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NATIONAL ASSEMBLY HANSARD 05 SEPTEMBER 2019 45-85

PARLIAMENT OF ZIMBABWE

Thursday, 5th September, 2019

The National Assembly met at a Quarter-past Two o’clock p.m.

PRAYERS

(THE HON. SPEAKER in the Chair)

ANNOUNCEMENTS BY THE HON. SPEAKER

PETITION RECEIVED

        THE HON. SPEAKER: Order, I wish to advise the House that on the 4th September, 2019, Parliament of Zimbabwe received a petition from Mr. Shepherd Murahwi of the Deaf Zimbabwe Trust, Number 12 Victory Avenue, Greendalale beseeching Parliament to exercise its constitutional mandate to protect the rights of children with disabilities as enshrined in the Constitution of Zimbabwe.

  The petition has since been referred to the Portfolio Committee on

Primary and Secondary Education.

ADJOURNMENT OF THE HOUSE

        THE HON. SPEAKER:  I also have to inform the House that the House will adjourn today until Tuesday, 24th September, 2019.  During the period of adjournment, only Committees with approved Public Hearings will be allowed to meet.

MOTION

BUSINESS OF THE HOUSE

     HON. TOGAREPI:  Mr. Speaker Sir, I move that Orders of the

Day, Nos. 1 to 5 be stood over until the rest of the Orders of the Day have been disposed of.

         HON. MATANGIRA: I second.

         Motion put and agreed to.

       HON. MATANGIRA:  Thank you Mr. Speaker, I rise on a point

of privilege.

        THE HON. SPEAKER:  Before I recognise you, I need a

seconder.

        HON. MATANGIRA:  Ndasekenda kudhara Sekuru.

       THE HON. SPEAKER:  You will be informed on how we should

proceed.

MOTION

PRESIDENTIAL SPEECH: DEBATE ON ADDRESS

        Sixth Order read: Adjourned debate on motion in reply to the Presidential Speech.

         Question again proposed.

    HON. TOGAREPI:  I move that the debate do now adjourn.

         HON. TONGOFA: I second.

Motion put and agreed to.

Debate to resume:  Tuesday, 24th September, 2019.

MOTION

REPORT OF THE ZIMBABWE ELECTORAL COMMISSION ON

THE 2018 HARMONISED ELECTIONS

Seventh Order read:  Adjourned debate on motion on the Report of the Zimbabwe Electoral Commission on the 2018 harmonised elections.

Question again proposed.

THE MINISTER OF JUSTICE, LEGAL AND

PARLIAMENTARY AFFAIRS (HON. ZIYAMBI):  I move that the

debate do now adjourn.

Motion put and agreed to.

Debate to resume:  Tuesday, 24th September, 2019.

MOTION

BUSINESS OF THE HOUSE

THE MINISTER OF JUSTICE, LEGAL AND

PARLIAMENTARY AFFAIRS (HON. ZIYAMBI):  I move that Orders of the Day, Numbers 8 to 32 be stood over until Order of the Day, Number 33 has been disposed of.

Motion put and agreed to.

MOTION

SECOND REPORT OF THE PORTFOLIO COMMITTEE ON

HEALTH AND CHILD CARE ON THE STATE OF MEDICINES

AND DRUGS SUPPLY IN THE PUBLIC HEALTH INSTITUTIONS

OF ZIMBABWE

    HON. TONGOFA:  I move the motion standing in my name that

that this House takes note of the Second Report of the Portfolio Committee on Health and Child Care on the State of Medicines and Drugs Supply in the Public Health Institutions of Zimbabwe.

         HON. MUKUHLANI:  I second.

HON. TONGOFA:  Thank you Hon. Speaker.  Since the last quarter of 2018, Zimbabwe’s public health institutions have been experiencing severe shortages of medicines and drugs as well as other essential products. This has rendered the general public at the mercy of the private sector which introduced a three-tier pricing system. This is in the form of the United States of America Dollar (USD), Equivalent of the USD in Bond (RTGS$) and demand of a markup percentage on products purchased through EcoCash and Swipe. These demands are beyond the reach of an average citizen in Zimbabwe, let alone the poor and vulnerable population in the country.

This unbearable situation led to the public outcry over the acute shortages of medicines and essential drugs in the public health institutions in Zimbabwe and the price distortions of the medical products. Consequently, the Portfolio Committee on Health and Child Care was prompted to conduct an inquiry into the state of medicines supply in the public health institutions in Zimbabwe.

Objectives

The objectives of the enquiry were:

  1. To understand the medicines and drug supply chain in the county;
  2. To appreciate challenges being faced by the Ministry of Health and Child Care in the supply of medicines and drugs in public health institutions; and
  3. To recommend strategies that may enhance provision of medicines and drugs in the public health institutions.

Methodology

The Committee held oral evidence meetings with the various stakeholders and conducted fact finding visits to the National Pharmaceutical Company of Zimbabwe (NATPHARM).

         Oral Evidence Sessions

The representatives of the Pharmaceutical Society of Zimbabwe appeared before the Committee on the 5th of December 2018 to present on the state of medicines availability in Zimbabwe.

The Director General for the Medicines Control Authority of Zimbabwe (MCAZ), Ms. G. Mahlangu appeared before the Committee on the 5th of March 2019 to present on the institution’s mandate, role, function and operations in the supply of medicines and drugs in the country.

On the 10th of April 2019, the Minister of Health and Child Care, Dr. Obadiah Moyo, briefed the Committee on the policy measures that the Ministry was taking to improve the supply of medicines in public health institutions and to address the price distortions in the market.

The Permanent Secretary for the Ministry of Home Affairs and

Cultural Heritage, Mr. M. Matshiya briefed the Committee on the 10th of April 2019 on the measures that the ministry has put in place to curb unlicensed trade of medicines on the streets.

Fact Finding Visits

The Committee undertook two fact finding visits to the National

Pharmaceutical Company of Zimbabwe on 12th of February 2019 and on 11th of April, 2019. The objective of the first fact finding visit was for the Committee to familarise itself with the operations of Natpharm in terms of medicines and drug supply in the country. The second fact finding visit was a verification exercise to confirm whether indeed, Natpharm had started receiving medicines as indicated, by the Minister of Health and Child Care on the 10th of April 2019.

The Committee Findings

State of Medicines Supply in the Public Health Institutions

As already alluded to in the introduction, since the last quarter of 2018, the country has been faced with severe shortage of medicines across the board. However, the crisis has been more severe in the public than in private health institutions as most essential medicines and drugs for chronic ailments such as hypertension and diabetes were out of stock. Consequently, senior doctors at Parirenyatwa Group of Hospitals have been on record protesting over shortages of medicines and supplies as the situation became dire, putting lives of the patients at risk of preventable complications and deaths.

