By Auditor General John Muwanga has in his 2022/2023 annual audit of government spending disclosed that Covid-19 vaccines worth Shs28 billion, bought using a World Bank loan and grant, have expired.
The finding is indicting of government’s vaccination drive set into motion at the height of the pandemic which reportedly took the lives of 3,632 Ugandans.
“Out of 12,595,920 doses of Covid-19 vaccines in store, 5,619,120 doses had expired. The expired Covid-19 [vaccine] value as at reporting date was worth Shs28.159 billion,” the report released to Parliament on Tuesday reads in part.
It is also feared that heavier losses will be registered during the coming year as more drugs are expected to be declared unfit for human use, resulting in the potential loss of more billions to Ugandans who must repay the borrowed billions with interest.
“More expired Covid vaccines still lie in various health facilities across the country and the total combined loss to be incurred next year is estimated at Shs300 billion. These are vaccines procured out of the World Bank loan advanced for Covid-19 support,” the report reads in part.
These fears directly resonate with concerns communicated to Parliament by the Ministry of Health late last year. Last October, Health minister, Dr Jane Ruth Aceng Ocero reported that 7,567,200 doses of Covid-19 vaccines would expire by end of February this year.
As she presented a statement to Parliament, Dr Aceng blamed the looming loss on low uptake of the vaccines by the citizenry.
In an interview yesterday, the ministry’s spokesperson, Mr Emmanuel Ainebyona confirmed the huge volumes of expiring drugs was down to a decline in infections amongst Ugandans, resulting in the reported low uptake as fewer, already sceptical Ugandans, saw the need to be vaccinated.
“The uptake became low given that the positivity rate was also below one per cent. So, to some extent, irrespective of the awareness campaigns, the uptake declined,” Mr Ainebyona said.
On December 16, 2021, the World Bank announced in a statement posted on its website the approval of additional financing for Uganda’s Covid-19 Response and Emergency Preparedness project to “expand affordable and equitable access to vaccines and to build a more resilient health system”.
“Of the $180 million (Shs684b), $164.3 million (more than Shs623b) is an International Development Association grant which includes $27 million (Shs102.6b) from the Covid-19 IDA sub-window for host communities and refugees and a $16 million (Shs60.8b) grant from the Global Financing Facility to support continuity of essential health services and the roll-out of Covid-19 tools,” the statement said.
“This upfront financing will help Uganda acquire vaccines from a range of sources to support the country’s objective to acquire a portfolio of vaccines under the right conditions, which include value-for-money, with appropriate regulatory approvals, and a swift delivery time,” said Mr Mukami Kariuki, World Bank country manager for Uganda. “The project will finance the deployment of the vaccines across the country to citizens and refugees free of cost.”
ARVs also go bad
The annual audit report also revealed that the National Medical Stores (NMS) “has non-viable/expired stock of drugs worth Shs33 billion, which was a 153 percent increase from Shs13.4 billion of the prior year.”
Mr Muwanga reported that “these majorly include Anti-retroviral medication (ARVs) which expired mainly due to changes in recommended treatment guidelines by the World Health Organisation”.
Among other challenges facing distribution of life-saving ARV drugs to persons living with HIV/Aids is reported competition from some livestock and poultry farmers.
On September 6, officials from the National Drug Authority (NDA) confessed before the House committee on HIV/Aids that it knew about the illegal and medically risky use of ARV drugs to allegedly fatten chicken and pigs but chose to remain silent.
In the shocking revelation by the senior Inspector of drugs at NDA, Mr Amos Atumanya, it was stated that the government first learnt about this highly dangerous practice a decade ago in 2013 but opted to remain silent for economic reasons.
Mr Ainebyona indicated that the health ministry will determine the next course of action in concert with NMS after looking at the AG’s report more closely.
“That is an issue we need to look into with the National Medical Stores because they also have a schedule under which they distribute these medicines. We will also be able to provide more information after really analysing that issue,” Mr Ainebyona said.
Parliament’s accountability committees are scheduled to begin looking into the AG’s findings and will subsequently make recommendations for adoption by the House, and expected follow-through action by the government.
Findings
In 2022/23, NMS budgeted to procure drugs and medical supplies worth Shs185.915 billion for 3,254 health facilities. Out of the 3,254 health facilities, 3,183 health facilities suffered under-deliveries of drugs and medicines supplies worth Shs26.403 billion.
The Health Service Commission planned to recruit 1,200 health workers. However, only 669 vacancies were filled, representing a recruitment performance rate of 56 per cent. As a result, there was unutilised wage expenditure in excess of Shs10.6 billion by June 30, 2023.
