A Costly Dose

By Charles Mafa | Makanday Investigates

During the cholera outbreak, the medicine supply agency made critical errors by over-procuring short-dated intravenous (IV) fluids from VL Pharmaceutical, ignoring clear internal warnings. These fluids are vital in treating severe dehydration caused by cholera, but the oversupply risks millions of kwacha wasted and medicines expiring unused.

Insiders at the Zambia Medicine and Medical Supplies Agency (Zammsa) say some officials may have been motivated by personal gain, prioritising kickbacks over the country’s urgent medical needs during last year’s cholera outbreak.

The procurement of near-expiry stock not only wasted public funds but also disrupted the use of longer-lasting fluids already in storage—leaving large volumes at risk of expiring unused. This episode is not an isolated case but part of a broader pattern of mismanagement and entrenched corruption in Zambia’s health system.

An earlier MakanDay report highlighted turmoil within Zambia’s drug procurement system, beginning with officials at the medical supply agency exploiting a border clearance loophole for personal gain. The scandal triggered a series of dismissals, a blame game, and the transfer of Health Minister Sylvia Masebo.

In the wake of such scandals—including the theft and misuse of donated medical supplies—the U.S. government recently withdrew K1.4 billion (US$50 million) in aid, citing the Zambian government’s failure to address systemic corruption. In response, authorities have begun reviewing Zammsa’s procurement processes, with the fluids deal now under increased scrutiny.

According to a MakanDay investigation, the oversupply of fluids was worsened by the introduction of a system, where medical supplies were distributed to health centres regardless of actual requests, based solely on assumptions of anticipated need.

This procurement took place under the leadership of ex-Zammsa Director General Victor Nyasulu and his team. During his tenure, the agency reportedly ordered an excessive quantity of IV fluids—enough to last over 17 months. Consequently, the Drug Enforcement Commission (Dec) has summoned several former directors for questioning, a well-placed source has told MakanDay.

“Among those summoned were former director of warehousing and distribution, Mpande Mukumbwa Mwenechanya, and Acting Director of Supply Planning, Racheal Musumuko. Investigators questioned Mpande on why, despite overseeing warehouse operations, she did not advise management against placing such large orders—especially given that existing stock levels were already adequate,” the source explained.

According to documents obtained by MakanDay, Mwenechanya advised management against procuring near-expiry fluids from VL Pharmaceutical. She recommended sourcing long-dated stock instead, advising that Zammsa already had a 24-month supply of fluids. She warned that adding short-dated stock would undermine the integrity of the existing long-dated inventory. However, her advice was ignored.

“Despite this advice, management went ahead and signed a contract with VL Pharmaceuticals to supply additional fluids, which were set to expire in November 2024,” the source said.

The Drug Enforcement Commission has confirmed that investigations are ongoing and that an update will be provided in due course.

Nyasulu, the former Director General, was contacted for comment but declined.

Due to the over-procurement of fluids, hospitals and health centres are now requesting the agency to collect the excess stock. A visit by MakanDay to Levy Mwanawasa Teaching University Hospital in Lusaka, a month ago, revealed that the facility still hold expiring fluids (5% Dextrose, 500ml) with an expiry date of 14 October 2024.

According to information obtained by MakanDay, to prevent the fluids from going to waste, the government has taken corrective measures by donating some surplus to neighbouring Malawi to prevent waste.

“In an effort to ensure the fluids do not expire, the Ministry of Health has facilitated the donation of some fluids to neighbouring Malawi this exercise was done last month,” the source said.

Despite these efforts, other medical commodities—such as Dextrose 5%—remain at risk of expiring while still in storage at Zammsa. This situation is linked to the agency’s earlier decision to procure short-dated fluids from VL Pharmaceuticals, at the expense of taxpayers. The move compromised other consignments that had longer shelf lives.

When MakanDay contacted Zammsa about the over-procurement of the fluids, the agency said the matter was under investigation and it could not comment.

“As is publicly known, these investigations follow the submission of the PwC forensic report to the law enforcement agencies by the Office of the Auditor General,” said Bradley Chingobe, Senior Manager for Corporate Communications.

“In line with legal and institutional protocols, and as a matter of principle, Zammsa is unable to comment or publicly engage on issues that are subject to active investigation. This approach safeguards the integrity of the investigative process and ensures that due process is upheld,” he added.

Chingobe said Zammsa remains fully committed to cooperating with all government investigative wings and continues to operate in line with its core values of transparency, accountability, and respect for the rule of law.

MakanDay has also learned that Zammsa is facing challenges in distributing essential medicines following the withdrawal of support from USAID.

According to a source, the agency’s current distribution rate stands at just 53%, and the first distribution cycle is still incomplete, with some parts of the country yet to receive essential medicines.

Chingobe said Zammsa has long used a hybrid distribution model, combining its own fleet with third?party logistics (3PL) firms once funded through USAID’s Programme for Advancing Supply Chain Outcomes (Pasco).

He explained that after USAID abruptly terminated the Pasco programme, Zammsa acted swiftly to contract a new third-party logistics (3PL) provider to avoid service disruptions. “The transition caused some temporary delays, but we accelerated the contracting process to minimise the impact,” he said.

According to Chingobe, distribution has now stabilised. He said Zammsa is using its internal fleet alongside the new 3PL provider, with support from the Government, the Global Fund, and the GHSC-PSM mechanism.

He added that the Ministry of Health continues to work with Zammsa to secure additional partners to ensure sustained distribution and uninterrupted access to essential medicines nationwide.

However, a source revealed that Zammsa’s core challenge lies in its weak governance structure, with most senior management positions currently held in an acting capacity. This lack of permanent leadership has created uncertainty in decision-making, hampered long-term planning, and weakened accountability within the agency.

Experts warn that weak leadership and acting appointments at Zammsa undermine effective procurement and distribution, calling for urgent reforms to restore donor confidence and ensure medicines reach health facilities on time.

They have recommended the urgent establishment of a robust governance framework, including the appointment of qualified and permanent personnel to key positions.

“Such a move,” said a source close to the procurement process, “is important not only for improving internal efficiency but also for restoring donor confidence, enhancing transparency, and ensuring that Zammsa can fulfil its mandate of delivering essential medicines and medical supplies to health facilities across the country in a timely and reliable manner”.

The Ministry of Health has not yet responded to MakanDay’s request for comment.

The AI-generated image used is solely for illustration purposes.