Effective supply chain will establish a strong road map to achieving Universal Health Coverage
Quality and affordable medicines is key in achieving Universal Health Coverage. However in Kenya the prices of medication is very high thus putting patients with Non Communicable Diseases especially Diabetes and Hypertension in financial hardship and others are not able to keep up with the medication leading to more complications.
It has also been noted that there is importation of illicit drugs and the government should be very keen in curbing this. How can the private sector contribute in improving the quality of medication and ensuring the medication is affordable?
Kenya Healthcare Federation (KHF) supply chain committee held it’s quarterly meeting on 28th August 2018 at KHF offices. The meeting was chaired by the committee chair Dr. William Mwatu. Supply chain falls in two of the president’s BIG 4 Agenda that is manufacturing and affordable healthcare. The supply chain committee has been pushing for the support of local manufacturers this makes the medicines affordable.
“What are the reasons that support parallel importation and what are the impact? One of the major reason is to make profit but this has a negative impact on patients safety” Dr. Peter Kamunyo, Director Kenya Healthcare Federation. “When it comes to the supply of medication, the private sector should use Public Private Partnership (PPP) as a channel to advocate for the pharmaceutical regulatories to operate within the law.” Dr. Anastacia Nyalita, Director.
There was a consensus on developing a unique identifier and best coding mechanism, for example each drug pack should contain original details so that when a patient uses the code to search on the details of the pack , they should be able to get them. “Therefore the supply chain should use PPP as a channel to advocate for this.” Dr. William Mwatu Supply Chain Committee Chair.
Recently, the Pharmacy and Poison Board (PPB) of Kenya made a bold decision to address what maybe the local pharmaceutical industry’s most controversial issue, ‘Parallel Importation of pharmaceutical products. There has been few attempts made to tackle this but not be successful, however PPB hopes that the current attempt will be successful through considering all important aspects in order to build a consensus among all interested parties in coming up with a policy position that is not only widely acceptable but also addresses most of the contentious issues once and for all.
The key issues to consider is create more incentives towards local manufacturing, change perspective and strategize on how to marketing for local products. A consideration should be put on what percentage off is to be given to the local manufacturer to give value addition. The main aim of reducing the cost is to increase on accessibility and not maximize profit. The committee will be pushing for implementation of the guideline draft act by pharmacy and poisons Board (PPB) Dr. William Mwatu was re-elected as the committee chair and Mr. Chris Masila was elected as the committee vice Chair.
Second Universal Health Coverage Conference in Nyeri
Kenya Vision 2030 delivery secretariat in partnership with Ministry of Health (MoH), Kenya Healthcare Federation (KHF), Amref Health Africa, Kenya Cardiac Society, Council of Governors, NCD Alliance Kenya, Kenyatta University and Nyeri county health department organized the second Universal Health Coverage Conference held at Green Hills Hotel, Nyeri County from 11th – 12th September 2018. The conference sought to address the non – communicable disease (NCD) challenge to the country and was appropriately themed “Universal Health Coverage for Sustainable Development – Transformative Solutions to Halt and Reverse the Non-Communicable Disease Epidemic”
The conference was graced by several dignitaries: Her Excellency Dr. Carol Karugu, Deputy Governor, Nyeri County; His Excellency Prof. Peter Anyang’ Nyong’o, Governor, Kisumu County; His Excellency Prof. Kivutha Kibwana, Governor, Makueni County; Dr. Julius Muia EBS, Principal Secretary, State Department for Planning; Dr. Racheal Kamau, CEC Health, Nyeri County.
Rev. Samuel Njenga of the Presbyterian Church of East Africa opened the conference with prayer and thereafter giving a brief address. He said that the church has a vital role to play in advocating for and sensitizing the people about good health.
Dr. Kamau welcomed participants and thanked the organizers for choosing Nyeri County to host the conference, adding that she looked forward to fruitful deliberations. “Nyeri County is facing a high burden of NCDs. We need to change our ways of practice and take up the challenge” she remarked. Thereafter Dr. Kibachio Mwangi, the Head of NCD unit at MoH highlighted the key objectives of the conference which were: Understand the NCDs challenge; outline the role of private sector in addressing NCDs; outline the role of consumer organizations in protecting the public from sale of harmful products; and outline the role of government, civil society and the youth in addressing NCDs. Dr. Mwangi emphamphised that NCDs are not purely a health agenda, but require a multi-sectoral approach incorporating sectors such as transport, education and agriculture particularly in prevention measures.
