Despite the success story of Ethiopia’s achievement in curbing malaria and meeting several Millennium Development Goals, the past year has seen many issues in the health sector. This ha included many bumpy roads with regards the multi-million dollar purchase of medical supplies, particularly those related to HIV-Aids test kits and condoms.
Public health issues too have been hot issues at different degrees, with the case of the milk product supply and Active watery diarrheal (AWD) extending beyond the capital. Transparency and communication on these issues were evidently poor, leaving the public in a fog,- competing narratives were prevalent in both situations.
The Aflatoxin Scare
Following the report of high incidences of a carcinogenic toxin in Addis Abeba’s milk supply, the government has formed a cross-institutional task force to study the issue and come up with recommendations in two weeks’ time.
“The task force comprises representatives from the Food, Medicine and Health Care & Administration Authority (FMHACA), Animal Feed and Drug Administration and Control Authority (AFDACA) and the Ethiopian Public Health Institute (EPHI),” said Tesfaye Hailu, acting director at the Ethiopian Public Health Institute.
The formation of the task-force was prompted by the findings of a study conducted by the International Livestock Research Institute (ILRI) and published in Food Control – a scientific journal published by Elsevier. This study found a cancer-causing, immunity-suppressing, growth-stunting, contaminant called aflatoxin in samples of fresh raw milk.
Not only were users alarmed, but those who at the bottom line of dairy milk production around the capital have gone into crisis.
Others, angry at the exaggerated rate of conversation, argued that malnutrition was the greatest killer – not the impact of aflatoxin. The scientific conversation revolved around the different regional standards. The research was set to evaluate Ethiopia’s dairy using the European Union (EU) standards as a yardstick.
HIV-Test Kit Procurement Saga
Ethiopia had an algorithm set in 2007. In 2012, it set out to update that algorithm, which after four years has still not been set. This is due to administrative interventions, and substandard processes, which even led to the intervention of the Anti-Corruption Commission.
This is the year that saw the worst shortage of test kits, after the country failed to purchase and import rapid test kits for the past two years. This is due to a back and forth in the procurement and standards setting process, with the setting of the country-level algorithm having failed repeatedly. It has reached a point where the shortage is said to have pushed officials to purchase based on international standard without any local standard set – a mandatory requirement WHO puts on countries for efficiency.
The auction was later dropped.
The authority decided to buy the kits after sample testing in labs and precluding field tests.
“The field tests are not that important,” Kesetebirhan Admasu (MD), Minister of Health, said. “We carry out a lot of testing; we will discontinue their use.”
Wary of the 14 months lapse, the Pharmaceuticals Fund & Supply Authority (PFSA) requested a fast track purchase be permitted. The Ministry of Health had commissioned the Partnership for Supply Chain Management (PFSCM) – a procurement service agent for the Global Fund. All companies listed on the Global Fund’s and WHO’s list of rapid HIV test kits were invited to bid..
The month brought no good news to the decision the Ministry made in February. The latest batch of HIV test kits the country bought were found to be inefficient, the Ethiopian Public Health Institute (EPHI) study indicates.
“We will tell them to take them back,” Kebede states, fully confident that the involvement of the Global Fund’s Supply Chain Manager is enough to secure compliance.
The Procurement Agency seeks the return of defective condoms. Though the company may be blacklisted, the implications of faulty condoms on the market are grave. The Authority filed its complaint and requested the blacklisting of the supplier, an Indian company, HLL Life Care.
Third Time Charm
New and updated testing methodology put sub standard testing kits back in the game. Despite consistently failing the quality checks, they have now been deemed safe for use, the Ethiopian Public Health Institute (EPHI) and the Ministry of Health (MoH) declared in a press conference.
While distribution takes place upon the declaration, the Ministry commissioned two more agencies, the Centre for Disease Control (CDC) and the local Armauer Hansen Research Institute.
Pending Investigation, PFSA Announces Disposal of Faulty Condoms
The Authority has unilaterally announced its intention to dispose of 69 million condoms worth close to two million dollars, on the grounds of sub-standard quality.
“Such a unilateral disposition, if carried out before any decision, can sabotage the whole process of redressing the damage,” an expert said. “The whole risk will shift to the Authority.”
ADW challenged, while the government was criticised for being secretive about the condition by many, including the Washington post. The city has already established a command post to oversee the effort. The post, presided by Mayor Diriba Kuma, comprises institutions such as the Addis Abeba Water & Sewerage Authority, code enforcement officers (Denb askebari) and the Police. In response, service-giving agencies, including 114 business establishments in addition to 32 butcheries and five private clinics were closed down. A volume of 4,800kg of food stuff, 4,500kg of fish and 8,000ltr of drinks were destroyed.
Condom Case Sealed – PFSA to Absorb its Failure
The Supply Agency are facing the wrap for the procurement of defective condoms from the Indian Company, HLL, which was let of the hook after it was deemed that the PFSA did not follow the correct procedures.
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