11 May 2011


Over the last week, I watched on Uganda Television the story of the arrest of the staff of Mbale Regional Referral Hospital for drug theft. This incidence perhaps vindicates President Museveni insistence that drug theft by health workers is the major problem of the Uganda health system.

It would be pedestrian to assume that having “caught the thieves”, we should forget to ask the most important question, “What is the cause of this problem?”

Answering this question makes us realize that far more is required to address this problem than a “neat” law-and-order solution: the thief is caught; the thief is tried the thief is imprisoned. I am sorry to disappoint, but this is not the SOLUTION.

Lest we forget, the proportion of Health facilities without stock-out of 5 tracer medicines and supplies is only 26%. Most times, the vast majority of Uganda government health facilities suffer from gross drug stock-outs (Annual Health sector Performance Report 2009/10). So not theft of drugs; but, system wide failures like:
  1. Unfair and inadequate financing for medicines; the government allocates only 8% of its budget to health way below the commitments it made in Abuja in 2001 with other African governments to allocate 15% of its total budget to health care;
  2. Lack of management capacities by health facilities. Doctors are not managers; they are trained to manage illness not run health facilities; 
  3. High medicines prices leading to loss of asset by the poor; for instance, the poor sell their assets like land, cattle etc. when a major illness strike; 
  4. Unreliable delivery systems by the National Medical Stores;
  5. Irrational drug use by both the health workers and patient. Health workers prescribe even drugs that are not indicated like antibiotics for viral respiratory tract infection or giving patients antimalarial for treatment of “clinical malaria”.
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