“We should put health first; unfortunately what are addressing is a result of our choices such as what we eat. Good health plays an important role in boosting the economy, reducing poverty, increasing education and boosting investment” Dr. Julius Muia said in his address to the conference.Preventive measures against NCDs took center stage in the deliberations. It was appreciated that more focus needs to move to prevention as we continue in disease management interventions.
The consensus on the way forward included creating awareness, education of the public and preventive measures against NCDs, adoption of a multi-sectoral approach, utilizing Public- Private Partnerships and supporting local pharmaceutical manufacturers to make medicines affordable and strengthening the supply chain. “Managing NCDs is very expensive. If we truly want to make UHC achievable, we need to address the issue of cost. If we reduce costs we’ll be able to expand the care. The biggest PPP opportunity in cost reduction is in supply chain”, said Dr. Peter Kamunyo, Director, Kenya Healthcare Federation.
Further, there was consensus that community health volunteers (CHVs) should be officially entrenched in the health system. It was recognized that CHVs play a very critical role in NCD public sensitization. It was agreed that NHIF be strengthened, that it should cover preventive health checks and that it should ensure that the poor and vulnerable are covered. The country should strategize on addressing the poor availability, lack of affordability and inadequate resources as barriers to UHC. Young people should be informed and sensitized on NCDs so they can act as role models to their peers in NCDs prevention. NCD education should be incorporated in the school curriculum.
A patient representative at the conference made an appeal to the health sector to address survivorship of NCDs, a phase of management that insurance doesn’t cover. She highlighted that cancer patients are usually deserted by friends and family after diagnosis due to the burden of their disease on their loved ones. “We are left alone. It’s time for medics to inform us how we can survive after diagnosis of an NCD like cancer. This way trauma can reduce and a patient can accept the situation, love on themselves and even achieve their goals. The price of medications is usually very high and almost unaffordable. Patients get financially drained while trying to get medication”, said Elizabeth, a cancer survivor of nine years.
Professor Nyong’o called on stakeholders to identify areas of inequity in health care, and strategize on how to fill the gaps. “Counties don’t have a strong primary healthcare system, the aim of UHC is to strengthen primary healthcare” said Dr. Karugu, while Prof. Kibwana called upon all pilot counties to learn from each other as a way achieving UHC uniformly, further adding that CHVs will play a big role in rolling out UHC, particularly in educating communities.
The conference was well attended attracting 400 delegates drawn from both public and private health sectors. There was representation from national government, county governments, World Bank, the United Nations office in Kenya, Non-governmental organizations and youth organizations. KHF was represented by the chairman, Dr. Amit Thakker, directors Dr. Peter Kamunyo and Dr. Daniella Munene, Dr. Joy Mugambi, deputy Secretary General, Kenya Medical Association (all panelists), as well as several KHF members who attended as delegates. A number of KHF member organizations sponsored the event.
China- Kenya Pharmaceutical Trade and Investment Forum
The China Chamber of Commerce for Import and Export of Medicines & Health Products (CCCMHPIE), held a trade and investment forum together with the Ministry of Health Kenya and the private health sector in Kenya on the 30th of August 2018 at the Laico Regency Hotel in Nairobi.
The main aim of the forum was to establish and maintain a good relationship between Kenyan and Chinese healthcare sectors and further explore investment opportunities in the Kenyan pharmaceutical industry. This forum was sponsored by UKAID and brought together participants from Ministry of Health Kenya, Pharmacy and Poisons Board Kenya, the Kenya Healthcare Federation, the Kenya Chamber of Commerce, the Economic & Commercial Counsellor’s Office at the Embassy of the People’s Republic of China, and the China Africa Friendship Association.
Ms. Guo Xiaodan deputy secretary of sub-chamber, department of pharmaceutical, CCCMHPIE, opened the forum by welcoming the guests. In her opening speech, she reiterated that she’s extremely happy to visit Kenya and establish a lasting relationship between Kenyan and Chinese healthcare sectors.
CCCMHPIE was established in May in 1989. It is the most internationalized and influential healthcare industry association in China the key areas of responsibility include: policy and industry coordination, conferences and training, exhibitions registration, consulting, market surveys and analysis reports in traditional Chinese medicines, pharmaceuticals, medical devices & dressings, biopharmaceuticals and functional cosmetics.
