The latest laying off of workers at the Zambia Medicines and Medical Supplies Agency (ZAMMSA) is just the latest in how Zambia has perfected a peculiar response to institutional failure: fire the officials, appoint replacements, announce reforms and wait for the next scandal.
At ZAMMSA, this revolving door has become almost routine. Yet medicines continue to go missing, procurement controversies persist, and patients are left wondering whether the drugs prescribed to them will ever reach their hospitals.
The uncomfortable question is this: Are we fighting corruption in the medical supply system, or merely changing the people who control it?
The problems at ZAMMSA did not begin with the United Party for National Development (UPND). Neither did they originate under the Patriotic Front (PF) or its predecessor, the Movement for Multiparty Democracy (MMD). They are longstanding national problems, inherited, perpetuated and, in different ways, worsened by successive governments.
When the PF government transformed Medical Stores Limited into the Zambia Medicines and Medical Supplies Agency (ZAMMSA) on 3 February 2021, under the Zambia Medicines and Medical Supplies Agency Act No. 9 of 2019, it expanded the institution’s mandate to include the procurement, storage and distribution of medicines and medical supplies.
The transfer of procurement responsibilities from the Ministry of Health to ZAMMSA was intended to insulate the process from political interference and undue influence by senior ministry officials. But did it achieve that objective?
The recurring procurement scandals and allegations of interference suggest otherwise. If anything, the experience has demonstrated that changing an institution’s name, legal status and mandate does not necessarily change its institutional culture, strengthen its independence or protect it from the very political interference it was meant to eliminate.
The UPND came to power promising to do things differently. Its New Dawn administration presented a strategy to transform the medical supply system, improve accountability and restore reliable access to essential medicines.
Five years later, what happened to that transformation?
MakanDay’s investigations have repeatedly exposed troubling weaknesses in Zambia’s pharmaceutical supply chain: allegations of political interference in procurement, questionable contracts, financial mismanagement, leadership instability and the erosion of ZAMMSA’s operational independence.
One investigation revealed that ZAMMSA had experienced eight directors-general, including acting appointments, within four years.
Another examined serious irregularities surrounding a controversial medicines procurement exercise involving contracts worth hundreds of millions of kwacha.
These revelations raise a fundamental question: How can an institution deliver consistent reforms when its leadership is constantly changing and its decisions are allegedly influenced by powerful individuals outside its management structures?
The government’s efforts have not been entirely without results.
Medicine availability has improved from the prolonged shortages that previously plagued public health facilities. That progress deserves acknowledgement.
But improved stock levels do not necessarily mean a healthy supply system. Medicines sitting in warehouses, stranded at borders or failing to reach rural clinics offer little comfort to patients.
And while dismissals, investigations and prosecutions may demonstrate a willingness to confront wrongdoing, they cannot substitute for structural reform. Those accused of criminal conduct must face due process, and guilt must be established in court.
The real test of reform is whether the system becomes less susceptible to abuse, regardless of who occupies State House or runs ZAMMSA.
Why does political influence appear to persist in an agency established to operate independently within a clearly defined legal framework? Why do procurement decisions remain vulnerable to interference? And why do funding and distribution failures continue despite repeated promises of reform?
Perhaps the more uncomfortable question is: Who benefits from keeping ZAMMSA institutionally weak?
Consider the agency’s reported prolonged absence of a board of directors, the very body entrusted with providing strategic direction and oversight. If ZAMMSA has been operating without a board for years, who has been exercising those responsibilities? Who appoints the Director-General, and under whose authority? More importantly, who holds the Director-General accountable?
These are not merely administrative questions. They go to the heart of ZAMMSA’s independence, transparency and accountability. An institution cannot be expected to operate free from undue influence if the structures designed to safeguard its independence are absent or ineffective.
Zambia needs more than another round of dismissals. It needs independent oversight, transparent procurement, predictable financing, professional appointments and enforceable accountability extending beyond ZAMMSA’s employees to everyone who influences its decisions.
The health of a nation cannot depend on political loyalty or the fortunes of connected suppliers.
Ultimately, the success of ZAMMSA should not be measured by how many officials are fired, how many investigations are announced or how many contracts are awarded.
It should be measured by whether a patient entering a public health facility can obtain the medicine they need.
Until that becomes the measure of success, Zambia will continue changing the faces of failure while preserving the system that produces it.
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