Please Pay Us, KEMSA Board Appeals to County Governments

The Kenya Medical Supplies Authority (KEMSA) board has issued a passionate appeal asking several county governments to prioritise settlement of more than Kshs 3.9 Billion pending bills to the Authority.

Speaking when she addressed stakeholders in the Pharmaceutical sector and Medical Associations, KEMSA Chairperson Mary Mwadime said the settlement of the bills would help accelerate reforms at the Authority.

She said some county governments had extended much-needed support to KEMSA by prioritising the settlement of bills to keep the Authority’s cogwheels running as the organisational reforms to address systemic challenges progress.

She said the Board would undertake the reforms in strict compliance to due process and labour laws as the Board is committed to remedying challenges’ currently bedevilling the Authority.

During the latest round of engagements on Monday, the KEMSA Board and the Authority’s Acting Chief Executive Officer Edward Njoroge updated the Senate Committee on Health members led by Senator Michael Mbito. The KEMSA Board also held a roundtable meeting with officials of the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU), Pharmaceutical Society of Kenya, Kenya Association of Pharmaceutical Industry (KAPI) Kenya Dental Association and the Kenya Health Care Federation (KHF).

Last week, the KEMSA Board paid courtesy calls to the Kisumu, Kisii, Nyamira and Uasin Gishu County Governments. The Board also engaged the National Assembly Committee on Health and the Development Partners for Health in Kenya (DPH-K). The DPH-K comprises stakeholders and representatives from the World Health Organisation, Global Fund, USAID, CDC, UNAIDS, Bill & Melinda Gates Foundation, and World Bank.

At the meetings, Ms Mwadime reiterated that the Authority was complying with a court order and had not declared any roles redundant nor handed over KEMSA’s leadership to external agencies. She added that operations at the Authority are proceeding under a business-as-usual model with a business continuity plan to avoid any disruptions.

“We have assured our stakeholders that our operations are proceeding on as usual and the Board and Core Management remain firmly in place,” She said, adding that, “A dysfunctional KEMSA slows down healthcare delivery goals and is a liability to the envisaged positive national healthcare outcomes and the Board is committed to facilitating reforms to set the Authority on a recovery path. This will include structured engagements with several county governments to settle their outstanding bills amounting to more than Kshs 6 Billion,” she said.

KMPDU Secretary-General Dr Davji Bhimji speaking after the KEMSA engagement, expressed optimism that the Authority will undertake the envisaged reforms lawfully.

He said the Board had assured stakeholders and KPMDU members that due process would be followed and staff members will not be victimised.

“We have been given detailed information on the reforms and have been assured that the role of professional stakeholders in the healthcare value chain will be mainstreamed in the reform agenda. We are ready to engage with KEMSA to ensure efficient supply of drugs and other items from KEMSA stores to health facilities,” Dr Bhimji said.

Last week, KEMSA Board confirmed that operations had been sustained through the core management and staffing team. If necessary, the core KEMSA Management Team will be assisted by a multi-agency team drawn from public sector experts.

The multi-agency officers will be drawn from the Public Service Commission, State Corporations Advisory Committee (SCAC), Ministry of Health, Ministry of Public Service and Gender Affairs, Ministry of Information, Communication, Technology and Youth Affairs, Ministry of Defence, The National Treasury and the Ministry of Interior and Coordination of National Government among others.

The reforms at the Authority are part of the far-reaching recommendations outlined in several KEMSA restructuring reports, including the latest KEMSA Immediate Action Plan and Medium Term Reforms Working Committee (KIAPRWC) report. Commissioned by the Board, the KIAPRWC report revealed challenges in critical functions.

The report confirms that KEMSA is grossly underperforming and largely unable to meet clients’ urgent needs, particularly the delivery of essential Medicines and Products to the Counties, Referral Hospitals and Programs.

The Authority is suffering from below-par productivity, with the order fill rate standing at 18% against a target performance of over 90%. KEMSA’s order turn-around time is an average of 46 days.

KEMSA is also suffering from a developing debtor and creditor crisis and is currently owed Ksh. 6.4 Billion by its clients, who are primarily county governments. The Authority owes its creditors Ksh. 4.5 Billion and is operating at 170% above its approved staff establishment of three hundred and forty-one (341) with an estimated staff complement of 922.

The Board, Ms Mwadime said, is committed to facilitating the necessary reforms to ensure that KEMSA challenges are sufficiently addressed. This commitment includes aligning the organisational structure to industry-accepted standards for a health commodities and technologies procurement organisation. It also calls for the introduction of global best practices, including transparent reporting relationships, an acceptable span of control, and command structures, compounding related functions for strengthened accountability and a re-determination of optimal staffing levels and norms.