During the oral evidence meeting on the 10th of April 2019, the Minister of Health and Child Care confirmed that the public health institutions in the country were in a dire state. He further stated that shortages of medicines and drugs, among other medical supplies, were being experienced right from the primary healthcare level to the tertiary institutions.

State of the Pharmaceutical Industry

Key players in the industry are the manufacturing companies, importing wholesalers, distributors, National Pharmaceutical Company (Natpharm) and retailers. There are five main local pharmaceutical manufacturing companies namely: Varichem, Plus 5, CAPS, Datlabs and Pharmanova. Unfortunately, the current state of equipment and manufacturing processes has affected their ability to produce vital drugs and medicines in the country. At the time of the enquiry, capacity utilisation of the industry was, on average running below 40% primarily due to inadequate foreign currency allocations.

Regulatory Framework

The regulatory authority that oversees the pharmaceutical manufacturing industry is the Medicines Control Authority of Zimbabwe (MCAZ). MCAZ is responsible for pharmaceutical surveillance, licensing, enforcement, laboratory services, evaluation and registration activities for the sector. It was established through the Medicines and Allied Substances Control Act (Masca) (Chapter 15:03). Registration processes are rigorous and thorough for both imports and exports with the aim to ensure citizens are safeguarded against counterfeit and unsafe medicines.

In the quest for promoting local manufacturing of drugs and medicines, the MCAZ reduced lead time to process local applications from 11-20 months in 2016 to 3 months in 2017. Furthermore, local pharmacies are given priority review on their applications and are offered trainings on bio-equivalency and in some cases, bio-equivalency can be waived where necessary. However, the Pharmaceutical Society of Zimbabwe representatives recommended that the lead time be further reduced to below 3 months for local manufacturing companies to enable them to start producing most medicines currently being imported. They added that these should include critical lifesaving and chronic medicines. They also requested that registration guidelines for dossier purchase be put in place, exempting most requirements such as bioequivalency studies and stability studies, so long as pharmaceutical equivalency is demonstrated.

Promotion of the Development of Traditional Medicines

The Committee was informed that Traditional Medical

Practitioners seem not to be keen to register their medicines. However, it was stated that there is a regulation for complementary medicines which is being worked on, where these traditional medicines will fall under.  The Committee was further informed that in February 2019, the MCAZ licenced one Traditional Medicine Manufacturer under the

Complementary Medicines Regulation and is located in Murehwa area.

Natpharm and Medicine Management

In 2014, the Portfolio Committee on Health and Child Care tabled a report on the State of Affairs in the Health Service Delivery System in Zimbabwe and revealed that:

Multi donor funds have provided support to the vital medicines and vital health services for the district health system. The programme supplies more than 75% of the country selected package of essential medicines. The programme excludes the five central hospitals, hence, the lack of essential drugs at the tertiary institutions… 98% of the drugs being distributed to various hospitals are donated by donors and do not seem to be purchased with morbidity patterns in mind and have very short shelf life plus or minus 3 months in most cases.

The result of the above-quoted scenario was that drugs were expiring at Rural Health Centres and District Hospitals whilst the Central Hospitals were in need of the same. The Report noted that this was due to lack of an effective redistribution system of the distributed drugs to reduce the quantities of drugs expiring. It recommended strengthening of the MoHCC’s monitoring system for effective drug management.

The Report also revealed that Natpharm had large quantities of expired drugs in its warehouse and recommended that it should sell excess stocks of drugs to private sectors and also donate to the schools, clinics, prisons and Mission hospitals to minimise expiries. Furthermore, the Report noted that Napharm, a quasi-government company mandated with procurement and distribution of drugs was incapacitated by lack of finance and strongly recommended for its recapitalization.

Five years later, the newly constituted Committee on Health and

Child Care undertook a familiarisation visit to Natpharm on the 12th of

February 2019. The Committee’s findings were disheartening in that Natpharm was still dogged by the above-mentioned problems. It still had huge piles of expired medicines and drugs in its warehouse and            issues of its capitalisation have not yet been attended to.

During the familiarisation visit, the Committee vehemently expressed its disapproval on the proposed idea for Natpharm to establish retail pharmacies across the country, at a time when the public health institutions did not have medicines. The majority of our population cannot afford medicines from the private pharmacies and rely predominantly on the public sector. Hence, the Committee proposed that the public health institutions be well stocked with medicines to improve on accessibility and affordability of the products to the general population. On the 10th of April 2019, during the oral evidence meeting, the Minister of Health and Child Care indicted that the Ministry had taken heed of the observation by the Committee. He further explained that the move to establish Natpharm retail pharmacies was to try and curtail the competition from the retailers who were charging in foreign currency, but, this has been overtaken by events and the proposal was dropped.

Unlicensed Selling of Medicines and Drugs

The Committee, greatly disturbed by the proliferation of the unlicensed selling of medicines and drugs in the country (black market), quizzed the MCAZ and the Ministry of Home Affairs and Cultural Heritage over the matter. In her presentation before the Committee on the 5th of March 2019, the Director General of MCAZ attributed the problem to the importation of undeclared medicines and leakages from the public health institutions. She informed the Committee that the

MCAZ, in conjunction with the Ministry of Home Affairs and Cultural

Heritage, carries out medicines and drug blitzes on the streets and at border posts. However, penalties are not punitive enough to deter the  offenders.

Presenting oral evidence before the Committee on the 10th of April 2019, the Commissioner General of Police, Mr. T.G. Matanga, confirmed the assertions made by the MCAZ Director General. He cited the arrest by the Police of three suspects who were caught in possession of huge consignment of medicines worth US$500 000 at a backyard warehouse in Waterfalls, a case which is still before the courts. He stated that part of this consignment belonged to the MoHCC.

The Committee was informed that although they carried out medicines and drug blitzes, the Police is inadequately equipped to combat such crimes. He stated that the Police had no vehicles and latest technology in combating crimes. He also stated that this was further worsened by the unattractive conditions of service and salaries of the police officers, resulting in demoralised officers. He also echoed the same sentiment regarding lack of punitive penalties to offenders, resulting in Police Officers being demotivated to follow upon such crimes.