In his speech, Mr. Tan Shengcai, head of the Chinese healthcare delegation gave a background of Kenya – China relationship especially in investment. He emphasized that Kenya has been contracting China in building and construction particularly in road construction. There is need to have deeper engagement especially in the healthcare industry. He invited the Chinese healthcare delegates to evaluate the Kenyan market and see possible investment opportunities in the pharmaceutical industry.
Dr. Amit Thakker, Chairman, Kenya Healthcare Federation welcomed the China healthcare delegation to Kenya. In his speech, he informed the attendees that the investment forum is very timely since it touches on two pillars of the BIG 4 Agenda i.e. Manufacturing and Affordable Healthcare for all. He however emphasized that there is need to bridge the gaps in healthcare drivers, such as Human Resource for Health, Healthcare financing healthcare and ICT and Mobile Health.
The Pharmacy and Poisons Board was clear on their regulatory role in the practice of Pharmacy and the Manufacture and Trade in drugs and poisons. The Board aims to implement the appropriate regulatory measures to achieve the highest standards of safety, efficacy and quality for all drugs, chemical substances and medical devices locally manufactured, imported, exported, distributed, sold, or used, to ensure the protection of the consumer as envisaged by the laws regulating drugs in Kenya.
There was a B2B session thereafter conducted by CCCMHPIE where the China delegation had an impactful engagement with the Kenyan health sector, both private and public. The China delegation touched on business opportunities and engagements that can be established between Kenya and China. The Chinese team visited Kenya Medical Supplies Authority (KEMSA) thereafter.
Strengthening Health Workforce in Kenya
The KHF Human Resource for Health (HRH) Committee held a breakfast meeting at KHF offices on 16th of August 2018 to discuss on the committee progress in advocating for adequate human resources in the health sector, recruitment and retention of human capital and how to get the neglected cadres recognized.
The meeting was chaired by the committee’s vice Chair, Dr. Joyce Sitonik. The committee has had several engagements with the Ministry of Health (MoH) to discuss on how to get the neglected cadres recognized. In last year’s meetings with MoH, the primary agenda for the committee was to identify the neglected specialized cadres and those that need more attention in terms of regulation and standardization in order to bring them to a good quality assurance level. Thereafter, a partnership formed between Amref Health Africa, Kenya Healthcare Federation and Malteser International to strategize on how these cadres can be strengthened.
The Identified cadres were, health records and information officers, emergency care professionals and community health workers. The discussions have been very fruitful, with outputs such as the current effort by emergency medical technicians to form a professional association.
KHF identifies gaps within the public health sector and advocates for improvement or restructuring,including through Public Private Partnerships (PPP). For example, there is a problem in recruitment and retention HRH in the public sector. The committee will be holding a workshop that will address neglected specialized cadres, recruitment and retention strategies, Innovations (Corvus Health) and setting up objectives and terms of reference for the committee. It was agreed that in the workshop, there will be a representative from MoH HR unit.
Mr. Kennedy Auma and Dr. Joyce Sitonik were re-elected as the committee chairperson and vice chairperson respectively.This was the first meeting under the directorship of the elected KHF vice chair Dr.Elizabeth Wala and Ms.Faith Muigai.
Seventh East Africa Healthcare Federation Conference
Ethiopia hosted the 7th annual East Africa Federation conference at Africa Union (AU) Headquarters in Addis Ababa from 9th to 10th July 2018. The conference is held annually and hosted in turns by EAHF members Kenya Healthcare Federation, Uganda Healthcare Federation, Rwanda Healthcare Federation, Burundi Healthcare Federation, Tanzania Private Health Sector and Ethiopia Private Health Facilities Employers Association. Last year’s conference was hosted by Tanzania Private Health Sector in Dar-es Salaam Tanzania.
The theme of the Addis Ababa conference was “Revolutionizing Healthcare through Digital Technology in Africa”, with the objectives as; to enhance the progress of healthcare in the region through technological advancements, to bring private sector stakeholders and policymakers under one roof to discuss means to achieve health and health related sustainable development goals and to engage in high level discussions on public private partnerships (PPP). The conference was graced by His Excellency Dr. Amir Aman, Minister of Health for Ethiopia, and senior officials from the World Bank and the African Development Bank.
