After being given a 14-day ultimatum to respond to the acute shortage of essential medication, Prime Minister Russell Mmiso Dlamini has outlined five causes of the precarious situation in public health facilities.
Presenting his responses to a Private Member’s motion 7/2025 (shortage of essential medication) moved in the house of assembly on July 7, Dlamini said constant availability of life-saving medicines was fundamental and foundational to a functional health system.
“Yet our clinics and hospitals have experienced stock-outs that have endangered lives, eroded public trust, and undermined our commitment to universal health coverage,” the PM said.
Dlamini had been allowed 14 days to sort out the health crisis in public health facilities. His responses followed unending complaints from the public and health workers on the challenges experienced in health facilities.
This included shortage of medical drugs and supplies, as well as challenges of staffing. In the last sitting that the legislators had, they were expected to adopt the responses that were tabled by the minister, but could not after deliberating on the issue and tasked the PM to take it up because they were not satisfied with the responses by the minister of health.
The PM shared that governance and oversight limitation at the ministry of health was a cause of the prevailing challenges. He said the ministry had suffered governance failures, which contributed to inefficiencies and indecision on critical matters pertaining to service delivery.
Dlamini said the root cause of recurring drug stock-outs was the weak capacity to forecast national demand for medical commodities.
He said for over a decade, the country’s essential medicines list (EML) was not updated, resulting in procurement plans that did not reflect current treatment protocols.
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He said local public health facilities lacked the data and technical tools to quantify drug needs accurately, which then results in the under- or over-ordering of medical drugs and supplies.
He said the shortage of essential medicines was not just a technical failure, but it was a threat to the dignity and well-being of the nation.
He said this eroded the foundations of trust in the health system.
“I call on this august House to support the ministry’s request for adequate and timely funding, to endorse procurement reform legislation, and to demand accountability from all actors in the supply chain. The lives of our citizens depend on the choices we make here,” the PM said.
Dlamini said the procurement of essential medicines was managed through a centralised system involving multiple agencies, which results in delays in tendering, supplier vetting, and approvals. He said this then causes critical medicines to arrive months later than anticipated.
The PM added that the procurement process was also not aligned with facility-level realities, which then created bottlenecks from requisition to delivery.
“The Central Medical Stores (CMS) is constrained by limited storage space, outdated inventory systems, and vehicle shortages. In some cases, deliveries were halted for stock audits or vehicle breakdowns,” he added.
Dlamini added that while the country allocated a significant share of its budget to health, the specific budget for medicines has often been inadequate.
He said in the recent fiscal years, the ministry of health requested allocations based on projected needs. However, he said the approved budgets were significantly lower, frequently covering only 40–60 per cent of the requirements.
He said there were also delays in disbursements, which had led to payments arrears to suppliers, damaging relationships and prompting them to suspend deliveries or inflate costs.
“The allocation of budget usually excluded maintenance of facilities,” he said. The PM said in order to restore confidence and ensure uninterrupted access to essential medications, government was going to immediately pay for partial deliveries to unlock suppliers’ capacities to deliver medical supplies. He said there was a security system that had been identified and procured to track the distribution and delivery of drugs. He said the minister for health would be tabling the CMS Bill to allow for the recruitment of senior management staff for the new parastatal.
“An electronic security system to track the distribution and delivery of medical supplies has been identified, and procurement has been initiated. This will prevent theft and diversion of supplies,” he said.
He added that they should commit to building a health system where no lives would be lost due to the unavailability of drugs, and no patient would be turned away because the medicine they need was not available in the hospitals.
The Speaker of the House of Assembly Jabulani Mabuza said since the PM has tabled the report, he would like the members of parliament to return to the house for deliberations today. He said they should read the report and apply themselves.
Eswatini Observer Press Reader