Major Challenges

Four factors were presented as the major challenges that have led to the acute shortages of medicines and drugs in the country and these are:

  1. Lack of foreign currency to import medicines and drugs and raw materials for local production; ii.Restrictive regulatory framework that affects the ability of the local manufacturers to produce vital drugs and medicines in the country;  iii.     Lack of investment in technology and equipment (Obsolete equipment) in the pharmaceutical industry; and  iv.        Lack of innovative research in the country owing to the current economic hardships.

Measures in place to improve supply of medicines in the public health institutions

The following are the measures the MoHCC had instituted to improve medicines and drug supply in the public health institutions as presented by the Minister of Health and Child Care during the oral evidence meeting on the 10th of April 2019:

Establishment of a Foreign Currency Allocation Committee

(FCAC)

In 2018, RBZ was allocating foreign currency on its own, leading to diversion by the pharmaceutical industry buying non-essential drugs as RBZ would make allocations based on the request that came directly to them. In order to mitigate against the abuse of funds by the beneficiaries in the pharmaceutical industry and to ensure the funds are used to procure essential drugs, the MoHCC set up a Foreign Currency

Allocation Committee. The Committee is chaired by the Principal

Director Curative (MoHCC). Other members include: Director of

Pharmacy Services (MoHCC); Natpharm (1); Pharmaceutical

Wholesalers (2); Pharmacy Retail Association (2); Pharmacy

Manufacturers (2); Pharmacy Association of Zimbabwe (2) and Finance Directorate. The Minister informed the Committee that since its inception in February, the FCAC has only received US$600 000 leaving a huge gap of financing required to meet the needs of the pharmaceutical industry, retailers and wholesalers. At the time of the oral evidence, the Minister indicated that Zimbabwe owes about US$50 million to the manufacturers outside the country.

Partner Engagement

The MoHCC has engaged partners such as the United Nations (UN) and entered into a swap arrangement. The Minister explained that this is, where, if Zimbabwe has invoices outside the country, instead of the partners to bring their foreign currency into the country, the Ministry requests them to pay for the invoices. He, however, stated that this arrangement is not always available as those monies are required for the general management and routine management of their missions in Zimbabwe.

Loan facility

The MoHCC, through the Ministry of Finance and Economic

Development has engaged funders who have foreign currency outside Zimbabwe on an arrangement that would see Zimbabwe repaying them over a lengthy period of time.

Tender requests in RTGS$

The MoHCC decided to have a blog and went to tender requesting for companies to submit in RTGS$. This approach worked because of positive responses from the prospective bidders. The Minister stated that the introduction of the inter-bank rate of 2. 5% helped them to be able to go to tender and request for quotations in RTGS$. As a result, the Ministry managed to secure RTGS$80 million worth of medicines. The first consignment of medicines worth RTGS$25 million was reported to have been delivered to Natpharm at the time of the oral evidence meeting.

The above-mentioned statements by the Minister, prompted the

Committee to undertake a second visit to Natpahrm on the 11th of April

2019 with the objective to verify his assertions. To the satisfaction of the Committee, the medicines were, indeed, being delivered to Natpharm when it arrived at the premise on the 11th of April 2019. However, the Committee noted that this was a drop in the ocean considering the quantities of medicines and drugs the country requires in the public health institutions. The Minister also stated that although the RTGS$80 million facility would be upped to RTGS$190 million, the situation remains dire as the country’s medicines and drug reserves had run dry. He informed the Committee that Zimbabwe requires US$400 million annually to ensure adequate supply of medicines and drugs in her public health institutions.

Promotion of Local Pharmaceutical Manufacturing Industry

According to the Minister of Health and Child Care, Zimbabwe is currently buying 80% of her medicines and drugs from India. In order to reduce the import bill, the MoHCC is working on promoting the local pharmaceutical manufacturing industry. The Minister informed the Committee that it intends to revamp and re-capacitate the local manufacturing industry starting with CAPS and other manufacturing companies such as Datlabs, PLUS5, Varichem among others. Since the pharmaceutical industry has representatives in the Foreign Currency Allocation Committee, the MoHCC would support them to get an allocation for them to buy raw materials. The Minister also indicated that the Ministry was in negotiation with Indian companies interested in revamping CAPS, but have challenges with its old equipment procured in the 1960s. To this end, the MoHCC, in conjunction with Minister of Industry and Commerce, have already identified potential companies. The Minister further informed the Committee that the companies from the UAE have also expressed their interest to support Zimbabwe in the creation of pharmaceutical manufacturing plants.

Donations from Well-Wishers

Zimbabwe has kept her doors open for well-wishers to assist with donations in the health sector. To this end, well-wishers such as the United Nations mostly and others as well as the United Arab Emirates have been forthcoming during these trying times. These donor agencies have kept the health sector on its wheels.

Committee Observations and Recommendations

Observation

The Committee noted with concern that at the moment there is no concrete solution to address shortages of medicines in the public health institutions as pharmacies are either non-functional or are inadequately stocked due to inadequate foreign currency allocation towards the procurement of medicines and drugs as well as raw materials to produce the products.  In light of this, the Committee recommended the following:

Portfolio Committee on Health and Child Care

Recommendation Number 1/2019

The Ministry of Finance and Economic Development, going forward, should prioritise regular disbursement of foreign currency to the health sector to ensure adequate and consistent medicines and drugs supply to the public institutions.  

It is further recommended that the Ministry of Health and Child

Care should ensure that pharmacies in the public institutions are immediately resuscitated to ensure increased availability and affordable medicines and drugs for the generality of Zimbabweans.

Observation

The Committee noted that while the private sector benefits from the foreign currency allocation by the RBZ, it is disheartening to note that the bulk of the products they were bringing into the country were non-essential drugs. In light of this, the Committee recommends that:

Portfolio Committee on Health and Child Care

Recommendation Number 2/2019

The Government of Zimbabwe should immediately stop allocating foreign currency to the private sector and allow them to charge their own prices while it channels the foreign currency to NatPharm for supply of medicines to public institutions to ensure availability of essential drugs in the country.

Observation

The Committee also noted that the existing regulatory framework and policies in the medicines manufacturing sector are not addressing the current demands for medical drugs in the country. Therefore, the

Committee, recommends that:

        Portfolio Committee on Health and Child Care

Recommendation Number 3/2019

The Ministry of Health and Child Care should develop user friendly regulatory framework and policies that promote, support and protect local pharmaceutical manufacturing industry by 31 December

2019.

Observation

The Committee noted that the promotion of the local pharmaceutical manufacturing industry seems to be skewed towards big players such as CAPS, Datlabs among others and recommends that:

        Portfolio Committee on Health and Child Care

Recommendation Number 4/2019

The promotion of local pharmaceutical manufacturing industry immediately be expanded to encompass the small to medium enterprises in the sector.

