The tender processes at the Rwanda Biomedical Centre have been dogged by bureaucracies, which have resulted in problems of medicine stock-outs at major hospitals in the country affecting the quality of healthcare.

The problem of missing drugs is more pronounced at the University Central Hospital of Kigali (CHUK), a major referral hospital with 560 beds that gets an average of 500 outpatients daily.

The problem was raised by the Auditor-General’s office, which reported that last year 110 drugs and medical items were out of stock at the hospital and restocking them took between 45 to 504 days. By the end of the year, the hospital had failed to restock 52 drugs and laboratory reagents.

Martin Nyundo, head of clinical services at CHUK, said this problem usually affects patients who have been referred to the hospital from the districts.

Dr Nyundo added that medicine stock-outs are a result of delays in procurement processes, which are handled by the Medical Procurement and Production Division (MPPD) at the Rwanda Biomedical Centre.

“The tender and procurement process takes 90 days, but can sometimes take up to six months,” he said.

“The process involves us sending our list of drugs to MPPD, which then requests bids from suppliers. However, the suppliers are few and those who are available sometimes don’t bring the quantity of drugs that we requested,” said Dr Nyundo.

He said that the most affected drugs by stock-outs are like those for cancer patients, which come in small quantities. Suppliers usually go for tenders for large quantities of medicine.

However, Dr Nyundo downplayed the impact of this problem, saying that such specialty drugs often have alternatives, which the hospital has in plenty.

“We have a list of over 5,000 drugs that we use and which are always in stock. So, not having 100 drugs does not mean our services should be hampered. There is not a single day we failed to provide medical care simply because drugs were missing,” he said.

To address this problem, the government is in the process of making the Medical Procurement and Production Division an autonomous entity.

One it becomes autonomous, it is expected that it will avoid the bureaucracies and red tape that bog its effectiveness while under the control of Rwanda Biomedical Centre.

Celsa Muzayire Gaju, the division manager at MPPD, acknowledged the problem and said the body should be autonomous by the beginning of next year.

“RBC is being restructured and making the procurement division autonomous has become a priority. I think this will make the process of procuring drugs faster and more competitive among suppliers,” said Ms Gaju.

Last month, a Cabinet meeting approved a draft Bill revising the organisation and functioning of RBC —a step towards making the procurement division autonomous.

In the meantime, CHUK has been authorised by the Ministry of Health to conduct its own parallel tenders with private suppliers whenever MPPD fails to provide the required drugs.