News
Medicinal drugs in short supply due to lapses by officials
View(s):A national audit has found that the dollar deficit was just one reason for the national shortage of medical supplies. Others include computer systems not having being updated, lack of coordination among relevant medical sector offices and a sheer disregard for procurement schedules.
The Auditor General’s special report regarding steps taken to avoid pharmaceutical shortages in Government hospitals was published online this week. It also found a sharp drop in the financial allocation and expenditure for medical supplies.
The Health Ministry’s total net allocation was Rs. 85.9bn in 2020, of which 99 percent went towards medical supplies. Last year, the total net allocation was Rs. 151.9bn, of which just 50 percent was for medical supplies.
But this is still higher than the quarterly average expenditure for medical supplies this year. In 2020, the quarterly average expenditure was Rs 20.8bn. It was Rs 18.4bn the following year. In the first quarter of this year, it was a mere Rs. 12.5bn, the National Audit Office (NAO) states.
The report shows that the Health Ministry, the Medical Supplies Division (MSD), the State Pharmaceutical Corporation of Sri Lanka (SPC) and the State Pharmaceutical Manufacturing Corporation (SPMC) do not work in coordination and this has crippled procurement.
A medical supply management information system (MSMIS) was established in 2015 to cover 82 institutions including the MSD, the SPC, the National Medicine Regulatory Authority and Health Ministry hospitals. It was extended to base hospitals for ordering, distribution and stock management. It facilitates stock receipts and annual inventory surveys. But the system has neither been updated nor used adequately, the NAO said.
The MSD submits annual order lists to the SPC using this MSMIS or ‘PRONTO’ computer systems with a lead time of 11 months. The SPC has delayed procurement until hard copies of these lists were received. It then took 18 days for the Corporation’s import division to receive the written order.
The computer system allows all the institutions to update progress of a relevant procurement at every step–from ordering to stock delivery. But SPC officials had not input information for the past seven years, citing a technical problem that they had failed to rectify.
Instead, the SPC stored information on Excel sheets without updating the common system. Information such as the date of technical evaluation of each tender, date of procurement committee decision, date of letters of credit being opened, etc, could not easily be obtained.
Meanwhile, the MSD has not monitored the progress of around 13,000 medical supplies orders for several years. And although it issued orders to SPC for drugs to be supplied within 11 months last year and this year, the relevant officials had not completed procurement for 27 orders at the time the NAO report was published.
Orders were issued to the SPC in 2020 (for 2021) and in 2021(for 2022) related to 11 pharmaceutical items listed as “vital”. Of these, just small quantities of four were received by the MSD. The others were held up owing to procurement issues or delays.
The policy is to issue orders with 11 months lead time. But inordinate amounts of time were spent owing to non-compliance with the procurement schedule, the NAO found. Thus, it took 12-27 months to complete the process for some orders issued by the MSD.
The NAO has provided numerous examples of procurement being held up–causing short supplies (in some cases, no supplies)–owing to lapses by officials. Some of the problems include orders being placed and cancelled. Thereafter, months are taken to place new orders. Requirements are not correctly identified. Sometimes, orders are not placed. Other times, letters of credit are delayed.
Affected drugs looked at by NAO include anti-rabies serum, the Streptokianse vaccine (vital heart disease drug), Tenecteplase (to replace Streptokianse), Suxamethonium Chloride vaccines (used for anaesthetic purposes), Cetirizine HCL syrup (used for allergies, particularly among children), Meropenem1g vaccine and Nitrofurantoin 50mg tablet.
The NAO has recommended that steps be taken to monitor orders placed by the MSD at least for the next year, with responsibility being “properly assigned to officers”. It also proposes the introduction of an “easy system” so that information regarding out-of-stock drugs in hospitals can be updated.
The best way to say that you found the home of your dreams is by finding it on Hitad.lk. We have listings for apartments for sale or rent in Sri Lanka, no matter what locale you're looking for! Whether you live in Colombo, Galle, Kandy, Matara, Jaffna and more - we've got them all!