Corruption feared in sh28b HIV deal
Dec 04, 2011
The Public Procurement and Disposal of Public Assets Authority (PPDA) has suspended a deal where about sh28.4b was to be paid for over 200 CD4 count machines that senior officials in the HIV campaign in the Ministry of Health say were not a priority in the HIV budget.
The Public Procurement and Disposal of Public Assets Authority (PPDA) has suspended a deal where about sh28.4b was to be paid for over 200 CD4 count machines that senior officials in the HIV campaign in the Ministry of Health say were not a priority in the HIV budget.
The machines, which are used to measure the immunity of a person living with HIV, were supposed to be allocated to Health Centre IVs countrywide. But officials say the money should have been used to put more Ugandans on ARVs.
However, the deal was stopped over allegations of corruption. Sources reveal that the National Medical Stores (NMS) recommended a bidder whose machines were deemed inferior and yet quoted a higher figure against the bidder with better ones that cost a lower amount. Complaints about the deal led to PPDA probe and eventual suspension of the transaction.
The deal
In a letter of April 8, 2011, the health ministry acting permanent secretary, Dr. Asuman Lukwago, wrote to the NMS general manager, Moses Kamabare, requesting him to utilise the money that had been saved from the affordable medicine facility and purchase 200 CD4 machines.
By press time, it had not been clarified whether this was the money that had been earmarked for putting more people on ARVs being diverted to buy less urgent machines. After the tendering process, the contracts committee awarded the deal to Alere HealthCare Services Limited on May 4, 2011.
But one of the aggrieved bidders then, Biomedics Products, contested the award citing unfairness and sought an administrative review of the tendering process from PPDA.
In the same month, PPDA instituted an investigation. In its 11-page report, PPDA boss Cornelia Sabiiti cited irregularities in the tendering process and ordered NMS to suspend the award of the deal that they had given to Alere.
PPDA recommended that the deal be re-tendered using open international bidding method with a reduced bidding period from 33 to 21 working days.
The players
Alere and Partec Munster Germany submitted bids to supply the CD4 machines to Uganda to NMS.
Alere, a South-African based company, was preferred as the best bidder but officials in the health ministry, who did not want to be mentioned given the sensitivity of their positions regarding the tender, questioned the approval.
They argued that the machines that Alere was intending to import had 10% possibility to abort results.
Documents seen by Saturday Vision show that Alere intended to import PIMA CD4 analyser machines that use cartridges while Partec wanted to import Partec CyFlow miniPOC CD4 machines which use reagents (antibodies).
Documents also reveal that Alere quoted $3.47m (sh9b) for the supply while Partec quoted $2.6m (sh6.7b). This means government was going to spend sh2.3b more than what it would have spent on Partec’s machines.
This is the second time NMS is recommending Alere for the tender, an issue that has raised concern once again.
Which was better?
Alere is a much younger firm, founded in 2001 and the PIMA machines that they intended to import were going to be used for the first time in Uganda.
On the other hand, Partec was founded in 1967 and has imported dozens of CD4 machines into the country before, according to the company website.
Sources revealed that the committee failed Partec because their machines were heavier.
Partec’s machine weigh 4.9kg including an inbuilt printer while Alere’s weigh 2.54kg but without a printer which is supposed to be connected externally. With the printer, the Alere machine could weigh the same as the Partec machine.
Specifications also show that Alere’s Pima CD4 machine has about 10% possible cases of aborted results, while the Partec machine does not abort results.
“The Partec machine takes one minute to test a patient compared to 20 minutes that Alere’s machine takes. Additionally, the Partec machine takes up to 250 patient samples a day compared to Alere’s 20. Considering the four tests per patient annually, a Partec machine covers 12,500 patients compared to 1,000 patients covered by Alere’s machine in a year,” a source noted.
Documents also show the Alere machine has a capacity to store data of 1,000 tests while the Partec machine stores data of over 20,000 tests.
With a Partec machine, the price of a single test is 3 Euros (sh10,500) while for Alere’s machine it goes at between 6-8 Euros (sh21,000 – sh28,000).
Wrong expenditure
Earlier, the AIDS Control Programme manager, Dr Zainab Akol, told stakeholders in the fight against HIV at Golf Course Hotel that money budgeted for putting people living with HIV on free ARVs had been diverted to purchase CD4 count machines.
The meeting noted that it was a bad decision because what the country needed more was to increase people on treatment than the CD4 count machines.
Research shows that access to HIV treatment results in a 96% reduction in the risk of HIV transmission through sex. Not only do ARVs improve quality of life, they also reduce the infectiousness of the HIV positive person.
Akol said the Government is still relying on foreigners to treat our people.
She said she was working hard to add 30,000 more people on free ARVs. Apparently, such diversion of money must be frustrating.
“Currently Uganda only gives free ARVs to less than 50% of the people who need them. Why should we divert money for more ARVs to buying CD4 machines we don’t really need urgently?” a senior person in HIV control at the ministry of health asked.
WHO RECOMMENDED ALERE HEALTHCARE SERVICES?
The acting health ministry permanent secretary, Dr. Asuman Lukwago, said the Central Public Health Laboratory (CPHL) was the one that recommended Alere’s Pima CD4 machine.
Tom Tenywa, the laboratory coordinator for the AIDS control programme at CPHL, confirmed that they recommend medical equipment for use in the country to the health ministry.
Asked why they had recommended the PIMA CD4 machine, Tenywa, a senior laboratory technologist, refused to comment.
“I cannot tell you that. It is the ministry of health which is better placed to give you that information. Our duty is to recommend on technical grounds.”
CPHL is the technical arm of the health ministry charged with ascertaining whether medical equipment is fit for use in the country. It is on CPHL’s recommendation that the health ministry approves or rejects medical equipments.
Lukwago says the deal was granted to Alere because the ministry’s set specifications pointed to the ones that the company had presented.
Asked why they chose a company that does not test children below seven years, Lukwago said there was already the Early Infant Diagnosis programme funded by the Clinton Foundation which was recently rolled out in the country to cater for children.
“We recommended Alere over Partec which had a cheaper quotation because in procurement, there are other variables, apart from cost. Value for money does not mean you select the cheapest bid. You may go for low price and get poor quality products.”
He, however, said NMS was independently in charge. “NMS is a self-accounting agency and they report directly to PAC (Public Accounts Committee) of parliament although we sometimes supervise them,” Lukwago explained. However, NMS General Manager, Moses Kamabare, refused to comment. But earlier, he had been quoted in the media saying Alere had the specifications that the health ministry wanted.