone lives happily ever after.
Alternatively, it is possible that it was actually the CMS senior manager/s who initiated contact with crooked retailers of pharmaceutical products, certain physicians in private practice and others, and offered to supply them with the drugs of their choice at discounted prices.
Question: At this point were the senior managers acting independently, or were they following instructions from certain highly placed government officials?
Again, poor controls regarding stock management at CMS, as has been revealed in a preliminary forensic report, allowed this criminality to thrive despite the auditor general raising concerns year after year about discrepancies in the quantity of drugs ordered and delivered, and the actual payments made to various suppliers of these drugs.
In fact, it was reported recently that in some cases drugs that hadn’t been ordered were delivered to CMS. This suggests collusion by some foreign, and/or local, pharmaceutical suppliers with perpetrators of corruption at CMS.
It may also have been at this point that some managers at CMS decided to set up their own side hustle by way of operating unlicensed pharmacies in some of the country’s densely populated peri-urban residential areas, as preliminary investigations into the medical drugs trade have revealed.
While all these illegal operations were going on, one can’t help asking: where were the cops? Surely, someone, somewhere within the law enforcement fraternity should have picked up a rumour or tip-off that a racket of this sort was going on.
DESIRED
If the Royal Eswatini Police Service (REPS) didn’t pick up on the medicaldrugs-for-sale racket much sooner, then the only conclusion to be drawn is that the REPS’s crime intelligence network leaves a lot to be desired, considering the magnitude of the illegal medical drugs operation at the time that it became publicly known.
But nothing happened. So then, one can’t help asking two follow-up questions: Could the cops have also been part of the medical-drugs-forsale racket? Even if they did not partake directly, could they have been recipients of kickbacks for their silence?
However, in order not to preempt the ongoing forensic audit into the drugs shortage problem, we will not speculate further about what may have happened, and how it could have happened, to grow the drugs theft monster, except to note with alarm how the level of impunity has affected the drug supply chain management operations and efforts to bring to book those who may be implicated in the theft and illegal sale of medical drugs in the country.
The antagonists
These are all those who acted and have acted in various capacities to discourage, in one way or another, the diversion of medical drugs to unauthorised persons and/or destinations over the years.
It is not difficult to speculate that at some point, some of the more honest healthcare workers and others in the supply chain management operations who witnessed the theft of drugs at various points and expressed or showed disapproval, were directly or indirectly threatened in some way. This is because the drugs theft operation was and continues to be so lucrative.
Which, in much the same way, is the reason higher ranking government officials like the Auditor General,Timothy Matsebula, Ministry of Health Principal Secretary, Khanya Mabuza, and others like Funduzi Forensic Services Executive Director, Zakhele Dlamini, are reported to have received death threats in connection with the ongoing forensic audit into supply chain management involving the procurement, delivery and distribution of medical drugs in the country.
Again, this is hardly surprising as we have been reliably informed that the drug theft operation network runs into millions of Emalangeni.
However, it is sobering to suddenly realise that what we may have going on here is a massive operation orchestrated by a drug cartel in the tradition of international cartels such as the Medellin cartel of Colombia in South America.
WONDERING
If this should be the case, then one can’t help wondering again: How and why was the REPS crime intelligence network was not able to pick up on this sooner?
An even bigger question is: Since this medical drugs theft issue, in light of its magnitude, borders on national security, why was the nation’s national security intelligence service unable to pick up on this sooner? Could this, indeed, be another example of the failure of the national security intelligence service as happened in its failure to anticipate the June, 2021 unrest?
Like the Medellin cartel, the Eswatini cartel, by issuing death threats against senior government officials and others, is openly challenging the Government of Eswatini. This is, undoubtedly, unprecedented in the history of the Kingdom of Eswatini, whereby a whole government is being held to ransom by a criminal enterprise.
In this regard, a serious question needs to be asked: In view of the apparent boldness with which the hypothetical cartel is conducting itself, is it, indeed, possible that it’s tentacles have penetrated the country’s corridors of power, right up to the august houses of Parliament?
INFLUENCE
The fact of the matter is that the Medellin cartel, besides wielding great influence and power even within governments, was known around the world for ruthlessly executing anyone and all who stood in its way in its illicit drug operations.
In this regard, the threats made against, first, a member of the Judiciary, then government officials, second, and, third, a member of the law fraternity and one or two others, cannot be taken lightly. More about this later.
The fact that the modus operandi of our protagonists has evolved into international cartel dimensions and proportions makes us wonder: Are the real kingpins of the medical drugs theft operation in Eswatini locally or foreign based?
The third force
To say that we were gobsmacked by revelations of death threats against senior government officials and others in the drugs theft saga is an understatement.
Just as we were recovering from this bombshell, new revelations are to the effect that the defence attorney for Central Medical Stores officers Principal Procurement Officer in the Ministry of Health, Sincedile Magwaza, and Deputy Director-Pharmaceutical Services, Fortunate Bhembe, whom we shall from now on refer to as the CMS Two, recently received death threats as well.
Let us recap. It’s worth recalling that, initially, it was reported that the government had applied for the recusal of Industrial Court Judge, Muzikayise Motsa, from presiding over the drugs procurement case involving the CMS Two. When the judge indicated that he would not recuse himself, he almost immediately thereafter reportedly received death threats to recuse himself or else .... , which he subsequently did.
Secondly, it has now been reported that Zweli Jele of Robinson Bertram Attorneys, as alluded to earlier, has received death threats in connection with his role as defence attorney for the CMS Two.
The implications of all this are that there appears to be a concerted effort by someone or group of persons, to deprive the CMS two of the opportunity to prove their innocence in a court of law. We have referred to this entity or entities as the Third Force.
So, we ask the question: Who could be behind the death threats against the judge and the defence counsel? Is it indeed possible that the very same people behind the drugs theft scandal are the ones determined to see the CMS two take the fall for the drugs shortage mess?
Consider the following:
a) At face value, it might appear as if the Third Force comprises individuals who are sympathetic towards the many patients who have suffered, and continue to suffer, because of the drugs shortage in the country. In this regard, they want to make sure that the CMS Two don’t ‘get away’ with defrauding the nation after causing much anguish, pain and suffering to sick and frail emaSwati, let alone causing much inconvenience and expense to relatives and loved ones. Well and good.
b) However, if the Third Force, indeed, wants to make sure that justice is served by the conviction of the CMS Two, why don’t they allow due process to take place? Or, is it perhaps that they don’t trust the judicial system to convict the CMS Two?
Or is it perhaps the case that the charges against the CMS Two are weak at best and completely unfounded at worst (or even trumpedup), meaning that there›s the distinct possibility that the CMS Two might beat the medical drugs theft rap, as the expression goes, if the matter were to go to trial?
Which makes us ask a follow-up question: Could the CMS Two have been ‘set up’? Indeed, could the judge who recused himself have, in his preliminary evaluation of the material facts in the medical drugs theft case, concluded that a prima facie case to charge the CMS Two with racketeering and other related charges, simply did not exist?
Could defence counsel Zweli Jele have arrived at a similar conclusion?
Finally, at this point we can’t help asking, ‘How strong or secure is the Anti-Corruption Commission’s witness protection programme?’