Observation

The Committee noted that public health institutions are manned by unqualified personnel in violation of the requirements of the Medicines and Allied Substances Control Act (Chapter 15:03) and that where pharmacists are serving, the ratio of pharmacist to patient is currently unacceptable. The Committee, therefore, recommends that:

Portfolio Committee on Health and Child Care

Recommendation Number 6/2019

The Ministry of Finance and Economic Development should unfreeze by September, 2019, the posts for pharmacists for the MoHCC to comply with the requirement of the Medicines and Allied Substances Act (Chapter 15:03).

Furthermore, the Ministry of Finance and Economic Development should provide concurrence for the review of the establishment of the posts of pharmacists by 31 December, 2019 in order to address the ratio of pharmacist to patient at public institutions in line with the current demands.  

Observation

The Committee noted with concern that despite the fact that a Report was tabled in this august House in 2015 during the 8th Parliament with recommendation to prioritise capitalization of Natpharm, no action was taken in that regard. Therefore, the Committee recommends that:

Portfolio Committee on Health and Child Care

Recommendation Number 7/2019

The Ministry of Finance and Economic Development should immediately avail funds to  expedite the capitalisation of NatPharm as per the MoHCC’s 2017-2020 Strategy in order to kick-start production of medicines and drugs by 31 November 2019.

Observation

The Committee is further concerned that not much has improved in terms of the drug management by Natpharm in line with the recommendations that were made in the report presented during the 8th Parliament. It also noted that there is unfair distribution of medicines and drugs with respect to Matebeleland North Province which gets its stock from Bulawayo. In light of this, the Committee recommends that:

Portfolio Committee on Health and Child Care

Recommendation Number 8/2019

The Ministry of Health and Child Care should put a mechanism in place to strengthen its monitoring system for effective drug management with regards to the redistribution system of the distributed medicines and drugs to reduce quantities of expiries by 31 October 2019.  

The Committee further recommends that MoHCC decentralises the distribution points of medicines and drugs from Natpharm by ensuring that each province has its own Natpharm Depot in line with the dictates of devolution by the first quarter of 2020. This arrangement would improve on timeous deliveries of the products to the public health institutions as distances to transport medicines and drugs would be shortened.

Observation

The Committee noted with great concern the delays by the Ministry of Finance and Economic Development in the approval of board of survey for the destruction of expired medicines and drugs, leading to huge piles of the same at Natpharm. The Committee recommends that:

Portfolio Committee on Health and Child Care

Recommendation Number 9/2019

The Ministry of Finance and Economic Development expedite the approval of board of survey in order to have the expired drugs destroyed by 31 October 2019.

Observation

The Committee noted that the health service sector carries a very high security risk as medicines and drugs find their way into the black market and recommends that:

Portfolio Committee on Health and Child Care

Recommendation Number 10/2019

Public health institutions should immediately put in place their own strong internal security to curb against leakages of medicines and drugs.

Observation

The Committee noted that the black market is thriving as a result of shortages of medicines and drugs in the public health institutions coupled with exorbitant prices of the products in the private sector. The Committee further noted the inadequacies by the Police to deal with such crimes and their demotivation in light of lack of punitive measures.

The Committee, therefore, recommends that:

Portfolio Committee on Health and Child Care

Recommendation Number 11/2019

The Government of Zimbabwe, going forward should avail adequate foreign currency to Natpharm for procurement of medicines and drugs as well as raw materials to boost the local production. This would ensure that public health institutions are well stocked and eventually cripple the black market.

It is further recommended that the Police be adequately resourced to deal with such crimes and offenders be given deterrent penalties to curb illegal trade.

Conclusion

The evidence gathered by the Committee has revealed that the state of medicines and drugs supply in the public health institutions is disheartening as it is characterised by severe shortages of essential products from the primary to the tertiary levels of care. Based on these findings, the Committee urges the Government of Zimbabwe to prioritise the health sector and create an enabling environment that would promote the growth of the local pharmaceutical industry. I thank you.

        HON. NDIWENI: When you look at health provision Mr. Speaker

Sir, health is divided into two major areas which is medicine and drugs. Medicines without the supply of drugs does not provide health to an individual, so the shortage of drugs in public health institutions therefore compromises the health of the nation.  I think if we look at ourselves as Members of Parliament or the general middle class, there is some hypocrisy of some sort.  Why do I say so? Drug shortages have been there for a while maybe for the past 10 years, it was just affecting the poor.  The poor person would go to a public hospital and not get his high blood pressure tablet called HCT, no one would worry even you as parliamentarians. That poor person would trudge along to a private pharmacy and they would charge three dollars for that drug.

        This poor patient unfortunately and I say this from experience Madam Speaker, they will not be able to buy one month supply of medication for three dollars. The middle-class, the parliamentarians who are not worried – the poor patient would walk out of the pharmacy, go away to the rural areas and would never come back because they will not be able to raise the three dollars to buy that medicine.  Then came 2018, the drug shortage now affected parliamentarians, the middle class and the drug prices shot up and this is when everyone now wakes up.  We started seeing headlines that drug prices have gone up; because now it was affecting us. That is the hypocrisy I am referring to.

        We should have realised on the onset when the drug shortages were just affecting those poor people that visited the public hospitals, that we should have raised a red flag and pushed the Ministry of Health to allocate more resources to the public sector.  So, we did let the poor people down as parliamentarians by not pushing.  Ninety percent of the population in Zimbabwe relies on the public health institutions not the private sector.

I want to give an example Madam Speaker.  When I was growing up, private pharmacies were not meant for us. We were even scared to walk in because we never used them, they were used by the rich and our health provision was done by the public sector.  That means the private sector is not meant for the ordinary person, the ordinary person is supposed to get all their health provisions from the public sector.  The shortage of drugs in the public sector Madam Speaker, there are plenty of causes that I can look at as alluded to by the report, like that shortage of foreign currency. I also concur with the report that we should not be wasting foreign currency allocating it to the private sector.  Let the private sector look after itself.  Whatever foreign currency that we have that has provisions for buying drugs, let us channel it to the public sector.  If we channel all the foreign currency to Natpharm, you will find that all the public sector pharmacies will be well stocked and then the poor person will be able to access their drugs.