In attendance were multi-lateral and bi-lateral development partners, such as USAID, CDC, international development organizations, and international institutions including the AU. From the private sector, international investors, CEOs, as well as medical directors of hospitals and medical universities were in attendance. In his opening remarks, the conference director Dr. Dawit Moges, of Sister Akelesia Memorial General Hospital said “ The primary goal for this conference is to bring together global leaders, policy makers, health professionals and investors as well as friends and partners of healthcare from around the world in an open dialogue, under one roof to discuss the issues facing the sector and to develop possible strategies on how the private sector can become aware and more engaged in initiatives taking place in public – private partnerships (PPP).
In her welcome address, the president of The East Africa Healthcare Federation, Ms. Zelealem Fisheha noted that “Access to good health is a right for all; each and every one of us wants to live in good health and healthy conditions; but it is a right that a lot of citizens in East Africa still cannot enjoy today. Ms. Fisheha expressed that “Using digitization, we will push through a paradigm shift in healthcare. From being expensive, reactive, and system – oriented, we make healthcare abundant, proactive and patient focused”.
Kenya Healthcare Federation (KHF),Chairman Dr. Amit Thakker thanked the private health sector team in Ethiopia for hosting them and for the great advocacy role they are doing. “The biggest challenge in achieving equitable healthcare across our continent is the lack of information sharing between all stakeholders. High quality of knowledge exchange about all healthcare requirements and activities is the first step towards strengthening the quality of policies and regulations that form the bed rock of robust national programs. Hence it is critical to focus on dialogue and strong partnerships between the government and private sector at the national, regional and continental level.” Said Dr. Thakker. The two-day conference brought together over 400 participants as well as a number local and international exhibitors.
Eighth Presidential Round Table
Kenya private sector alliance held the 8th presidential round table at statehouse Nairobi on 10th May 2018, under the chairmanship of H.E President Uhuru Kenyatta. This was the first presidential round table for the year 2018. The major focus was on the BIG 4 Agenda with an objective of structuring the way forward to strengthen private sector participation. This being the second and last term for President Uhuru Kenyatta, provided and opportunity for the private sector, to align it’s business Agenda with the government Agenda to enhance collaboration towards common goals.
The meeting was moderated by Mr. Waita Nzioka, chief of Staff who welcomed both the private sector and the government for very informative and enlightening discussion. This was also reiterated by Cabinet Secretary, Ministry of Industry, Trade and Cooperatives Hon. Adan Mohamed.
Ms. Carole Kariuki – CEO KEPSA introduced KEPSA to the attendees where he highlighted the improvements achieved through the partnership with the government to improve the business environment and the path to ranking position 50 and below on the Ease of Doing Business from the current position 80. She however highlighted that the private sector has put a major focus on an economy led transformation towards realization of the Vision 2030 goals.
Ms. Kariuki mentioned that the BIG 4 Agenda presents numerous opportunities for private sector investment including SMEs and therefore the need to strengthen the engagement and partnership with the government through the various Public Private Dialogue (PPD) platforms towards unlocking these opportunities.
‘Implementation of BIG 4 Agenda, will see many job creation’ this was the presidents directive while vision casting the BIG 4 Agenda for his second and last term. Mr. Macharia – KEPSA Chair, ICT sector board presented overview of the Ajira Digital Project whose Vision is to create 1 million online jobs through training and mentorships owing to growing demand among the youth for online jobs. 7,168 youth had been trained on the Ajira Digital project in 2017. Mr. Macharia emphasized the need for partnership between the government and the private sector in developing the skills required for the BIG 4 and development of jobs with long term sustainability at the local level (Ajira Mashinani). He proposed creation of jobs portal for mapping available skills, job experience and the job markets to enhance linkages.
Ms. Flora Mutahi, chair – KAM highlighted the current situation of the manufacturing sector noting declining growth (at 3%) and low contribution to GDP which currently stands at 8.4%, low value addition, low cadre jobs creation. The main bottlenecks constraining manufacturing competitiveness include high energy costs, Import Declaration Fee (IDF) and Railway Development Levy (RDL) taxes on raw materials, low labour productivity, delayed payments, multiple charges, inefficient logistics and low access to affordable credit all which affect firm level competitiveness. In accessing markets, the main challenge is illicit trade and poor access to local markets, regional and global markets. At policy level, the main hindrance to manufacturers is the lack of predictability due to ad-hoc policies.
