KAMPALA – When Prossy Akampurira (Rubanda Woman MP) took to the floor of Parliament last week to demand responses why health facilities across Kampala are grappling with stock out of polio vaccines, the country never anticipated to learn that Uganda’s health sector was bickering with Ministry of Finance over donor funds.
Akampurira told Parliament last week that she was forced to cut her maternal leave short and come to Parliament after her attempts to have her baby vaccinated against polio at Nakasero Hospital hit a dead end.
At Nakasero hospital, the Legislator was informed that the vaccines were out of stockand proceeded to another facility within Kampala and found the same challenge.
But now, the State Minister of Health-General Duties, Sarah Opendi has warned that the continued freezing of accounts for the National Medical Stores (NMS) by the Ministry of Finance is likely to cripple the supply of medical supplies across the country.
Opendi said that although Uganda has enough vaccines at the NMS with the last deliveries of the vaccines having been made in June 2018, the future of these deliveries is uncertain following the decision by the Ministry of Finance to freeze the accounts of NMS.
The Minister blamed this on the new directive from the Ministry of Finance in a 27th March 2018 letter by the Permanent Secretary to the Treasury, who wrote to NMS informing the entity that effective 2018/2019, NMS was to operate as other Ministries Departments & Agencies.
According to Opendi, implications of Muhakanizi’s letter means that NMS must wait for funds to be sent to their account by the Ministry of Finance.
She added that whereas NMS has funds on its accounts at Standard Chartered Bank, Stanbic Bank including Bank of Uganda, the institution can’t carry out any transactions.
In fact, the Accountant General, reaffirmed Muhakanizi’s earlier stand in his 4th July 2018, letter where he directed NMS that payments can only be made on Integrated Financial Management Information System (IFMIS) and thus cannot be made from these Accounts.
Although, Opendi told Parliament that Treasury’s decision is likely to have dire consequences arguing: “NMS cannot operate as an MDA and effectively deliver on its mandate which is to efficiently procure medicines and other medical supplies, and distribute them to health facilities across the country.”
Opendi informed Parliament that NMS operations are Supply Chain Operations and any delays in availability of funds will ground the system to a halt, resulting in the stock outs of Essential Medicines and other Health Supplies (EMHS), and in return negatively affect service delivery.
The Minister argued that NMS was created by an Act of Parliament, and as such, it is supposed to operate as an autonomous institution.
“For the Supply Chain to run smoothly, there must be an uninterrupted flow of resources, especially funds. The system imposed on NMS by Ministry of Finance does not allow for flexibilities,” Opendi said.
At the moment, NMS has to wait the Ministry of Finance to release funds, which will then be used to procure fuel for medicine trucks, truck drivers’ allowances and provide other transport logistics.
The Minister said that whereas the drug stock outs were anticipated and brought to the attention of the Ministry of Finance, the Ministry did not appreciate the unique processes of NMS.
Yet still, the same matter was raised before the Parliamentary Health Committee, and the Committee agreed that to have the Status quo of NMS financial operations maintained until an evaluation was done by Parliament.
In fact, the Committee recommendation was upheld by Parliament in its 2018/2019 ministerial policy statement for NMS, however, the Treasury team has remained defiant despite NMS hoping Muhakanizi to comply and reverse his earlier directives.
The Minister said that to date, no such reversal has been made with the Accountant General having reaffirmed the earlier directive of the Secretary to the Treasury, in what Opendi described as acting in total defiance of the decision of Parliament.
“NMS has had to comply with the directive of the Secretary to the Treasury and Accountant General, but it is expected that the situation will get worse as we move along,” Opendi remarked.
She also told Parliament that the Development Partners like USAID, UMCEF and others, that deliver commodities and support NMS with service charge to deliver these items to health facilities, in principle, will not pay the service charge in the Consolidated Fund.
The Ministry of Health argued that the development partners have refused to comply with the directive of the Ministry of Finance and prefer to continue working directly with NMS.
Currently, NMS is unable to accept commodities/medicines from these Partners for Warehousing and Distribution, with the institution anticipating stock out of these commodities/medicines.