Some of the observations that the report notes is the existence of the regulatory board, MCAZ.  That regulatory board is supposed to be one of the best in Africa - fair and fine, I applaud them for being one of the best.  The problem is, they are as stringent as first world regulatory bodies.  I personally feel we are over stretching ourselves, we are a third world country and we cannot have a regulatory board that then insists on first world standards when we are in a third world country.  I am not down playing quality by saying this Madam Speaker, but all that we have to be cognisant of is what we have in terms of finances and providing quality drugs to our population.  We should not be astringent.  I want to give an example Madam Speaker, on our recent visit to St

Luke hospital in Lupane, this is a mission hospital and they run an IV Infusion Unit which by themselves.  That unit is capable of supplying IV fluids for the rest of the southern part of the country, meaning

Matabeleland and Midlands. It has got that capacity.

        They have been applying to MCAZ for a licence to fully utilise that capacity of their unit but have been having problems in getting a licence.  Why I am saying there is so much rigidity in this regulatory board is, this unit has been producing IV fluids for mission hospitals in the whole of Matabeleland for the past 5 or 6 years and no one has ever died because of... – [HON. MEMBERS: Inaudible interjections.] – no one has ever died or there has not been any tragedy on using these IV fluids.  So, why cannot we give them a licence so that they will supply almost half of the country with IV fluids?

        So there I do not see the rationale of supplying some hospitals and them being refused to get a licence to fully utilise the units that they have. Madam Speaker, like I said, we should not be relying on the private sector on the health of the nation. Private sector drug provision is just complimentary and as I alluded to, it just covers 10% of the population, 90% is covered by public health institutions.  When we are zeroing in on Natpharm and the manufacturing sector, when we give them the scarce foreign currency, let us insist that they produce only drugs that are essential.  There is a list that the Ministry has a come up with which comprises of essential drugs.

        What we should do is to channel our strengths to drugs that are essential to our nation.  So when you are allocating this foreign currency, we should just restrict ourselves to products that are essential for the public sector.  The private sector can cater for themselves.   I second the idea that the wastage of drugs which could be one of the causes of the shortages of drugs in the public health institutions is due to unavailability but I would not call it unavailability because now we have got plenty of pharmacy personnel in the country though through the freezing of posts in Government public institutions, posts for pharmacists have been frozen.  The pharmacist is the fundi when it comes to drugs. So he or she is the professional that look after drugs. Currently, most district hospitals do not have pharmacists. Municipal clinics do not have pharmacists but may be Harare City Council might have one or two pharmacists yet they look after the health of millions in this country.  They do not have pharmacists. So the drug supply and provision – this is when you see notices that there will be expiry of drugs because there is no qualified professional that is looking after the drug supply.

         There is a point that was raised in the report about the tender that was flighted sometime back for RTGs provision of drug, we allude and want to commend the Ministry for having flighted that tender because we did help in a way in the supply of drugs to public health institutions.  My worry whilst I am on that point is when these tenders were flighted, we suddenly saw new companies sprouting up.  Some of these new companies got the bulk of these tenders so we wonder who is behind some of these new companies that just sprouted because there was this RTGs tender.

         Madam Speaker, it is not all gloomy, that report was centred on year end 2018 and the start of 2019.  We visited public hospitals around the country and the situation has vastly improved and we are grateful to His Excellency the President for pushing – [HON. MEMBERS: Hear, hear.] – on the purchasing of drugs.  When we moved around Madam Speaker, we realised that most public hospitals now have a drug availability of between 55 and 72% - [HON. MEMBERS: Hear, hear.] – I urge the people responsible that this should not be a once off occasion,  it should be sustained.   This is what the health professional on the ground is saying.  If it is sustained, definitely we are going to achieve health for all by the year 2010   Thank you.

        HON. MUKUHLANI:  Thank you Madam Speaker.  The

universal coverage of health is not only determined by the availability of health professionals or the infrastructure to deliver that health delivery system; but the availability, accessibility and the quality of medicines.  Treatment can only be treatment if patients or clients visit health institutions and at the end of the process they get tests, diagnosis and medicines.  When patients and clients visit our health institutions and leave without medicines, the treatment cycle is incomplete.

         Madam Speaker Ma’am the provision of medicines to a country is not entirely dependent on a private sector.  It is a joint effort between the public sector and the private sector.  Our focus and our interest as Parliament and Government is that our public institutions which dispense the public health system must be fully equipped not only in equipment and personnel but with the necessary medicines.

What is pertaining today Madam Speaker Ma’am is that health delivery has become a source of impoverishment for many in our country today.  As has been indicated, the issue of foreign currency plays a major role.  Between March, 2018 and August, 2018, the Reserve Bank of Zimbabwe did allocate an amount of US$30 million for the sole purpose of procurement of medicines for this country.  It is interesting to note that you need around US$40 million to up the production of the eight pharmaceutical companies in this country.  So $30 million comes out of the Reserve Bank which is almost the same amount that is needed to up the production services of this country and yet still at the time when this Report was done there were no medicines, regardless of the $30 million having been sent out.

What has happened in Zimbabwe which is a sad state is that we have technically converted Zimbabwe into one big pharmaceutical flea market where a cabal or a set of few players who own wholesales control the procurement and distribution of medicines.  NatPharm is supposed to be the sole procurer of medicines for use within the public sector.  NatPharm should be responsible for procurement, storage and the distribution, that position has been taken by big wholesalers who are accessing forex from the Reserve Bank.  That should be changed.  The ideal situation that should be there in this country is that NatPharm should be the first priority in terms of allocation of foreign currency so that they procure medicines for the country.

The second tier which should get foreign currency should be your manufacturers and I will explain why.  If you take US$1 million today and give it to a wholesaler, they will buy medicines that are worth US$1 million and after four weeks those medicines would have finished because medicines are consumed, they do not last forever.  If you take a million dollars and you give it to a manufacturer, you manufacture medicines that are worth US$3 million. So we have expanded the US$1 million, not only have we done that, we have paid tax,  created employment and we have done import substitution – [HON. MEMBERS: Hear, hear.] – so your manufacturers should be your second tier line to be allocated foreign currency.

The last line of allocations should be your wholesalers and the wholesalers should only access foreign currency if they are servicing a NatPharm tender for public consumption.  If they are not doing that, they should not access funds, and I will explain.  A wholesaler has got lines that they distribute for instance, wholesale X distributes for Johnson and Johnson, wholesale B distributes for Sibler, wholesale C distributes for SunnysummerFor you to be given exclusivity to distribute products, you must satisfy certain levels of procurement from the manufacturer.

