Now Daily Analysis
The chief executive officer of the statutory National AIDS Council (NAC), Tapuwa Magure deserves to be fired to save the lives of people with AIDS in Zimbabwe. Not only has he run what was an exemplary AIDS programme into the ground through alleged corruption and mismanagement; he has also caused the unnecessary deaths of thousands of people from AIDS after NAC’s key donors withdrew vital funds for medicines and other requirements.
Dressing up like a cabinet minister, driving fancy cars, dining in expensive restaurants like The Venue in Avondale and flying first class abroad regularly has antagonized donors, employers and workers who are contributing money to the poorly-managed National AIDS Trust Fund, which Magure is supposed to administer. Coupled with that, Magure has awarded himself a six-figure salary which would make the CEOs of profitable listed companies envious. All this on the back of dying Zimbabweans who need nothing more than a few antiretroviral medicines (ARVs) and testing facilities.
Magure’s callous attitude is the reason why ARVs sourced by NAC have flooded the black market in Mbare township and private pharmacies but cannot be accessed by sick people in clinics and hospitals where they are supposed to be found. To make matters worse, Magure and his team of bunglers are in the habit of making amateurish denials whenever people complain that they are failing to get drugs, testing equipment and other services in hospitals.
Magure (or Mahure as some cynically call him, alleging he likes feting prostitutes with NAC funds at endless ‘workshops’), regularly misinforms the NAC board about the state of affairs, creating even more confusion. He doles out money to his friends and friends of friends through millions of workshops at expensive five-star hotels, while people are dying in misery, without the care and support promised by the law under the NAC Act.
Magure’s reckless attitude is unforgivable. The Expanded Support Programme, which was contributing 22 percent of NAC funds, pulled out in 2012 citing poor administration, which caused endless shortages of ARVs, known as ‘stock outs’. One of the ESP’s major complaints was Magure’s hefty salary. Magure denied there were any stock outs, and made NAC chairman David Mutambara issue the following statement.
“During the course of the year the country experienced negative publicity emanating from hearsays of medicine stock outs. There have been no stock outs of medicines; the country is fully stocked with ARV medicine. The country continued to record a significant improvement in the national response to HIV and AIDS in particular treatment coverage,” Mutambara claimed falsely in a statement accompanying the NAC annual report.
But an audit of NAC, whose results were published in the same annual report said: “Generally, there were some stock outs and stock variances observed during the exercise. Reagents were still being controlled centrally by National Microbiological Referral Laboratory (NMRL) in Harare. This has resulted in some hospitals in remote areas such as Binga failing to receive reagents on time.”
The report cited ‘stock outs’ among the key challenges affecting the country’s AIDS programme.
“There is need to improve the drug delivery and supply system,” the NAC report said.
The latest report on NAC by state auditor Mildred Chiri shows that shortages of AIDS drugs are rampant in Zimbabwe.
“Mpilo hospital was hit by drug stock outs for periods of up to one year,” Chiri said. “Patients were not getting anything when the drugs were out of stock. Furthermore, patients were being asked to buy some of the drugs such as Nevirapine syrup for children. Stock outs affect service delivery and directly impact on livelihoods of those that rely on the drugs. The Council (NAC)’s staff at provincial and district level should effectively monitor the operations of implementing partners and ensure that stock outs are avoided.”
Chiri’s report is a direct affront to NAC chairman Mutambara’s false claims that there were no shortages. It also gives a chilling insight into the chaotic state of the country’s much-vaunted HIV/AIDS programme.
In simple terms, AIDS funds are being stolen in Zimbabwe.
Shortages of AIDS drugs may be rife but what has shocked the public and experts monitoring the country’s once-shining United Nations-funded AIDS programme recently is to see evidence of theft and mismanagement of the available meagre resources.
According to Chiri, the blame falls squarely on the NAC, which is failing to supervise the activities of ‘implementing partners’, especially the hospitals, where thefts, recklessness and confusion are said to be rife, endangering the health of patients.
Commenting on the lax controls by NAC, Chiri said drugs were being “misappropriated without trace”.
