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Private pharmacies in Nairobi County public hospitals? Why Sakaja Cabinet plan has sparked uproar

City Hall

Members of the public walk past the entrance to City Hall in Nairobi on April 19, 2024.

Photo credit: Francis Nderitu | Nation Media Group

A plan by the Nairobi City County government to partner with private healthcare providers to establish private pharmacies in the health facilities run by the county government has sparked a storm. 

Nairobi Governor Johnson Sakaja’s cabinet last week resolved to partner with private healthcare providers to establish pharmacies in all the Level 4 and Level 5 healthcare facilities, an effort to fill the gap for the shortage of drugs in facilities run by the county government. 

But the MCAs led by Health Committee Chairperson Maurice Ochieng’ are already reading malice in the project and are now faulting the county executive for failing to come up with the relevant legislation to guide the process. 

The county government had dubbed the new establishments as “revolving fund model pharmacies” where they will “reinvest profits back into the system” to maintain and expand drug stocks for patients visiting the health facilities. 

“Despite receiving the lion’s share of the health sector budget, these facilities have faced chronic shortages and stock-outs of essential medications, affecting service delivery. The revolving fund model pharmacies are designed to address these critical gaps by ensuring a consistent supply of medications. This model not only aims to stabilise drug supply but also to make healthcare more affordable and efficient for Nairobi’s diverse population,” read a cabinet dispatch from the county government. 

The pharmacies will be running under a public-private partnership where the private companies operating the pharmacies will be in charge of operations and ensure frequent supply of goods and services. 

“The pharmacies will operate in strict compliance with national and county health regulations to ensure that all medications distributed are safe, effective, and appropriately priced. Regular audits and reviews will be conducted to maintain high standards of accountability and transparency,” the county government said. 

On Wednesday, the MCAs said the county had not submitted any legislation and regulations to guide the process insisting that unscrupulous medics and businessmen will take advantage and exploit members of the public who visit these facilities. 

Need for legislation 

“The cabinet resolved to establish the pharmacies but we are urging them to come up with a legislation to be passed before the assembly. Today, Mr Sakaja might be there but tomorrow he may not be there. That is the main reason we need a legislation to create order in the city. That is how governments work,” Mr Ochieng said. 

The ward representative also faulted the ‘rushed’ manner in which the process was carried out without public participation as required by law. 

“We need to see the policies, regulations and the framework from the relevant chief officer. This is something that needs a public participation where people are taken through the whole process. You cannot just wake up and bring private pharmacies in the county government healthcare facilities without consultation,” Mr Ochieng said. 

It was not immediately clear whether the county government will be parting ways with the Kenya Medical Supplies Agency (Kemsa) that has been supplying drugs to the county governments.

Nairobi County owes the second highest at Sh243 million after Kilifi which owes Sh276 million.

In May, the Senate Health Committee directed Kemsa not to supply drugs to counties due to a Sh3 billion debt. 

County health facilities have been faced with shortage of drugs due to the mounting debts with private pharmacies and chemists ‘mushrooming’ around the healthcare facilities to feel the void.  

The issue has however raised conflict of interest concerns given that a section of the drug stores is run by the medics who are serving the healthcare facilities. 

In 2018, City Hall under the leadership of former governor Mike Sonko demolished over 30 pharmacies near county health facilities after it emerged that they were involved in the theft of drugs from the public hospitals. 

The exercise was later spread to other private clinics, pharmacies, and laboratories near the county health facilities.

The MCAs expressed concern that the implementation of the project would see some of the pharmacies back and erode the quality of healthcare in the county facilities.