Now, the levels of procurement from the manufacturer are the ones that are needed by the country.  What has been happening is that Government has been running procurements for wholesalers for their benefit as private companies. Not only do wholesalers stock essential drugs, non essential drugs and vital drugs.  I will explain this again

Madam Speaker Ma’am.  Drugs that are used are categorised in the following classes.  You have got vital drugs, essential drugs and non essential drugs.

A wholesaler stocks and warehouses everything from vital drugs, essential and non essential drugs.  Only NatPharm can stock essential and vital drugs.  So, our money should go to NatPharm where they buy only vital and essential drugs.  We have been giving our monies to wholesalers who are buying vital, essential and non essential.  Wholesalers only buy products that move. For instance, if cough mixtures are my fast moving products, if I get money from the Reserve Bank, I will buy cough mixtures, but do we need cough mixtures in our public health institutions?  No, we do not.  We need drugs for anti tuberculosis, hypertension, oncology, cardiovascular and Malaria.  That is what this country needs and what this Parliament and Government represent.

In terms of manufacturing, I think there is need for a deliberate effort and inclination within the policy to focus on manufacturing.  If you look between 1980 and today, there has been only two start ups within the pharmaceutical industry – that is VARICHEM and Plus Five.  In 39 years there are two start up pharmaceutical companies.   In 39 years, there have been only two acquisitions within the industry that is ZIM PHARM and DATLABS.  This means that this sector is static.  We need a policy framework that allows the growth and the incoming of new players within that industry. What is the problem?

The problem is that the entry barriers are too high and stiff.  The MCAZ which regulates the registration of policies, pharmaceutical industries, the registration of medicines is too rigid.  It takes between 18 months to 36 months to register a molecule.  It takes two years (24 months) to develop at least a liquid preparation within a pharmaceutical company.  If you say two years of developing the molecule, three years of registering the molecule that is five years, two years of setting that molecule within the market, you are at seven years.  Who has money to be tied on a product for seven years?  We need a change within the approach that MCAZ regulates and allows molecules and medicines to be registered in this country.  We need a framework that changes the way the pharmaceutical industry is regulated and registered in

Zimbabwe.

Of interest is that we are importing 90% of our medicines out of India.  It takes you 30 minutes in and out to register a drug in India - the same medicine that takes 36 months to register in Zimbabwe.  It does not make sense.  We need a policy framework that changes that. Not only that – we are importing 90% of our medicines out of India.  What we import from India is finished products but the raw materials for those medicines come out of China.  India does not manufacture active pharmaceutical ingredients – they get them out of China.  We could as well import our active pharmaceutical ingredients out of China and manufacture here than to wait.  India imports out of China – manufactures in China and then sell to us.  Yes, one would say there are economies of scale because of their population in India, so you get them much cheaper.

If we can have an import substitution scheme by manufacturing our medicines here, it will go a long way in making sure that the much needed forex that we are complaining about, that what is affecting and hampering the delivery of medicines within our country is foreign currency – we can deal with it by making sure that we have manufactured locally.  Not only do we manufacture for ourselves – we can then export.  There is no manufacturing company in Malawi, Botswana, Namibia, Lesotho and Swaziland; there is one manufacturing company in Zambia, hence there is a market within the SADC framework.  All what we need is that our own industrial policy and framework must allow for players to manufacture medicines here with an outward looking.  Yes, we are 13 million people - but if we look at the SADC bloc, then there is a market.

Furthermore, the infrastructure for the dispensing a health delivery system does exist in Zimbabwe.  What is not there is the products.  We have turned Natpharm into a donation receiving warehouse, which is a problem.  I am in support of donations coming to our country and well wishers donating to us but we are creating an industry in their own home country.  When UNICEF brings medicines from Copenhagen – they are creating employment in Sweden.  When they bring medicines out of America, they are creating employment within America.  I do not have a problem with donations, but a donation is still a donation if it is bought from VARICHEM, DATLABS or CAPS.  Our donations must have a

percentage that is locally bought so that we also support our own local industry. It cannot be 100% donation, 100% procurement from outside and 100% product comes out of the foreign territories.

Furthermore, we do not necessarily mean to manufacture a whole product within Zimbabwe.  We can do part manufacturing here.  We can bring products in bulk and finish the manufacturing in Zimbabwe.

MCAZ must allow that – that is still manufacturing.

In conclusion, there are two areas that I think we need to look at – firstly, our regulatory framework which should allow and reduce the entry barriers for registration and creation of new factories to manufacture medicines.  Secondly, we should have a proper and scientific way of allocating forex and determine who gets forex from the

Reserve Bank of Zimbabwe.  I thank you.

HON. DR. LABODE:  Thank you very much Hon. Speaker ma’am. I would like to thank the members of the Committee for a well elaborated report.

I must put this fact down that the availability of drugs in

Zimbabwe is way below 50%.  Once in a while, you get a spin off and it is dangerous to come into this House when the Committee is besieged with a petition from the people living with HIV that there are no ARVs and then we sit here and give the impression or make someone somewhere happy that they do not have to look for money to buy drugs.

It is dangerous.

I also want to talk about some of the issues that we found – a very import issue in particular that I believe that as a country we are serious about making sure that the scarce resource gets as far as it can; one of the issues is poor movement of drugs.  There is a tendency that the first clinic or hospital that requests for drugs from Natpharm gets whatever is available.  This means that the remaining 99.9% get nothing.  The drugs go and expire at point A when point B to Z have nothing.

I think the Ministry of Health and the pharmacist profession need to come up and do what was done yester year where there were pharmacists at provincial hospitals and Natpharm never allocated one who ever comes first but rather divided medicines equally in the country and the fact that you have got a specific drug does not follow that people that need that drug will come to your institution.  If you see that you have got too much of it, you are supposed to phone or circulate in a system to say I am overstocked by this drug, who needs it?

That system is no longer happening because pharmacists are running their own pharmacies.  Nobody is there to follow up on the whereabouts of the distributed drugs.  It is very sad because it is also a fact that there is no foreign currency that is being put out there.  These wholesalers we are taking about are making contacts outside and bringing in their own drugs.  There is literally no foreign currency going to the manufacturing sector or to the wholesalers.  Whatever drug you are getting right now in the private sector is being bought using the black market or striking deals with companies in India who then give them drugs with the hope that one day foreign currency will come.   

We have a serious problem on the ground and so I am pleased that we have to talk about this issue and see where the Ministry of Finance and Economic Development can get the money from.  We have a petition which the HIV Committee met to deliver on.  From what we have heard from the Ministry of Health and Child Care including the Global Fund, we still have not paid our counter funding.  So we are literally in danger of losing over $400 million because we are failing to raise a certain amount of money that would give us those drugs.

