Anxiety over expiry of Sh100m drugs

By Elizabeth Mwai

A procuring blunder has left the Government in a quagmire over the distribution of emergency contraceptive drugs worth Sh100 million.

Planning officials at the Ministry of Public Health find themselves in an awkward position to deal with a huge consignment stuck in the ministry’s stores that are nearly expiring.

Investigations by the Financial Journal has established that the imports acquired in the current financial year by Kenya Medical Supplies Agency (Kemsa) were excessive and the Government now faces the daunting task in dispensing the stock before the March 2012 expiry date.

A spot check at district hospitals across the country and Kemsa central warehouse, where the consignment is held, revealed excess stocks of the E-pill (emergency pill), most of which are set to expire in March next year with the rest in the subsequent year.

Race against time

In desperate race against time, the Government hopes to turn over the five million doses of contraceptives, which were purchased at a cost of Sh20 per dose to the private sector for redistribution.

But this option, however, comes with a price. The private sector players that include pharmacies stand to make fortunes from drugs that otherwise the Government would have offered for free.

While there is an agreement that they should not charge, the private sector, according to industry insiders, insist that they would peg a Sh30 fee for guidance and counseling fee when dispensing the contraceptives, a position the Government is unhappy with and way above the procurement price of Sh20.

Public Health Head of Reproductive Division Dr Shiphira Kuria, however, denies that there was any such arrangements adding that no discussions were held to hand over the drugs to the private sector.

"If we have to do that we shall inform the media, but no such arrangement do exist," explained Kuria. However, an insider who sought anonymity said the Government plans to use the tag Public Private Partnership to cover up the planned exercise as it deals with the drug glut that could cost the exchequer millions of shillings in losses.

However, Kemsa chief executive officer, Dr John Munyu, defended the agency position for acquiring the drug. He contends that there was no mistake made in procuring the huge drug consignment adding that the purchase order was as per request made by the reproductive health division.

Shopping list

"Kemsa gets a shopping list of items required, the quantities needed and the budget available," explained Munyu.

Munyu said the agency usually uses the economies of scale to procure items, as per the monies available and in the event there are some funds left, it surrenders the extra cash to the ministry.

"We cannot buy a unit more ....we return the excess money to the Ministry that placed the order," noted Munyu.

Even as the Government denies that there were no discussions to partner with the private sector, owners of chemists are said to be eagerly awaiting the exercise, the first of its kind. They hope to make a kill in terms of boosting their revenue base during the current hard economic times.

Emergency contraception—which basically amounts to taking a high dose of "regular" oral contraceptives very shortly after unprotected intercourse—is now widely acknowledged as capable of making a dramatic contribution toward reducing unintended pregnancies and, therefore, abortions. However, it is equally clear that a concerted public education effort is necessary for this medical technology, which has long been used in other countries, to live up to its full public health potential.

Traditionally known as the "morning-after pill," ECPs prevents pregnancy if taken within 72 hours of intercourse where there was known or suspected contraceptive failure or where no birth control was used. The regimen usually involves taking two or four oral contraceptive pills at first, followed by two or four more 12 hours later. The E-Pill is an important anti rape medication.

Although the emergency pill in private sector retails at Sh120, in Government it is dispensed free of charge, but members of the public still prefer getting them from chemists where there are no queues.

Alert

This, medics argue, is because those using contraceptives are not sick and therefore cannot be expected to queue.

FJ learnt that Kemsa has already alerted the reproductive health division of the impending expiry of the drug due to the slow disposal rate.

Munyu said in an interview that the rate of uptake of the E-pill was of concerned and that they risk expiring if action is not taken.

He is strongly convinced that the private sector is well suited to distribute the drugs given their efficient distribution network.

In any case, Munyu reckons the drugs would not go to waste since they will be delivered to the people that the Government had initially targeted.

He says Kemsa is ready to dispatch the drugs to the district stores once it gets the green light from the reproductive health division.

He, however, noted that there is no provision that permits Kemsa to distribute the drugs to the private sector.

An investigation by FJ in Nyanza and Western regions revealed a slow rate of consumption of the drugs at the public facilities.

At the Mbale Rural Training Health Centre, where FJ went for a fact finding mission, Clinical Officer Jacob Odipo confirmed they have a lot of the emergency contraceptives in store.

"But people are not coming for them, instead they are going to private chemists where they are selling like hot cake," explained Odipo.

Odipo said Vihiga District has a stock of about 20,000 doses of emergency contraceptives, which he said was excess going by the rate of uptake.

He said when the life span of the contraceptives falls below six months, they intend to return them to Kemsa for redistribution elsewhere.

Although the reproductive health division has dismissed claims of the impending offloading, a series of meetings are taking place to discuss how the large quantities of contraceptives will be dealt with before they expire leading to a loss of millions of shillings.