FUNDUZI REPORT ON DRUGS CORRUPTION AT CMS: GLOBAL FUND GIVES ESWATINI ULTIMATUM

LOBAMBA –   The Global Fund has given Eswatini an ultimatum to change the Central Medical Stores (CMS) setup.

This follows the glaring mismanagement of antiretroviral (ARV) treatment funds, which was captured in the report compiled by Funduzi Forensic Services (Pty) Ltd, after the probe into the drugs shortage and procurement processes in the country. The forensic report raised a number of purported anomalies at CMS and it is yet to be implemented by State investigating entities.

As the report was tabled in February 2024, the Anti-Corruption Commission (ACC) has instead investigated some of the people who were responsible for unearthing corruption in the procurement of medical drugs. Among these people is the auditor general (AG), and this prompted a public outcry as some people were of the view that those who unearthed corruption were being punished for their effort to normalise the situation.

Concerns

They also raised concerns that there was still no medication in hospitals, despite the loopholes in the health sector being identified.  Meanwhile, government was advised to change the current setup, as well as the proposed hybrid setup of CMS and model the Lesotho setup before October this year. In October, the Global Fund is supposed to release the next batch of funding to support HIV/AIDS, malaria and tuberculosis programmes. Failure to do so might mean the biggest supporter of health services in Eswatini might think otherwise since the fund is not happy with CMS. This comes after a visit by the Global Fund representatives to CMS who were recently in the country.

The Global Fund to Fight AIDS, Tuberculosis and Malaria (or simply the Global Fund) is an international financing and partnership organisation that aims to ‘attract, leverage and invest additional resources to end the epidemics of HIV/AIDS, tuberculosis and malaria, to support attainment of the Sustainable Development Goals (SDGs) established by the United Nations. Eswatini is a donee to the Global Fund and an implementer of Global Fund-supported programmes.

The visit by the representatives was confirmed by the Country Coordinating Mechanisms (CCM) Chief Executive Officer (CEO), Dr Advocate Dlamini. The CCM is more of a local office for Global Fund. He stated, however, that he could not share the discussions with the representatives. It has been gathered that the representative’s visit to the country, among other things, was to discuss the glaring discrepancies that have been uncovered by the auditor general as well as Funduzi’s reports.

According to sources, the representatives met with some stakeholders, including the National Emergency Response Council on HIV/AIDS (NERCHA), as well as the chairperson of the Health Portfolio in the House of Assembly in Parliament. It was gathered that most discussions during the meeting were about the status of CMS and how it contributed to the medical drugs theft and how procurement procedures made it easy for donor funds, especially those from Global Fund, to be looted as per the findings of the audits.

In a virtual meeting that was held a week ago, sources revealed that the Global Fund representative advised Eswatini to model the Kingdom of Lesotho’s CMS, not the proposed model, to ensure that Global Fund continued to fund Eswatini. In the meeting, the Chairperson of the Health Portfolio Committee was with other chairpersons of the same portfolio in Lesotho and Zambia. The sources revealed that Somntongo Member of Parliament (MP) Sandile Nxumalo, who is the Chairperson of the portfolio committee on Health in Parliamental, was asked if the country would be able to conduct a benchmarking exercise and further formulate legislation that will include the Lesotho findings before the release of the funds in October.
Nxumalo confirmed that he was indeed part of a virtual meeting with Global Fund representative as well as other health portfolio committee chairpersons, including Maghotsi Makhalanyane from Lesotho.

Happy

Nxumalo said: “Global Fund is not happy with the way our CMS is working, like everybody is not happy with it.”  When he was asked about the Global Fund timelines, Nxumalo stated that he was not sure what would happen in October 2024, but, during the virtual meeting, it was evident that the funder was not willing to put money where it was clear to everyone that there were no proper controls. “You also saw the Funduzi report which speaks to ARV funds that have been mismanaged, those are Global Fund contributions. Global Fund money was not spared from the looting that was happening in the drugs,” he said.

He added that in the meeting it was stressed by the Global Fund representative that government needed to formulate legislation that would change the current setup of CMS.
“We were advised that we should go to Lesotho and benchmark because they are happy with how Lesotho is performing regarding their CMS. Lesotho is not faced with the problems we have. The donor is against the proposed hybrid setup,” he said. Nxumalo said the representative also stated that the setup that Eswatini should model should be that of Lesotho, because it was safer from looting, among other issues that have been raised about the Eswatini CMS. He said during the meeting, Makhalanyane pledged that Lesotho was willing to assist Eswatini in the transitioning of its CMS.

Looting

“Lesotho is more than willing to help Eswatini but the issue is, do we want to be helped or we want to continue with the looting? Do we want to reduce the costs of buying medication by getting rid of the middleman? Global Fund has its eyes on Eswatini,” he said. In Lesotho, there is the National Drug Service Organisation (NDSO) , which operates as the CMS for the Ministry of Health. Their mandate is to procure, store and distribute the health sector goods, in line with the health facilities. Legally NDSO was established as a trading account through a legal notice Supplement No.4 to Gazette No.19 of March 2, 2007.

The organisation has seven functional departments. These are human resources and administration, finance, procurement, logistics, quality assurance, information technology and customer service. Each of these departments is headed by a senior manager, who is responsible for the overall strategic direction of the department towards organisational objectives.
NDSO promotes the health of the people of Lesotho by developing, implementing and maintaining reliable systems for procurement, storage and distribution of good quality health sector goods for all health facilities in Lesotho at the lowest possible cost.

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