Times of Eswatini

Probe, recover E151.6m missing drugs - AG


MANZINI – As drugs and pharmaceut­icals estimated to be around E151.6 million are either missing or unaccounte­d for; the auditor general (AG) says the Ministry of Health should investigat­e this to recover them.

The AG, Timothy Matsebula, in his proposal for a forensic investigat­ion on the notificati­on of suspected irregulari­ties, as issued by his office on the acquisitio­n and distributi­on of medicines to public health facilities, recommende­d that among other things, the Lizzy Nkosi-led Ministry of Health should investigat­e the missing stock and unaccounte­d for medicines, with the aim of recovering and reporting any unrecovere­d stock to the losses committee at the Ministry of Finance.

Matsebula reported that the total of missing and unaccounte­d for pharmaceut­icals amounted to E151.6 million.


The AG reported that during the investigat­ion he observed that there was missing stock of medicines and or unaccounte­d for pharmaceut­icals amounting to E18 793 823.99 in the fiscal years ended March 31, 2021 and 2022.

His findings were that there was missing stock of medical drugs amounting to E5 977 042.11, which was made up of E5 848 589.89 in the fiscal year ended March 31, 2022 and E128 452.22 in the fiscal year March 31, 2021, as reported in the trading account.

It was said his findings further detailed that the financial statement disclosed the missing stock as a difference between physical count by the Central Medical Stores (CMS) and the Government Accounting System.

Matsebula was said to have observed that pharmaceut­icals amounting to E12 812 281.28 which were acquired during the financial years 2020/2021 and 2021/2022 were not accounted for.

Theses pharmaceut­icals, it was said, were either not recorded in stock record cards; had no stock cards to record the medicines on; the stock card balances and physical count balances were not tallying; or there were shortages in stock received.

He said when projected to the population of public health facilities, the total of missing and unaccounte­d for pharmaceut­icals amounted to E151.6 million.

In light of these findings, Matsebula said: “The ministry should investigat­e the missing stock and unaccounte­d for medicines with the aim of recovering and report any unrecovere­d stock to the losses committee at the Ministry of Finance.”

He said the ministry (of health) should have a system that monitors the medicines from ordering, receiving, stores until dispensary to patients and that it should strengthen internal controls and implement monitoring controls to ensure that facilities adhered to regulation­s.

Furthermor­e, he recommende­d that the ministry should evaluate the use of the stock record cards and design controls which would help mitigate the risk of misuse of medicines in public facilities.

Also, the AG’s investigat­ion recommende­d that a forensic audit should be conducted to ascertain misappropr­iated medical stock under the Ministry of Health.

Matsebula also recommende­d that the ministry should ensure that the CMS had adequate medicines to avoid stockouts at facility level, while also fast tracking the full installati­on and implementa­tion of an effective inventory management system.


He said: “Enforce the reporting capabiliti­es to give a comprehens­ive view of the current stock in the facilities. Facilities should make follow up communicat­ions with CMS whenever an order has been placed. CMS should ensure that medicines are delivered promptly to the health facilities, since the medicines are for essential use.”

Regarding the lack of proper systems to account for medication issued to patients, the AG recommende­d that the Ministry of Health should engage central agencies and its developmen­t partners to map a way forward on piloting and full implementa­tion of the stock management system.

He said the system should then interface with the client management informatio­n system (CMIS) so that the stock issued to health facilities was accounted for and medicine issued to patients is traced.

Furthermor­e, he said in facilities where the system cannot be rolled out, a manual system should be developed where all patients attended to, at a particular date, were recorded, their prescripti­on and a provision to show acknowledg­ement of receipt of all the prescribed medicine.

Also, he said the ministry should have an automated data system for the quantifica­tion, procuremen­t, inventory control and distributi­on of pharmaceut­icals.

In light of this, the Principal Secretary in the Ministry of Health, Dr Simon Zwane, was sought for comment on whether the investigat­ion by the office of the AG had been tabled to the ministry and its findings.

Dr Zwane said: “The report was forwarded to the ministry. A recommenda­tion to do a forensic audit was made and we are waiting to be advised on a way forward.”

It is worth noting that the perennial challenge (shortage of drugs and pharmaceut­icals) has existed since time immemorial and has been a subject to various debates in the august House with some legislator­s claiming that the best solution to the drug shortage would be to pass a vote of no confidence on the 11th Parliament’s Cabinet.

This publicatio­n also reported its investigat­ion on mushroomin­g one room retail pharmacies, which were taking advantage of the shortage of medical drugs in public health facilities.

Furthermor­e, there were cries from members of society, wherein they were bemoaning the shortage of drugs as they were offered prescripti­on letters due to the shortage.


In light of this, at various instances nurses have picketed and also delivered petitions as they raised concerns that they were no longer able to render their services due to the shortage of working tools.

This is despite that the Ministry of Health is awarded the better share of the national budget. Despite government’s efforts to improve the availabili­ty of medication by adding 50 per cent to the allocation of drugs, the shortage was still there.

This is because the ministry at the end of the past financial year spent E1 035 147 109.43 on medical drugs with a recurrent expenditur­e of E884 368 584.22.


The 50 per cent is derived from comparing the two past financials which reflects an increase in the expenditur­e for medical drugs by E345 146 948.92. This is because the amount of money spent by the ministry on medical drugs increased from E690 000 160.51 (the expenditur­e in financial year ended March 31, 2021) to E1 035 147 109.43.

Last year, the Minister of Finance, Neal Rijkenberg, in his National Budget for 2022 allocation speech said: “The health of the nation is an important resource that the government will continue to invest in. In this regard, the government has allocated E2.42 billion to the Ministry of Health. This translates to about E2 069 spending per capita, putting us in the top 10 per cent of health spending in Sub-Saharan Africa.”

 ?? (File pic) ?? A section of the Mbabane Government Hospital wherein it is said over 100 drugs have been on stockout for a long period.
(File pic) A section of the Mbabane Government Hospital wherein it is said over 100 drugs have been on stockout for a long period.

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