Arrival of medical kits a wasted opportunity

The arrival of large numbers of expensive medical kits into the country is a wasted opportunity to effectively and efficiently address the health crisis.

According to the findings from a recent government audit, the medical kits may not relieve much of the pressure on our underfunded and under-resourced health facilities as their contents are not matched to specific needs and many items may be unnecessary.

Failure in properly assessing the needed type of medical supply items and at appropriate volumes to health facilities in specific provinces and regions has resulted in significant oversupply and wastage. [p41]

The arrival of the kits into five regional ports was announced this week by Health Secretary Pascoe Kase. Kase said that by early February all aid posts, clinics and health centres should receive their stocks.

However, the Secretary is well aware the procurement, distribution and contents of the medical kits has been heavily criticized in a damning audit report from no less a source than the Department of the Prime Minister.

The audit, conducted last year, highlights the fact the medical kits are not tailored to the individual needs of different health facilities or the different disease patterns in different parts of the country.

Kits are pushed onto the primary health facilities without properly assessing the needed types of medical items and at appropriate volumes. We observed that primary health facilities are over supplied with the items and quantities of 100% Kits that they cannot use all of them. Consequently, these expensive medical commodities are kept at the primary health facilities and reach their expiry dates.  [p42]

The medical kits are being supplied by Borneo Pacific Pharmaceuticals Limited, at a cost of K57 million according to the audit.

PNGi has previously published a series of reports about Borneo Pacific, highlighting the questionable circumstances around the awarding of its contracts, evidence of overpricing, concerns about the quality of some of the products it supplies and its wider business connections – Profiting From Sickness Part 1, Part 2, Part 3.

The audit from the Prime Minister’s department also reveals issues surrounding the contents of the medical kits are exacerbated by the Department of Health not having any mechanism for receiving feedback from local health facilities.

Shockingly, the audit found there is ‘no system in place that would allow health facilities to assess and provide feedback on the value for money appropriated by GoPNG and spent on the entire procurement and distribution of medical supplies’. [p32]

This does not mean though the Secretary or his Department would have been previously unaware of the problems with the kits. As far back as 2014, research  published in the Journal of Pharmaceutical Policy and Practice revealed how the kits fail to address clinical needs:

Kits were observed to be underutilised or not used at most service delivery points, and were present in significant excess at some facilities. One remote facility had a very large excess of kits which suggested that it was a repository for kits which were unable to be stored elsewhere in the province. The ongoing ‘push’ distribution of these kits appears to be unnecessary in the provinces visited.

The recent audit recommends for NDoH to ‘carefully review the contents of both Health Centre and Aid Posts Kits and determine the accurate volume of the contents to be distributed to specific provinces and regions based on their disease patterns’. [p41]

Unfortunately, this recommendation has not yet been implemented, which means that while the current distribution of medical kits may provide some limited relief, it is a failed opportunity to really assist the 99% of people who rely on the public health system.