The meeting majorly focused on how to improve the manufacturing industry that will also see many job creation. Some of the proposed pointers for improving the manufacturing industry were; Provide Quality and Affordable Energy, Removal of IDF & RDL from raw materials, industrial input and machinery and increasing them imported finished goods, Low industry labour productivity, Delayed payments, Ad-hoc Policy Processes disrupting manufacturing, Global Market – create market access, Ensure trade flows as per EAC Protocol on Rules of Origin awaiting verification, Purchase minimum 40% & publicly report especially on Big Four Agenda contracts.
It was agreed that in the next PRT meeting, Affordable housing will be the main Agenda, hence all the key players to prepare their presentations. Affordable Healthcare will be discussed in the third PRT meeting while food security will be the last one.
Ms. Carole Kariuki – KEPSA CEO highlighted the five key areas that are of deep concern to the private sector in the implementation of the BIG 4. These include: Access to clean affordable and reliable energy; Governance (dealing with corruption, bribery, impunity and wastages); improving the business environment in Nairobi county which contributes 60% of the country’s GDP and sets the pace for other counties, enhancing access to affordable finance for businesses especially SMEs; comprehensive review of the PPP Act, and improving policy environment predictability. The CEO noted that resolving these issues would be a crucial enabler to enhance private sector participation in the BIG 4.
The Chairman appreciated the government led by His Excellency for meeting the private sector for the 8th Presidential Roundtable to resolve the business issues that may hinder private sector participation in the BIG 4. He took note of previous engagements with the President and MSFs that had led to great success in resolving issues presented in the NBA-II. He called for more collaboration and partnership in implementing the third NBA and the BIG 4 Agenda. Addressing corruption which is the biggest challenge at present, policy reforms to improve the business environment to position 50 and below, digitization of government systems, adoption of modern technologies (Block chain, Artificial Intelligence, etc.), addressing the obstacles to business competiveness such as access to reliable, clean and affordable energy, access to financing and market linkages are some of the areas that need to be prioritized. The chairman proposed that MSFs be held every 4-6 weeks and not more than eight weeks to resolve various business issues.
In his closing remarks, president noted that the leaders present at the PRT were the only ones with the capacity to make a difference for the rest of the Kenyans. He noted that the government cannot achieve its objectives alone but rather with the support of the private sector.
The president emphasized on the need for collaboration in fighting corruption, and inaction by leaders. “it is up to the government and the private sector to say we have reached an end to this problem” he said.
He urged everyone to avoid shortcuts, expressed his government’s commitment to creating an enabling environment for genuine business to thrive and urged everyone to report all incidences of corruption through the hotline “0791333222” which he committed to personally follow up and act.
President Uhuru asked the leaders to help the government in facilitating the private sector to help grow the country and achieve the BIG 4 agenda.
He noted that the 8th PRT was a start; continuous engagement will focus on finding solutions to getting manufacturing contribution to GDP to 15% from the current 8.4%. The Cabinet Secretaries and other government leaders were reminded that they were entrusted with running their offices on behalf of the government and any failure would not be tolerated.
The meeting was well attended by Cabinet Secretaries, Chief Administrative Secretaries, Principal Secretaries, leaders of State Agencies and private sector representatives.
Kenya Medical Association (KMA) at 50 years
Kenya Medical Association (KMA) is a voluntary membership organization open to all medical and dental practitioners, registered in Kenya. KMA was founded in 1968 and currently has close to 3000 members. The Association main objective is to champion the welfare of doctors and quality healthcare for all through continuous professional development and advocacy.
At 50 years, KMA prides itself in tranceeding specific objectives as follows; tremendous growth in promoting the practice of medicine in Kenya, upholding high standards of medical ethics and conduct, advicing the Government, other medical bodies and the public at large on health matters, promoting the welfare of doctors, maintaining the honor and interest of the medical profession, supporting continuing professional development (CPD) through periodic publications, seminars and scientific conferences and liaising with medical associations around the world.
Through KMA’s remarkable performance in advocacy and good working relationship in the East African region, Federation of East African Medical and Dental Associations (FEMDA) was birthed in which KMA is an active member.
KMA was proud to host its 46th Annual Conference and celebrate its 50th anniversary from 18th – 21st April 2018 at Nyali Sun Africa Beach Hotel & SPA in Mombasa. The official opening ceremony was conducted by Dr. Peter Cherutich representing Health CS Mrs. Sicily Kariuki on 19th April 2018.The theme of the conference was “Healthcare Financing Towards Universal Health Coverage” this brought together 365 delegates from 5 African countries and representation from world Medical Association and students both local & International. The conference was closed on a dinner celebration to mark 50th Anniversary.