SALIMA-(MaraviPost)-Amid drug shortages in public health facilities, district councils are demanding 50% drug budget devolution increase from 10%.

Directors of health services in local councils, through Health Services Managers Network (HESNET) observes that health service delivery is being compromised in the councils with the current 10 percent devolution.

The demand comes as reports show that drug budget for the 2024/2025 fiscal year is already depleted in most councils.

During this week’s a high-level engagement with national actors on health service delivery and funding trends to local authorities in Salima, HESNET, one of the arms of Malawi Local Government Association (MALGA), decried the inadequacy of the 10 percent devolution.

Although HESNET acknowledged current devolution funding is helping to improve service delivery, more resources are needed.

MALGA Executive Director Hadrod Zeru Mkandawire told The Maravi Post in interview that 50 percent devolution of the drug budget increase is justifiable.

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

“The current devolution funding isn’t enough to meet councils’ health facilities demand hence the need for 50% increase,” appeals Mkandawire.

But health authorities are not comfortable with the drug budget increase.

Amon Nkhata, Ministry of Health’s Director of Health Sector and Intergovernmental Coordination argues that the current drug budget for councils is enough to meet the demand.

He said 50 percent devolution is not possible, citing capacity, management and accountability gaps in 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 and among others,” he explains.

Nkhata therefore stressed the need to strengthen Medical Stores Trust (CMST)’s 80 percent functional capacity as the biggest supplier of essential medicines.

“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,” argues Nkhata.

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 High-level engagement between Health Services Managers’ Network (HESNET) leadership and key national actors and multistakeholder interface on local government financing trends which MALGA organised, an umbrella body of all local government authorities attracted chairpersons of health and local government committees of Parliament and members of the Local Government Service Commission, among others.