Councils intensify push for 50% drug budget devolution

Directors of health services in local councils, through their Health Services Managers Network (HESNET), have intensified the push for 50 percent devolution of the drug budget, reiterating that health service delivery is being compromised in the councils with the current 10 percent devolution.

During a high-level engagement with national actors on health service delivery and funding trends to local authorities on Tuesday in Salima, HESNET, one of the arms of Malawi Local Government Association (MALGA), decried the inadequacy of the 10 percent devolution, although acknowledging that “it is helping improve service delivery” in health facilities overseen by councils.

But government says “it is comfortable” with the current drug budget for councils, stressing that key is strengthening by at least 80 percent the functional capacity of Central Medical Stores Trust (CMST), which is supposed to be the biggest supplier of essential medicines.

In an interview after the engagement, MALGA Executive Director Hadrod Zeru Mkandawire justified the push for the 50 percent devolution of the drug budget.

He stated: “There are so many gaps with the current 10 percent, including delays. Surely, these gaps are affecting health service delivery in local government authorities”.

Apparently, according to HESNET, the drug budget for the 2024/2025 fiscal year is already depleted in most councils.

Local authorities get the 10 percent for emergency purposes to be able to buy drugs from pre-qualified suppliers while 90 percent is supposed to be procured by CMST.

The 10 percent is a mathematical model to make councils function in terms of emergencies, authorities add.

Amon Nkhata, Ministry of Health’s Director of Health Sector and Intergovernmental Coordination, said 50 percent devolution is not possible, citing capacity, management and accountability gaps in councils.

“Will this huge money be safe? There must a cost analysis because even within the 10 percent there are grey areas requiring clarification.

“The other thing is strengthening CMST functional capacity by at least 80 percent to be able to offer services efficiently”.

But Mkandawire brushed aside government’s assertions on gaps in local authorities, stating there is no evidence of mismanagement of the drug budget.

“What is out there is a narrative that is just a speculation. We have not seen any element where the local authorities have been accused of mismanaging the drug budget.

“Of course, we cannot entirely rule out issues of mismanagement, but those I should believe they are insignificant”.

The engagement meeting also drew chairpersons of health and local government committees of Parliament and members of the Local Government Service Commission, among others.

MALGA, an umbrella body of all local government authorities, held the meeting.

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