Wrangles, scandals threaten to cripple Ministry of Health

Health Cabinet Secretary Susan Nakhumicha briefs the media after touring Mwai Kibaki teaching and referral hospital and holding consultative meetings with area leaders, January 9, 2022. [Mose Sammy, Standard] Over the last 12 months, the health sector has been marred by damning scandals, even as it struggles to implement the much-hyped Universal Health Coverage (UHC). The Kenya Kwanza government, under President William Ruto, has been struggling with scandals reported in various agencies within the Ministry of Health. The agencies which have been rocked by scandals include the National Health Insurance Fund (NHIF) and the Kenya Medical Supplies Authority (Kemsa). President Ruto went on to sack Health Principal Secretary(PS) Josephine Mburu, and suspended Kemsa Chief Executive Officer (CEO) Terry Ramadhani after the two were implicated in a Sh3.7 billion mosquito nets scandal. Ruto, who appeared agitated in an interview in a local media station after the scandal came to light, assured Kenyans that he planned to restore order at Kemsa. "Watch this space, what you have said is correct. I am doing something about it, and I do not want to speak it now, you will see results," said Ruto. For emphasis, he added: "I want to give you my commitment that I will clean Kemsa, whatever it takes, whatever it costs, I will clean up Kemsa." Ms Mburu became the first high-ranking government official to be sacked, just a few months after taking office. Irregularities witnessed in procurement of mosquito nets at Kemsa saw the donor withdraw the tender, which was handed over to Wambo.Org. In the scam, Kemsa's technical evaluation committee had identified Partecea East Africa as the winning bidder. However, in its review, the Global Fund found that none of the bids were responsive. In the tender, Kemsa was to earn Sh74 million, Sh111 million and Sh185 million for procurement, warehouse services and distribution services respectively. Officers suspended alongside Ramadhani were Martin Wamwea, Lenson Kariuki, Dr Pauline Duya, Livingstone Njuguna, Dr Charles Kariuki, Justus Kinoti, Cosmas Rotich and Anthony Chege. Investigation into the matter is ongoing by parliamentary and senate health committees, and the Ethics and Anti-Corruption Commission (EACC). Ruto appointed Dr Andrew Mulwa as the acting Kemsa CEO, and Irungu Nyakera as the chairperson. The two were appointed alongside Hezbon Omollo, Bernard Bett, Dr Jane Masiga and Ms Jane Mbatia, who are all board members. Health Cabinet Secretary (CS) Susan Nakhumicha has maintained that she is determined to fight corruption at Kemsa. "I will not stop at anything, even if it means sending home an entire department, I am ready to do it. This institution must be clean. We are going to uproot all the roots, all the evil spirits that have been planted in this institution - nitazing'oa (I will uproot them)," said Nakhumicha during inauguration of the new CEO and board at the authority. But to stop corruption at the authority, Prof XN Iraki, an economist and a professor at the University of Nairobi, said monopoly should be done away with. Lack of competition, he said, has continued to affect smooth flow of work at Kemsa, resulting into substandard work. "Kemsa should not be a monopoly. Anyone willing to buy medical commodities should buy from an open market so that Kemsa is just a supplier, just like any other," said Iraki. "Anytime there is competition, people will improve on quality, efficiency, delivery. But without competition, it is natural we shall have substandard work." According to Iraki, once the monopoly status is done away with, there will be transparency and efficiency in service flow at the authority. James Kamau, a health economist, and the CEO of Kenya Treatment Access Movement said Kemsa should be an independent authority. Mr Kamau said Kemsa operating under the Ministry of Health affects its independence. "Kemsa is influenced by individuals at the ministry, a move that has led it into trouble as it has to play to tunes of individuals with interests," he said. Also, to avoid misappropriation of funds and irregularities in distribution, Kamau observed that Global Fund and other donors should procure commodities directly and hand them to the Kenyan government, instead of providing the country with tenders for supplies. "We get allocated Global Fund money to buy medical commodities, but we 'steal' it. Why can't we then receive commodities instead?" posed Kamau. Wrangling at NHIF has also seen its managers in Nairobi and Meru Counties suspended over alleged minting of millions of shillings through hospitals in their areas. Hospitals under probe in the scandal include Jekim Medical Centre in Meru, St Peter's Orthopaedic and Surgical Hospital in Kiambu, and Afya Bora Hospital in Mwea, Meru. Others are Joy Nursing and Maternity Hospital in Kamukunji Nairobi, Jekim Hospital in Imenti South, and Beirut Pharmacy and Medical Centre. It is alleged that the hospitals were paid at least Sh1.54 billion for 3,011 claims made between July 2022 and June 2023. Nakhumicha admitted that corruption at NHIF was deep-rooted. "We have a big problem. How is it over 60 per cent of payment goes to private facilities," she said while appearing before the National Assembly Health committee led by Robert Pukose. The CS asked the committee to support her in the fight to align the Health system.

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