- ARVs, other medicine stocks low
- Buys medicine from local pharmaceutical companies
- Ministry returns N$700m to treasury
Renthia Kaimbi
The Ministry of Health and Social Services appears to be back in business with ‘middlemen’ as medicine shortages deepen and emergency purchases drive up costs.
The Central Procurement Board of Namibia (CPBN) has invited bids for the supply of antiretroviral drugs for 12 months, raising questions about a return to intermediaries ‘middlemen’ after a shift to direct procurement from manufacturers.
This follows as Namibia faces shortages of essential medicines.
Sources who spoke to the Windhoek Observer said the ministry returned about N$700 million to the treasury while hospitals struggle with low stock levels.
Two weeks ago, the ministry carried out an urgent buyout from local pharmaceutical companies with registered products.
These are the same intermediaries it had tried to bypass. Sources say prices were up to five times higher than normal.
“This is actually a cost exercise to the government because the main players in the private sector (known to the Windhoek Observer) are supplying the government with medicine that costs five times more than what even the middlemen were charging. They understand that the government is desperate and will inflate their prices of stock on hand due to the high demand,” an anonymous source said.
Documents seen by the Windhoek Observer list nearly 300 commodities at the Central Medical Stores.
These include antiretrovirals, insulin, morphine, malaria test kits, vaccines, antiserums and contraceptives.
Health workers say shortages are affecting services.
“The doctors are all complaining about the shortage of medicine and operations have to be postponed due to lack of medication. Hospitals are now buying medicine directly from middlemen, so it’s a bit chaotic at the moment. But the bottom line is there is no medicine in the country,” a source said.
The executive director in the ministry, Penda Ithindi, confirmed reduced stock levels at facilities and the Central Medical Stores.
“The ministry requested CPBN to invite a one (1)-year open international bidding process in terms of Section 30(a) of the Public Procurement Act, 2015 (Act No. 15 of 2015), with a view to entering into a long-term contract. The value is above the public entity threshold,” Ithindi said.
He said deliveries are ongoing and engagement with suppliers continues.
“Efforts are ongoing to ensure sustained availability of all essential medicines. For some of the above-cited commodities, deliveries have been received already. This does not negate the need to maintain effective engagement with the manufacturers and suppliers to honour their contractual obligations.”
He said stock levels average above 51%, while sources claim they are below 40%. “Bulk deliveries are being received from the manufacturers on a monthly and sometimes on a weekly basis to replenish the stock level to achieve the target minimum level of 80%,” he said.
In September last year, health minister Esperance Luvindao scrapped the use of middlemen in the procurement of medicines and clinical supplies.
At the time, the ministry said buying directly from international manufacturers could save the government more than N$221 million.
The move followed a commitment by President Netumbo Nandi-Ndaitwah, who had earlier said Namibia would begin sourcing pharmaceuticals and medical supplies directly from suppliers.
The ministry has previously accused some business people who benefited from the tender system of trying to undermine Luvindao.
Those business figures, however, have pushed back, accusing the minister of bypassing procurement laws by engaging manufacturers directly.
This week, Ithindi rejected claims that the direct procurement model has failed.
“The direct procurement approach has not failed; rather, it is a strategic intervention aimed at stabilising supply and improving long-term availability. Manufacturers have varying delivery times. In between the delivery lead timelines, necessary gap-filling procurement measures are undertaken through ministerial exemption to ensure stock rebuilding,” he said.
The Windhoek Observer established that antiretroviral drugs for more than 200 000 people are close to running out at health facilities and the Central Medical Stores.
Fixed-dose combinations for adults and children are at low pack levels. Other items, including Dolutegravir and HIV test kits, are also running low.
The direct procurement model, introduced to reduce costs, is now under scrutiny.
In one case, the ministry bought polio vaccines worth N$100 million from a manufacturer in India.
The same vaccines were previously supplied for about N$105 through intermediaries, but under direct procurement the price rose to nearly N$400 per dose.
The ministry declined to provide detailed pricing. It said procurement follows regulatory processes to ensure value for money and transparency. It added that direct procurement has delivered savings of at least N$200 million.
Regulatory delays remain a challenge. It can take three to five years to register products with the Namibia Medicines Regulatory Council. This affects manufacturers supplying directly.
Questions sent by the Windhoek Observer on pricing differences between registered and unregistered medicines were not answered.
Sources say unregistered medicines can cost about N$80 per pack, while registered versions can reach N$600.
“Manufacturers’ orders are delayed because of the permits needed from NMRC to proceed sending unregistered medicine to Namibia,” sources said.
However, Ithindi said the ministry is working to resolve permit and regulatory issues.
“The ministry is actively addressing regulatory and permit-related challenges in collaboration with relevant authorities. Resolving these bottlenecks remains a priority to ensure timely delivery of commodities,” he said.