The auditor’s latest report on NAC cites other cases that include theft, negligence and abuse of drugs and AIDS equipment. The NAC procures drugs from suppliers using funds provided by workers, employers, the United Nations Global Fund on HIV/AIDS and other donors such as the United States president’s emergency fund on AIDS (Pepfar). The drugs are received and distributed by the state pharmacy NatPharm, which is supposed to distribute them on behalf of NAC.
Chiri found that drugs that were to be delivered to Chinhoyi hospital by NatPharm simply vanished. These included 3000 boxes of Nevirapine and 4 300 boxes of Tenofovir.
“The NatPharm invoice indicated that the drugs were delivered but there was no documentary evidence in the hospital records to confirm that they were actually received. Drugs procured may have been diverted, hence prejudicing the bona fide beneficiaries,” Chiri said, recommending an official investigation.
Evidence of theft from official stores was also found at Rusape general hospital where a physical count of the available medicines showed a massive difference with what was in the records.
While thefts have resulted in shortages in government health institutions, AIDS drugs of any kind can be bought at the ramshackle open markets in the teeming Harare township of Mbare, at exorbitant prices. The black market traders will likely lie that the drugs are sourced from Zambia or South Africa. However, official investigations have proved that all these drugs are sourced directly from local hospitals and clinics.
Daring state health workers are stealing truckloads of the drugs, merely by tampering with the paperwork. Ordinary people are also conniving with corrupt nurses and getting the drugs using the medical records of people that are long dead, or generating fake records of non-existent AIDS sufferers.
“NAC should develop some mechanisms and systems to monitor some critical activities undertaken by implementing partners such as these hospital pharmacies,” the auditor-general’s report said.
Besides theft, negligence and recklessness in drug administration and equipment handling were found to be common.
Mutare general hospital, for example, received 6 000 units of the drug Alluvia 100 mg/25 mg just four weeks before its expiry on March 31 2012. The drug was not dispensed until April and May, when some of the expired medicines were distributed to the family and child health unit.
“On May 8, the remaining 80 boxes of 60 units were declared no longer suitable for human treatment and hence transferred to the expired drugs store, notwithstanding the fact that on two occasions the drugs had been dispensed in their expired state,” Chiri said, adding that there was no authority sought from the state Medical Laboratory and Clinical Council to allow the hospital to distribute the drugs in their expired state.
“The health of patients may be compromised through consumption of expired drugs,” the auditor-general said.
NAC was also expected to provide funds to the basic education assistance module (BEAM) for the benefit of children orphaned by AIDS. This has failed to happen, causing hundreds of thousands of children to drop out of school or not to take examinations. According to the auditor’s report, the BEAM programme was so hopelessly corrupt that children of employed parents were being sponsored while deserving orphans were going without assistance. Relatives and friends that Magure employs without much supervision enjoyed the benefits while the CEO was busy entertaining politicians in expensive five-star hotels and travelling frequently abroad.
Investigations by parliament’s thematic committee on HIV/AIDS, Unesco and the government auditor have all come to the conclusion that was already public knowledge, that the country’s AIDS programme is chaotic.
Magure is running NAC like a private business with a profit motive, which is wrong. When the government set up this enterprise, its sole objective was to save lives, which is why there was buy-in from workers and employers. It is, therefore, shocking that between 2009 and 2012, Magure diverted $13 million to so-called ‘investments’ while people, including workers contributing to NAC, were dying due to shortages of drugs, trained staff, equipment and testing facilities. There is no evidence that the so-called ‘investments’ on the money market bore any fruit or were degraded like most other assets due to the collapse of numerous banks and financial institutions. In fact, even if the investments paid off, they cannot bring back people who are in the ground because of bungling by NAC.
Actually, some of these investments are poorly managed. For example, NAC purchased an office stand in Mashonaland West in 2005 but never developed it. The idle stand was recently valued at $62 000, an amount that could buy 15 CD4 count machines.
While Magure was holding on to these huge amounts, hundreds of thousands of children orphaned by AIDS failed to go to school or write examinations because NAC failed to pay their fees as required by law.
All we can see are endless ‘capacity building’ workshops and gala dinners for politicians, whose results are hard to quantify. What we are sure of, though, is that NAC officials running the functions get hefty allowances at the expense of sick people and those at risk.
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