from ARNOLD MULENGA in Lusaka, Zambia
LUSAKA, (CAJ News) – ZAMBIA’s public health system has lurched into crises and no amount of spin doctoring can mask the dire fact that it is on its deathbed.
The thousands of vacancies still to be filled and months-old shortages of drugs and other medical supplies have dragged the sector down from its heyday.
Then, the Southern African country had a well-developed public and private healthcare system that was an envy of the region, providing specialized medical services.
The current crisis poses a major headache for the new government of President Haikande Hichilema, which has partly been blamed for the woes.
These crises fly in the face of the government declaring health care as a priority sector.
The calamities also are in contrast to the vision of “equity of access to assured quality and affordable healthcare services, as close to the family as possible.”
This is to be achieved through the “establishment of a strong, responsive and reliable health sector which is founded on the principles of strong leadership, equity of access, affordability, cost‐effectiveness, decentralization, partnerships and accountability,” according to the government of Zambia’s blueprint vision.
Recent developments nonetheless dispute the commitment to above principles.
This is a major test to the new government, which has hobbled through seven months in office.
As has been the case since the opposition United Party for National Development (UPND) defeated the Patriotic Front (PF) after hotly-contested elections last August, blame has been apportioned.
Critical shortages of essential drugs and other medical supplies have worsened in recent weeks, with some health centres completely running out of drugs and consumables such as syringes, gloves and swabs.
Some of the medicines in short supply have been the painkiller Panadol, nifedipine and furosemide.
This at a time the country is battling the ninth-worst COVID-19 pandemic in the continent, with 316 550 cases including 3 966 deaths at the time of publishing.
The government has attributed the shortages to an “overhaul of the drug procurement system.”
Such is said to be essential after for example in 2019, government shifted the lucrative tender to supply health centre kits from the Missionpharma to the then-unknown Honey Bee Pharmacy.
“No drugs. Not even stationary,” lamented Dr Brian Sampa, Resident Doctors Association of Zambia (RDAZ) president.
The opposition has rubbished the overhaul of the drug procurement system by the government, which came into power with a pledge of enhancing investment in health care and addressing inequalities in health service delivery.
“It cannot be denied that there’s a critical shortage of drugs in our health centres, clinics and hospitals. The government at the highest level has failed to truthfully and simply explain the reasons for this shortage,” said Fred M’membe, President of the Socialist Party
He alleged government’s indecision over who should be given the business contracts to supply the drugs.
“We have a local drug supplier who is forced to send workers home because the government doesn’t want to buy drugs from the company.”
M’membe noted that shortages meant patients had to increase out-of-pocket costs to buy at private facilities.
The opposition leader dismissed Hichilema’s recent televised assessment visit to the Ministry of Health as “nothing but political posturing, a facade.”
“The provision of health services to our people cannot be micro-managed in that way,” M’membe criticised.
PF member, Chishimba Kambwili, alleged the current drug shortage was a result of the government diverting money to buy drugs to finance free education.
“This allegation is unfounded and a sheer figment of Mr Kambwili’s imagination,” Chushi Kasanda, chief government spokesperson, refuted.
Former diplomat, Emmanuel Mwamba, blamed the crisis on the Minister of Health, Silvia Masebo, and Hichilema.
“Masebo and her technical team have not bought any medicine and medical supplies in the last six months claiming that they are re-organising the sub-sector,” Mwamba claimed.
He argued the now scant medicine and medical supplies were left by the PF government of Edgar Lungu.
Hichilema, according to Mwamba, “has regurgitated what constitutes the lies and narrative that Masebo has peddled to the nation, in the last six months.”
The president has blamed procurement and legacy issues such as pilferage and corruption, as factors affecting timely delivery of medicines to hospitals.
Mwamba said the government had collapsed the health sector by abandoning a working system that had taken decades to establish and refine with cooperating partners.
“The numerous deaths that have occurred during this period and attributed to this confusing scenario must be documented and Masebo and her team made to account,” the ex-diplomat said.
Masebo has butted heads with health professionals since her appointment.
RDAZ is opposed to the new Ministry of Health organisation structure whereby heads of parastatals will report to the minister instead of the Permanent Secretary.
“How can a civil servant report to a politician?” Sampa asked. “We are now turning the civil service into political bedrooms.”
The minister recently suspended five directors accused of promoting irregularities during the delayed process to recruit the over 11 200 health workers.
“This clearly, this is a side-show designed to divert our attention to a matter that has raised anxieties and preoccupied the nation with concern…the critical shortage of medicines and medical supplies in hospitals and clinics,” Mwamba said.
The process to fill the 11 270 positions in the ministry has finally taken off the ground after the Civil Service Commission releasing the advert for the recruitment and publishing details of the number of slots, duty stations, and qualifications needed.
Nurses form the majority of the recruits, with 3 260 slots available.
Other slots are for cleaners, medical officers, general workers, mortuary attendants and drivers.
“No corruption, segregation, discrimination or indeed nepotism will be allowed during this exercise,” Hichilema assured on the eve of the announcement of the recruitment.
In conclusion, the president threw a veiled jab at the opposition and critics.
“We are optimistic that working together we will achieve and eventually win against those who may not be appreciating the need for unity, business opportunities, jobs, quality education, quality health care services and ultimately quality life,” Hichilema said.
With an estimated population of 19 million, Zambia’s life expectancy is at 64,7 years, up from slightly over 40 years in 1950.
– CAJ News