Millions of Kenyans are at risk of missing out on essential drugs in public hospitals due to the failure by county governments to service a Sh1.1 billion debt they owe the Kenya Medical Supplies Agency (Kemsa).
Those at greatest risk are residents of 14 counties, whose debts run into tens and hundreds of millions of shillings for unpaid deliveries accrued over time.
Leading in the category of counties which owe Kemsa huge amounts of money are Nairobi (Sh234 million), Narok (Sh104 million), Homa Bay (Sh81 million), Kilifi (Sh78 million), Kiambu (Sh76 million), Migori (Sh58 million) and Machakos (Sh50 million).
County governments that have failed to service their debts over the last three months include Bungoma (Sh25 million), Busia (Sh8 million), Homa Bay, Kericho (Sh26 million), Kiambu, Kilifi, Kisumu (Sh35 million), Machakos, Migori, Mombasa (Sh17 million), Murang’a (Sh46 million), Nairobi, Narok, Taita Taveta (Sh49 million) and Trans Nzoia (Sh41million).
Kemsa has since suspended Governor Samuel Tunai’s Narok County for failing to demonstrate any commitment to clear the debts.
The counties have consistently blamed their failure to pay Kemsa on the National Treasury's delay to disburse money to the devolved units.
What is clear, however, is that in many instances, it is a question of misplaced priorities — counties prioritise the funding of projects such as official residences at the expense of essential services to the public.
This has left many county hospitals undersupplied with medicines, including those used to manage HIV.
In this year's budget, Kilifi County has set aside Sh214 million for the construction of a deputy governor’s official residence while it has also allocated Sh200 million for the construction of the Speaker’s residence.
Nairobi has allocated Sh130 million for the Speaker’s residence.
County governments that have allocated exorbitant amounts towards the construction of county assembly offices include Kilifi (Sh500 million), Nairobi (Sh400 million) and Bungoma (Sh400 million).
These are among the devolved governments that owe Kemsa large sums.
There are some counties that did not owe the medicine supplies agency anything as at August 3, meaning that their residents will continue enjoying the supply of essential drugs.
These include Elgeyo Marakwet, Embu, Isiolo, Kajiado, Kakamega, Kirinyaga, Kisii, Kitui, Mandera, Marsabit, Makueni, Wajir and West Pokot.
Residents of Bomet (Sh2.7m), Kwale (Sh160,000) and Laikipia (Sh100,000) can also sit pretty as their respective county governments have consistently serviced their debts and owed Kemsa negligible amounts as at August 3.
Nairobi residents may also get some reprieve after the county government reached an agreement with the agency.
“We have since had an agreement with Nairobi County and they will be paying Sh30 million every month to reduce the amount,” Kemsa CEO Jonah Mwangi said.
Vesca Kangogo, acting health executive, said: "We have had fruitful discussions with Kemsa. We expect supplies to resume by the end of next week. The value of the first consignment is slightly over Sh200 million."
The controller of budget, Ms Agnes Odhiambo, recently raised the red flag over the huge debts that devolved governments owe KEMSA, ordering them to prioritise the repayments during this financial year.
Despite majority of the county governments owing the agency millions of shillings, others have overpaid and are just waiting for fresh supplies.
These include Mandera, Meru, Tana River, Nyandarua and Uasin Gishu.
“Overpaying means that it is the authority that has pending supplies to make to the counties,” Dr Mwangi explained.
Whereas Kemsa maintains that it has never declined to supply drugs in situations where a county government makes a written proposal and gives a commitment to pay, counties have accused it of denying them drugs despite repeated requests.
Many hospitals in the country have not been stocking enough drugs and doctors have been referring patients to private pharmacies that are selling prescribed medicines at high prices.
However, the agency termed reports that it had blacklisted some counties as inaccurate and misleading.
“At no time has Kemsa ever declined to supply commodities if a county makes a written proposal and a commitment for payment,” communications director, Elizabeth Mwai, said in a media statement.
Dr Mwangi said Kemsa has entered into service agreements with a majority of the county governments to open a special purpose account to service the debts.
“Kemsa has continued to appreciate the challenges that counties are facing in terms of funds and, through mutual agreements, has previously extended the credit period to 45 days,” he said.
He, however, warned that the agency will be unable to supply drugs if county governments fail to service their debts.
“If we have half of our money out there, we will not be able to stock drugs. It means many Kenyans are going to suffer.”
This comes after it was reported that Kemsa had decided to stop supplies to counties that still owe it money.
Nairobi Governor Mike Sonko sought the intervention of Health Cabinet Secretary Sicily Kariuki as the agency allegedly refused to supply its health facilities even after being paid Sh58 million.
“I direct Kemsa to start supplying medicine to all Nairobi hospitals as the governor and his team sits down with Kemsa to see how the pending bills will be settled,” Ms Kariuki said during the launch of the World Breastfeeding Week at Pumwani Hospital.
Additional reporting by Collins Omulo