Abdulkadir Gelgelo (MD), director general of the Ethiopian Pharmaceuticals Supply Agency (EPSA), is attempting to revitalise the national drug supply chain, broadening the Agency’s revenue streams. His efforts come as public health centres buckle under a crippling shortage of medications and medical supplies.

When Parliament reconvenes in September, the Director and his deputies hope to table the new bill to legislators.

Reestablished in 2007, the Agency supplies pharmaceuticals and medical equipment to state-run health institutions and private facilities through its 19 branches. Two of these are in the Tigray Regional State, out of operation since late 2020. The Agency taps on a revolving drug fund financed revenues it generates and contributions from donors. Over the first three quarters of last year, the EPSA supplied public health institutions with drugs and medical equipment valued at 25 billion Br.

However, its officials say the volume is hardly sufficient to meet demand.

Abdulkadir was appointed head of the Agency two years ago, transferred from the Oromia Health Bureau. His legal experts are drafting a bill allowing the Agency to borrow from domestic financial institutions.

The bill proposes to reorganise the revolving fund to maintain constant and adequate drug supplies. The fund’s operations will be overseen by an 11-member board of directors comprising officials from the Ministry of Health (MoH), the Customs Commission, and the Ministry of Transport & Logistics.

The bill will also allow the Agency to engage in bulk procurement, coordinating its activities with other institutions operating in the health sector.

Officials say the ambiguous line of responsibilities in the health sector has been detrimental to drug supply. There are at least five entities in the pharmaceutical supply chain, including the Agency, the Health Ministry, and regional health bureaus. They conduct forecasting, procurement, storage, and distribution of pharmaceutical products independently, complicating the supply chain and creating a duplication of efforts.

The restructuring of the Fund will help to bring the scattered drug procurement efforts under a single unit, according to Awole Hassen, communications director.

However, the pharmaceutical supply’s most pressing problem remains inadequate financing.

“The demand for drugs is beyond the budget allocated for drug procurement,” said Regassa Bayesa, director of drugs and medical supplies at the Health Ministry.

The World Health Organisation (WHO) recommends that developing countries set aside 40pc of the annual health budget to procure drugs and medical supplies. Ethiopia sees around half the recommended ratio allocated to procurement.

The Agency provides over 1,000 medicines and medical equipment to over 5,000 public health institutions. It charges the health centres it serves 10pc in service fee. Awole described this as “low considering the size of the operation.”

The bill in the making proposes to grant the board of directors the mandate to set profit margins on the sale of drugs supplied by the Agency.