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Why Kemsa is not a lost cause

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Kenya Medical Supplies Authority (KEMSA) warehouse in Nairobi. PHOTO | LUCY WANJIRU | NMG

A country’s health system is often described as one of the vital pillars of national sovereignty.

The Covid-19 pandemic was perhaps one of the most vivid justifications for the need to prioritise health systems’ resilience and view them as strategic security installations, almost mirroring investments in the national defence systems.

At the heart of a country's health system is the national drug stores and, in our case, the Kenya Medical Supplies Authority (Kemsa), which maintains statutory obligations. As outlined by law, these responsibilities include the procurement, warehousing and distribution of health commodities to all public health facilities.

This statutory responsibility requires Kemsa to operate world-class supply chain facilities and provide solutions that keep the local health system running. With Kemsa as the heart of our national health body, our more than 11,500 health facilities are our first-line defence mechanisms and arteries for primary health care and disease management. The government should not tolerate failure to pump these arteries with the relevant health commodities through operational inefficiencies and other management challenges.

With a base of more than 11,500 health facilities, Kemsa is best placed to procure health commodities at wholesale volumes and in good quality. Such procurement efforts allow the agency to enjoy better pricing, passed on as a benefit to the health facilities ordering through Kemsa while fiercely protecting the patient from substandard products.

Of course, this also makes fertile grounds to make the compelling argument that, as with any other strategic and critical public installation or agency, the stakeholders can’t afford to throw the baby out with the bath water. Kemsa is not a lost cause. It may not have met its mandate as efficiently as expected. Still, recent transformation efforts, management focus and integrity enhancement measures have proved that the agency can once again rise from the ashes like the proverbial phoenix and deliver world-class supply chain solutions.

It is no mean feat to bring life back to a giant and complex institution like ours, and the road to reforms has been long and winding. For almost a decade or more, various stakeholders have voiced their concerns about Kemsa’s capacity to support our national health needs as required.

From funding partners to local clients, including counties running health facilities in Kenya, the stakeholders have been unanimous that Kemsa is barely meetings its mandate. Some stopped calling the spade a big spoon and affirmed that Kemsa was dysfunctional, almost on its deathbed, requiring urgent resuscitation.

One of the stakeholders that have continued to take the state of Kemsa with the seriousness that the matter deserves, and rightly so, is the Government of Kenya, which also funds the authority through the exchequer.

The various State agencies, from the Ministry of Health to the Cabinet and beyond, have constantly maintained their heartbeat check on Kemsa's performance, leading to several task forces, committees and other reform teams.

Externally, independent bodies such as the Office of the Auditor General and several multilateral bodies affiliated with the Development Partners for Health in Kenya, including USAID and the Global Fund, have all released detailed reports on the state of affairs at Kemsa.

Besides the operational challenges, the State Corporations Advisory Committee and the Auditor General, on their part, have consistently raised the alarm that Kemsa is overstaffed and inefficiently operating at three times above its approved staff establishment level of 378 employees.

All these reports have almost unanimously confirmed the existence of systemic challenges that had eroded Kemsa’s operating capacity, particularly the ability to meet its statutory mandate to procure, warehouse and provide last-mile delivery of health commodities.

Against this background, the Health ministry established a Kemsa Immediate Action Plan and Medium-Term Reforms Working Committee in mid-2020. It delivered a detailed report outlining the need to activate urgent reforms at Kemsa. The Kemsa Reforms Implementation Committee swiftly followed this committee commissioned to spearhead priority reforms.

The reform agenda at Kemsa must be sustained to guarantee service delivery for Kenyans. This is a commitment that the reforms team at Kemsa continues to hold dear and is dedicated to achieving. Indeed, success is not about never failing, but it is found in how often you get up after a fall, dust yourself up, and keep moving.

The writer is the chief executive officer at Kemsa. Email: [email protected]