So let us be serious and tell the truth as it is.  We are talking on behalf of Zimbabwe and we have 2.5 million Zimbabweans on ARVs who would die if we do not get those drugs.  So for me, that is what is important.  What is important is the drugs are not there and we have petitions.  We have no drugs in hospitals and we need to do something about it.  Thank you Madam Speaker.

HON. DR. MATARUSE:  Thank you Madam Speaker.  Allow

me to thank the presenter of this motion.   He articulated very well the views of the Committee.  I want to add just two points.  The first issue is that we are seeing the impact of the health levy in the hospitals we visited.  So we recommend that the 10% health levy, the whole of it, should be reserved for the procurement of drugs.  The hospitals have got the bond, what they are lacking is the foreign currency.  At least they have got something to use to buy the foreign currency.  So I really recommend that the whole 10% health levy be reserved for drugs.

The other issue is, there should be efficient use of drugs.  There should also be efficient procurement of drugs.  If I take the example of Ingutsheni Hospital, it is a quaternary referral centre where Harare Hospital refers psychiatric patients to and Ngomahuru in Masvingo is also a referral centre where the eastern side of the country refers psychiatric persons to.  The two hospitals are manned by general practitioners.  The quantities and types of drugs procured there are prescribed by the general practitioners.  So I strongly recommend that for efficient use of drugs there should be properly qualified specialists in specialised hospitals.  I recommend that we employ psychiatrists at

Ingutsheni Hospital and Ngomahuru Hospital.

At the same time in these specialised hospitals we need clinical psychologists.  They do not prescribe drugs.  Most of these psychiatric patients do not need drugs.  So, to efficiently use these drugs so that we do not just give drugs to people who do not need them, we need to employ clinical psychologists at specialised hospitals like Ingutsheni, Ngomahuru, Harare Hospital and so on.

At Ngomahuru we found that there were no psychiatric drugs, but at Ingutsheni there were psychiatric drugs.  The problem was, there was no specialised person to procure the drugs.  The experience of procuring drugs is also needed.  So we need to employ properly qualified pharmacists at specialised institutions with interest in specialised drugs.  I thank you.

*HON. P. ZHOU:  Thank you Madam Speaker Ma’am.  I want to

add my voice on this motion concerning medicines and drugs.  This is a very pertinent issue but it is surprising that you find that you can see drugs being sold in the streets, like panadols going for $1 for two and you wonder what is happening.

HON. SIKHALA:  IZanu-PF yakazvisakisa izvovo – [HON.

MEMBERS:  Inaudible interjections.] –

THE TEMPORARY SPEAKER:  Order.

*HON. P. ZHOU:  I think you have heard that in the Committee we travelled and we have seen that the commissioners of police are saying that those who sell and are being caught are only being given lenient years.  So there is nothing that they can do because those people continue to do it.  We plead that the police should be well resourced so that they can do random searches at any given time when they suspect that drugs are being sold on the streets especially panadols.

Secondly, all the clinics or health public centres, we want them to have drugs.  When we travelled we heard that in most places the drugs were there and we saw them, but the issue is with Natpharm.  It did not have all the drugs that are needed.  You find that in the area of HIV there are no drugs.  You also find that drugs which are not there are those for silent killers especially BP and diabetes.  If it were possible, Natpharm should stock those drugs and they should be distributed to clinics.

If you listen very carefully you will find that people in the rural areas are just collapsing and dying but after postmortem you find that they die because of high blood pressure.  So you are saying that Natpharm should be well resourced with drugs and they should be distributed to health centres like clinics so that these silent killer diseases are dealt with at that primary level.

Coming to the purchase of drugs, you find that what pensioners are getting and the drugs that they are supposed to take, there is no collaboration.  You find that if Natpharm gets a lot of drugs and then the drugs which are channeled to public health institutions, it means that our people will be able to buy medicines, but if they are channeled to the private pharmacies you will find that our people will not be able to afford them. It will be out of reach. Although the use of United States dollars is no longer allowed, they still charge in United States dollar.  So I think there should be strong monitoring when it comes to that so that drugs are sold in RTGS.

When it comes to allocation of funds, I will support that it should be given to Natpharm and it should also be given to local manufacturers because you have heard that if they are given let us say $1 million, it will be three times what they produce.  So we are pleading that local manufacturers like CABS, Datlabs, those that are not functioning well should be helped.  They should be given more money to recapacitate them so that our drugs will be manufactured locally. Let me leave others to contribute.  Thank you.

*HON. SHAVA: Thank you Madam Speaker Ma’am.  I stood up

to support the report which has been moved by Hon. Tongofa and supported by Hon. Ndiweni concerning the shortage of drugs in hospitals.  Madam Speaker Ma’am, in our hospitals we are not getting many of the drugs and the reason is that there are doctors in hospitals who are running pharmacies.  You go there and all the drugs are in stock but when you go to hospitals, you pay for the consultation and yet there are no drugs.  The Government should also make a follow up on the drugs that they disburse to hospitals and ensure that all the drugs are being used because that is where everything is failing; we have shortages.

When the drugs have been transported, for example to Kadoma General Hospital, you will realise that an empty box will have been delivered to the hospital. The Government should make a follow up and see whether that box has all the consignment that was intended for the hospital. The drugs that are found in hospitals would have expired and they take unexpired drugs and exchange with the expired.  Stiffer penalties should be given to those who break the law, they should be jailed for life.  In the rural areas people are suffering and they cannot afford the blood pressure pills.  The Government should intervene by providing drugs for chronic diseases for free.

In conclusion, we should get help by making a follow up on the drugs that are distributed to hospitals.  We visited one hospital and were told that some hospitals are not collecting allocations and when there is a lot of pressure they start making a follow up.  If the date that they are given to collect drugs passes, they will have to make another appointment.  Thank you Madam Speaker.

*HON. KARENYI: Thank you Madam Speaker Ma’am.  I would

like to thank Hon. Tongofa on this pertinent report on our livelihood here in Zimbabwe.  People are suffering from a lot of chronic diseases.  Madam Speaker, many people suffer from diabetes, high blood pressure and cancer and they need a lot of drugs.  What has been said in this report shows that there is a short supply of drugs.  What made me to be happy is that the Committee has tabled what they think the Government should follow so that all of us can access drugs from our hospitals.

Many Government hospitals do not have drugs.  As a Committee, we visited one of the hospitals like Karanda, which is not a Government Hospital and we found that many people from Harare, Bulawayo and even Chimanimani and Masvingo abandon their local hospitals and visit Karanda Hospital to get help where they have realised that they obtain good services and drugs.  It is a sign that as Government, our hospitals are not giving people good services by giving them drugs.  So, the Government should allocate enough money for drugs so that our people will live well.

