Thursday, March 23, 2023

Ministry of Health dicing with children’s lives

Almost all public health facilities throughout Botswana are without measles vaccines for infants – thanks to the ailing Central Medical Stores (CMS) procurement system.

Babies who are supposed to receive measles vaccination at the age of nine months have still not been vaccinated and mothers are being told to “keep on checking” as there are no supplies at the CMS.

A cursory visit at clinics in and around Gaborone shows that many babies should have received vaccinations three months ago and mothers are as helpless as the CMS is.

A Denmark based company, Mission Pharma, has been given a renewed contract to supply CMS with vital drugs despite the fact that it has failed to supply drugs on a letter of credit for more than two years.

The Ministry of Health has elected not to respond to enquiries by this publication for two weeks after it emerged that despite having consultants to bring efficiency in procurement and distribution of medical drugs, consultants are now in the process of further outsourcing services.

The Sunday Standard can reveal that the Ministry of Health, upon realising that that shortage of drugs throughout the country was no match for the CMS, sought to directly enlist the services of Botswana Couriers.

The Ministry of Health has requested for a waiver with the Public Procurement and Asset Disposal Board (PPADB) to use an evaluation method not prescribed in the Public Procurement and Asset Disposal regulations for the CMS proposed tender for provision of warehousing and outsourcing services (Tender No. PR11/3/1/12-1).
The decision was approved by the PPADB last month.

“The board approved the use of the direct procurement method in respect of Botswana Couriers as recommended by the Procuring Entity, the Ministry of Health, at its board sitting of 28 November 2012,” said Ditapole Tsheboeng-Chibua the PPADB spokesperson.

There are concerns that the tender was not advertised but Tsheboeng-Chibua says, in accordance with the PPAD Regulation of 2006, the Direct Procurement method does not require advertising but the open competitive bidding method requires advertising for special lead times in accordance with Regulation 33.

“The tender has not yet been awarded as Botswana Couriers is still to submit a bid which will then be evaluated and adjudicated accordingly,” said the PPADB spokesperson.

Despite the PPAD having confirmed direct procurement in respect of Botswana Couriers as requested by the Ministry of Health, Botswana Couriers Managing Director Leatile Medupe claimed no knowledge of the tender.

“I am not privy to the tender or award that you refer to and as such would be constrained to comment on the matter,” said Medupe.

Why does the country find itself in this mess?

The Sunday Standard can reveal that problems at CMS began in 2008 when the government tried to transform it from being a government entity to a semi-autonomous body and this is contained in a “Confidential Paper on Progress of Transformation Project at CMS” of December 2010 seen by the Sunday Standard, which was meant for the eyes of the Permanent Secretary in the Ministry of Health.

During the year, there was already a consultancy firm called UTi Pharma engaged on an interim contract basis to re-engineer the systems and processes ahead of turning the organisation into a quasi-government institution.

The interim contracts of three months went on until UTi was terminated completely in 2009. The Ministry of Health had to come up with another plan since the idea of transforming CMS had not been abandoned and a proposal was made to BOTUSA to assist with recruitment and financing of salaries of the management consultants.

When all this happened, the existing CMS management of locals was not taken on board to give input.
The six consultants engaged assumed positions of leadership at CMS without a plan of what they will be doing.

“There was neither an Oversight Panel nor the Project management team at ministerial level with terms of reference or Project Charter at the time of the consultant’s arrival. As a result, the consultants spent six months without a strategic plan of what their project seeks to deliver,” according to the confidential paper.

The consultants spent six months without being accountable to anybody in terms of deliverables since no authority could measure their performance.

Upon starting business at CMS, these Consultants or Technical Advisors adopted an approach that was geared towards a semi-autonomous entity. Radical changes were introduced within the first three months that saw management team of locals converted into understudies. The Supplies structure was dismantled with the transfer of the Assistant Director of Supplies resulting in six other senior officers below rendered redundant and leaving the CMS.

“On 23 November 2009, business at CMS almost came to a standstill as the entire organisation embarked on a de-cluttering exercise directed by the HR Director with the objective to rid the offices of those materials that are not used by officers on a day to day basis as well as to create space in offices,” says the paper.

It says CMS is practicing a totally different model of records management against recommendations of the Botswana National Archives and Records Services and the Auditor General’s office standards.


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