Patients forced to buy from private clinics as Mubende Hospital sits on 121million worth of expired drugs

Gorreth Namugga, the Vice Chairperson, Public Accounts Committee, has announced plans to probe circumstances under which drugs weighing 2322Kgs and valued at Shs121, 238,895 expired in the stores of Mubende Regional Referral Hospital, yet during that same time; patients were sent away and ordered to buy medicines from the private clinics.

She made the pronouncement while meeting officials from Mubende Hospital, where they had been summoned to respond to queries raised in the December 2023 Auditor General report.

Auditors noted that despite the health facility grappling with challenges of drug stock outs occasioned by late deliveries from NMS, even some of the drugs delivered late got expired and ended up being destroyed.

“We are going to find out where the problem was, if these medicines were delivered to you with all factors constant and it was because of your negligence, of the failure to supervise your people that we had expired drugs, you will make good of the loss. This money will be paid by you. That is why you have to provide all information adequate. You must put your case clear. We are going to carry out more investigation with National Medical Stores (NMS) to find out where the problem was. If it was with Mubende hospital, you are going to pay for these drugs,” said Namugga.

Namugga stated that Ugandans like those in Mubende pay taxes for government to purchase drugs, but when drugs are brought to the hospital, they are locked in the stores, because the expiry is at times due to the failure to give these drugs to the users.

She added that, “So you have to explain why you have expired drugs to the tune of 2322Kgs? The challenge with expired drugs is that we lose money throughout, you spend money buying them, and also spend money disposing them off, so after looking money to buy the drugs, you also look money to dispose off,” added Namugga.

Emmanuel Batibwe, Mubende Regional Referral Hospital, Director, informed the Committee that the facility has been experiencing challenges in maintaining adequate stocks of the different medicines in the hospital, mainly because of the shortfalls in the quantities versus orders made and the challenge is further compounded by the delays by NMS to deliver the requisitions made by the Facility.

He also attributed the huge volumes of expired drugs on the changes in the treatment line for HIV and Tuberculosis patients, which saw many health facilities abandon the older line of treatment.

“Overall, you find we have stock outs of many items and if they have delivered, again they run out faster than you would have expected and that kind of scenario sees patients being requested to procure drugs outside the hospital. There were changes which occurred in some of our drug regimen and as result of that, we had expiry especially those treating HIV and Tuberculosis and if there are changes, you can’t use them nationally,” said Dr.Batibwe.

Grania Nakazibwe (Mubende District Woman Representative) urged the Committee to probe the issue of delivery of drugs in Mubende saying the constant stock outs have affected access to health services.

“The fact that NMS doesn’t deliver on time actually affects the kind of service which is delivered to the people and that is why actually, that is why we see so many private facilities mushrooming around regional referral hospitals and I believe this is the gap created by the delivery of medicines.” she added.

“One finds no reason of going to the regional referral hospitals because I can’t come to your hospital just to bring my 32 pager book to be prescribed the drugs that I am supposed to take, then you will find people in clinics even some go as far as prescribing for themselves, than coming to line up, only to have draft of the drugs to buy.” Added Namugga.

On the issue of expired drugs, Namugga states that they are going to go as far as getting the value and the Auditors should bring out the quantity of expired drugs so that the committee can attach value for Ugandans to know that as they attach value, in supplies, they also have this percentage in terms of value that expire as noted by the Auditor General.

In a survey conducted by the National Center for Biotechnology Information in America in 2010, medicines prone to expiry in most developing countries like Uganda, include those used for vertical programmes, donated medicines and those with a slow turnover.

In the statutory Internal Audit report for the year 2017/2018, revealed that health facilities in the city under KCCA, the National Medical Stores (NMS) supplied 36 units of Huma Count Cleaner, a laboratory reagent, to Kisugu Health Centre III, but only one unit was issued to the laboratory as 35 units were recorded to have expired.

But the report notes that although Kisugu Health Centre III management indicated that the usage of the reagent was minimal, NMS kept on delivering more units of the reagent.

According to the Medicines and Supplies Manual of 2012, donation of drugs should be based on expressed needs from users and obtained from a reliable source. Also, used or returned medicines are not supposed to be accepted as donations.