Online Reporter
Rumbidzayi Zinyuke , Harare Bureau
THE Ministry of Health and Child Care is instituting reforms to deal with persistent medicine shortages at public hospitals by implementing a targeted approach to correct systemic supply chain issues with the National Pharmaceutical Company (NatPharm), which holds enough stocks.
Despite NatPharm’s substantial stockpiles of essential medicines, bureaucratic obstacles have impeded the efficient distribution of these resources to healthcare facilities, leading to patients experiencing significant difficulty accessing them.
In response to one of the issues that came out of President Mnangagwa’s impromptu visit to NatPharm, Parirenyatwa Group of Hospitals and Sally Mugabe Central Hospital last week, the Ministry said it was now focused on identifying and addressing the root causes of the challenges within the supply chain.
The goal being to establish an effective and streamlined distribution system that can better meet the needs of public hospitals and their patients.
Health and Child Care Permanent Secretary, Dr Aspect Maunganidze, said in an interview that they were now rolling out reforms, including an electronic logistics management information system (eLMIS) to track deliveries and improve coordination.
The eLMIS is a software-based system designed to automate the process of capturing, managing and analysing supply chain data.
It is a digital evolution of traditional paper-based systems and is crucial for efficient logistics operations, particularly in healthcare and other sectors where managing the flow of goods is critical.
Dr Maunganidze said plans were underway to decentralise distribution hubs and streamline financial flows for medicine procurement and delivery from NatPharm.
“The ministry is in active discussion with Treasury to stabilise and prioritise these essential health disbursements,” he said.
“In parallel, we are advocating for increased support for non-communicable diseases medicines, which are often in short supply due to the lack of donor funding. Sustaining NatPharm’s revolving fund and improving last-mile distribution requires both consistent funding and accountability across all levels of the health system.”
Dr Maunganidze said public hospitals depended on both Treasury allocations and the Health Services Fund (HSF) to pay NatPharm.
When those funds are delayed, hospitals cannot procure medicines, even when they are available, he said.
“Public health institutions are expected to use part of their HSF and Treasury disbursements to pay NatPharm for supplied medicines,” said Dr Maunganidze. “The ministry has reinforced this policy through circulars and monitoring systems.”
He added: “However, the effectiveness of this arrangement depends on how regularly and promptly those funds are received. When disbursements are delayed, so too are payments to NatPharm and, in turn, the delivery of medicines. This is particularly problematic for non-donor-supported medicines, such as those for non-communicable diseases (NCDs like hypertension, diabetes and asthma), which are often the first to be affected.”
Additionally, Dr Maunganidze said, transport and logistical operations (such as fuel, vehicle maintenance and delivery scheduling) were directly affected by funding constraints.
Ideally, funds are disbursed by Treasury quarterly, but according to Dr Maunganidze, delays sometimes occurred due to fiscal pressures and competing priorities.
He said these delays affected the facilities’ ability to purchase medicines and pay for associated logistics costs such as fuel and vehicle support, which are essential for last-mile delivery.
“As a result, even when medicines are in stock at NatPharm, patients may still experience shortages at the facility level,” he said.
NatPharm is mandated by the Government to procure, store and distribute medicines and medical supplies to public health institutions across the country.
The company has six warehouses, one in each of the following areas: Harare, Bulawayo, Chinhoyi, Gweru, Masvingo and Mutare.
NatPharm managing director Mr Newman Madzikwa said while the company holds various medicines in stock, dispatch to facilities was delayed due to payment lags and logistical hurdles.
“Once medicines are received into NatPharm warehouses, they undergo a rigorous quality assurance and verification process to ensure compliance with regulatory standards of the Medicines Control Authority of Zimbabwe (MCAZ),” he said.
“Following this, orders are processed based on requisitions (or orders) from public health institutions under a pull system on a quarterly basis with delivery run conducted by NatPharm to all public health facilities across the country within 30 days of placing the order.
“While various factors influence exact timelines, efforts are made to ensure most medicines are dispatched within six to eight months of arrival.”
Other orders outside of this schedule, including emergency orders, were accepted and fulfilled ideally within 72 hours depending on the size.
Mr Madzikwa emphasised that NatPharm’s commercialised model depended entirely on payment for services to remain operational.
“The public health facilities under the budget of the Ministry of Health and Child Care are the main customers and thus their ability to pay for products and services that we offer will ensure sustainability of the entity,” he said.
“Delayed payments by these public health facilities significantly impact NatPharm’s operations and subsequently its ability to replenish stocks.”
NatPharm on its part also faces other logistical constraints, including an aging delivery fleet and rising maintenance costs, which compromise its ability to reach remote areas on time.
NatPharm serves about 1 700 health facilities across the country and idealy requires 7 496 lines to fully fulfil its mandate.
The delays in fund disbursement to NatPharm, combined with communication breakdowns between health facilities and the central supplier, mean medicines can sit in storage for weeks, while patients suffer or resort to private pharmacies, where prices are often unaffordable.
Speaking during the impromptu visit by President Mnangagwa, Presidential spokesperson Mr George Charamba described the extent to which the pharmaceutical supply chain was inefficient and unresponsive to patient needs.
He called for an urgent overhaul of the system.
“If you just look at the movement of drugs, you have drugs which get imported into the country, they get received by NatPharm. NatPharm will only release drugs provided it has been paid by the requesting health institutions,” said Mr Charamba.
“It’s not always that the disbursement of funds is expeditious. It’s not always that the interface between the users of the drugs and those that store and receive them is that efficient. Then you also have, within referral hospitals, central stores again stocking pharmaceutical products.
“So, that whole delivery chain just needs revamping because it is not responsive enough to assist patients. Then the general sense of neglect.”
His comments highlighted the systemic bottleneck that has undermined the country’s push for universal health coverage.
Patients in public hospitals often receive prescriptions for basic medicines like antibiotics or chronic disease drugs, only to be told the hospital pharmacy has none in stock.
The delays in fund disbursement to NatPharm, combined with communication breakdowns between health facilities and the central supplier, mean medicines can sit in storage for weeks while patients suffer or resort to private pharmacies, where prices are often unaffordable.
With public healthcare facilities already under strain due to shortages of staff and equipment, the sluggish delivery of medicines has added another layer of hardship for thousands of patients relying on Government hospitals.
