Crisis as Kemsa runs out of essential dialysis, ICU, surgical drugs

A section of the Kenya Medical Supplies Authority Embakasi Depot, Nairobi County on May 18, 2023.


Residents of 20 arid and semi-arid counties are in a crisis as the national drugs distributor has run out of essential medicines and kits used in dialysis, surgery and intensive care units (ICU).

The supply problem is being experienced in Machakos, Garissa, Wajir, Mandera, Marsabit, Turkana, Samburu, West Pokot, Elgeyo Marakwet, Baringo, Isiolo, Laikipia, Nakuru, Lamu, Tana River, Taita Taveta and Kilifi, with the counties waiting for months after making orders.

Some of the missing drugs are usually used as anaesthesia, a requirement in surgery.

These specialty drugs are often biologic – medicines derived from living cells, and which are injectable or infused though some are oral.

They are used to treat complex or rare chronic conditions like cancer, rheumatoid arthritis, haemophilia, HIV, psoriasis, inflammatory bowel and hepatitis C.

Kenya Medical Supplies Authority (Kemsa) yesterday acknowledged the delays, but insisted that the procurement would be completed soon.

“The reality is that Kemsa was dying and had zero essential drugs and commodities before we came. After talking to suppliers, we have 38 of the 47  critical items needed,” Kemsa Chief Executive Officer, Andrew Mulwa, said on September 16, 2023.

Dr Mulwa said in April that only four essential drugs were in stock.

“Tendering, which ended last week, captured all essential drugs. The Kemsa of yesterday had bad planning and priorities,” he told the Sunday Nation.

The affected devolved governments have complained of having to turn away critically ill patients.

“We know there is a new team, which has not gone through the full tendering, but lives are at stake. What are we to do?” an official in Machakos County asked.

“The fill rate at Kemsa has always been a problem. If one has an order of 100, for instance, you don’t get everything you asked for. The items just do not come.”

He accused Kemsa of poor visibility on the status of drugs and medical items needed by county governments.

“Kemsa prioritises payments, meaning county governments that have no money have to wait for a long time,” the Machakos County government official said.

Dr Mulwa said it would take Sh3.5 billion to fix the procurement challenges at the government agency.

 “We cannot have a steady supply of essential medicines and commodities by giving hope. We must pay suppliers. This is why we urgently require Sh3.5 billion to resuscitate Kemsa and get it out of the ICU. We need Sh2 billion to get it up now and Sh1.5 billion later,” the CEO said.

Dr Mulwa added that the previous team at Kemsa incurred a Sh2 billion loss, crippling operations.

“The Kemsa of yesterday spent Sh1.9 billion on Covid-19 commodities, which we do not need now. Some have even expired,” he said.

“That was poor prioritisation. After three months of taking to suppliers, I can confidently say we have moved in and are doing our best.”

Lawmakers in 2021 recommended an investigation of former Senate Deputy Speaker Kembi Gitura and the entire Kemsa Board over a Sh7.8 billion scandal after a report tabled in the National Assembly by the Public Investments Committee recommended that then top Kemsa directors be prosecuted and suppliers who benefited from inflated payments forced to make refunds.

“The Ethics and Anti-Corruption Commission should investigate the interference of Mr Kembi Gitura and Mr Joel Onsare (who were on the Kemsa Board), with a view to prefer charges against them for violating the Public Officers and Ethics Act,” the PIC report said.

The committee that was chaired by Mvita MP Abdulswamad Nassir – now Mombasa governor – said suppliers who benefited from inflated prices of face masks be made to refund excess payment.

Also recommended for investigation and prosecution were then-suspended chief executive officer Jonah Manjari, director of finance and strategy Waiganjo Karanja, head of legal department Ferdinand Wanyonyi and suspended director of procurement Charles Juma.

In May this year, President William Ruto sent the entire Kemsa Board packing, including suspending the then-CEO Terry Ramadhani and former public health Principal Secretary Josephine Mburu over the bungled Sh3.7 billion tender for the supply of treated mosquito nets for low-income households.

He named former Housing PS Irungu Nyakera the Kemsa Board chairman and Dr Mulwa chief executive.

Earlier this week, the CEO said Nairobi County owes Kemsa Sh243 million, Nakuru (Sh53 million), Homa Bay (Sh104 million), Busia (Sh82 million), Trans Nzoia (Sh49 million), Mombasa (Sh12 million), Nyamira (Sh9 million) while Kisumu County has accrued a three-year debt of Sh34 million.

“When I was Makueni Health executive, Kemsa always delivered on time. I never worried about the availability of drugs and essential commodities,” Dr Mulwa said.

“But Kemsa orders started delaying. Order delivery time was 10-15 days but moved to 45 days. From that time Kemsa lost footing,” Dr Mulwa said.