Madam Speaker, I am happy because the report is talking about recapitalisation of Natpharm.  It is very good that as a Government, we should focus and make sure that these are implemented because if the donor does not ownr up in giving us drugs, it means that Zimbabwe will come to a standstill.  So, I recommend that if it is possible, the

Government should allocate enough money so that as Government, we are well resourced when it comes to the supply of drugs.

The supply of foreign currency to Natpharm has been talked about and this is very painful that as Government, how is it possible that we do not have foreign currency to Natpharm but when we get into the streets we see new United States Dollars, which means that foreign currency is here in Zimbabwe.  However, the foreign currency is being misdirected by the Government.  What I can recommend is that the Government should monitor the Reserve Bank of Zimbabwe when allocating money to find out who the beneficiaries of foreign currency are.  Are we not giving foreign currency to those involved in the parallel market whilst killing our people on the other side through shortage of drugs?

Madam Speaker Ma’am, I would also like to look at the expired drugs that we have in our hospitals.  It is very painful as a Government that there are no drugs in hospitals but expired drugs are there at Natpharm.  I am not happy because the Permanent Secretary was not even aware that the drugs have expired and was also questioning Natpharm why the drugs get expired.  This means that as Government, we do not have channels in place to monitor.  I recommend monitoring and evaluation of the movement of our drugs from Natpharm to the district hospitals.  The drugs should be directed to clinics in terms of their catchment areas and needs and not direct drugs which are not needed in certain hospitals and clinics. It does not help to disburse malaria drugs to places which are not prone to malaria.  I think we should distribute drugs according to the need of that area.  So, it is my desire that the drugs that we distribute should be in sync with the diseases which are frequent in those areas. As I sit down, I want to say that after investigating all that is boiling down to good governance. What is causing the drugs to expire when we have them is follow up and it is boiling down to issues of governance. We have heard one of the

Hon. Members who is a pharmacist saying that our bureaucracy as Government is not good.

        If you go to India there are policies with regards to manufacturing of drugs and their period is very short but as Government of Zimbabwe there is a lot of bureaucracy which hinders progress. So we go back to Government that issues of policy and bureaucracy should be made easy so that supply of drugs is made easy because our people are dying.

        We have elderly people in places like Tsholotsho and

Chimanimani who have chronic diseases which is not by choice. All this shows that these grandmothers are dying, not because of age but due to lack of medication. Due to issues of HIV and AIDS, many are looking after orphans. So when they come into Mutare and want to look for BP drugs, they are charged in US$ but they do not have the US$. Even if we say it is being bought in RTGS, the truth is that drugs are being charged

in US$.        

As Government, we should be able to supply Government hospitals so that all those who get sick should collect their drugs from hospitals so that we will be able to save our elderly and the women because when the economy is not well people will end up with BP and stress. Many women end up having those diseases and they need to be helped. We want our Government to make sure that tablets are distributed in the local clinics and pharmacies where forex is not demanded. I thank you.

         *HON. CHIKUNI: Thank you Madam Speaker Ma’am. I would

want to add a few words to this motion, the one that concerns drugs in hospitals. Now the drug situation is better than before. In the past we used to have problems getting these drugs but now it is better. I would want to say that it is better to have electricity in different hospitals so that they install fridges for keeping these drugs, especially for people who are not mentally stable. Some of them use an injection that needs to be kept in fridges and in most cases they are found in faraway places, so they face difficulties over and over again.

On the issue of medication, I would want to say this is the medication that is very scarce. In addition, I would like to say that there should be reduction in prices as we buy medication with our local currency. We should be able to afford this medication. I thank you.

HON. NDUNA: Thank you Madam Speaker Ma’am. I will not

disappoint you. I will be very brief. I have got four issues that I want to ventilate on. The first one is all to augment and complement the deficit and depletion of the tablets in the pharmacies, particularly in the public health institutions. I am going to talk about the cross border vehicles. As I speak to that one I want to talk about the separation of vehicular and human traffic at the border posts.

        The second one I am going to touch on is the issue that she has spoken about, the issue of psychiatric patients that we remove them from the Ministry of Justice and give them to the Ministry of Health.

        The third one that I am going to touch on is the issue of Traffic Safety Council of Zimbabwe where about 43 people are getting injured each day, that is every 30 minutes we have got an injury due to traffic accidents. I am going to propose that whole department is removed from the Ministry of Transport as its mandate is  to also take care and give awareness to the electorate, the unsuspecting innocent citizens of Zimbabwe who at the end of the day are involved in traffic accidents if they are not properly schooled in that regard. That is the third issue that we take that whole department from the Ministry of Transport and we make it reside with the Ministry of Health, and I am going to explain why.

              The fourth one is the issue of increase of royalties. Just recently the

Minister of Finance came here and proposed a royalty increase from 0.5% to 1% for small scale miners and 3% to large scale miners. I am going to propose that there be a 0.5% increase in terms of taxes or royalties on gold deliveries to finance the health care delivery system of Zimbabwe so that we complement, augment the tablets in the public health sector and also the medication as alluded to by the presenter of this motion.

        The separation of vehicular and human traffic at the border post, as a Committee of Justice, Legal and Parliamentary Affairs chaired by

Hon. Mataranyika where I am a new entrant after being kicked out of the

Transport Committee Chairmanship, but I am quite happy in that Committee. There is a petition that came through to that Committee which speaks to and about child molestation and abuse in terms of child prostitution – that petition is pregnant with such issues Madam Speaker. If you delay a 30 tonne truck of sugar at the border post when it therefore lands in Harare, it will have increased the price of sugar by 4 cents.

        If you delay a 30 000 litre truck of fuel, you will have increased the price of fuel when it lands inland by 2 cents. I therefore urge the Executive to separate these two institutions, the vehicular and the human traffic at the border post so that places like Chiredzi, Beitbridge,

Chirundu are not infested by child molesters and child prostitution

which is a cause for the proliferation of HIV and AIDS scourge that is championed by the truck drivers.  The more you delay them at the border, the more they start looking for small little houses to house children that they then engage in child prostitution with. I ask that there be separation so that there is expeditious clearance of such cargo.

        The other issue that I touched on is the issue of taking that whole department from the Ministry of Justice in particular the correctional services and those that deal with incarceration of offenders. If somebody has been deemed to be a psychiatric patient, that whole department needs to be removed from the Ministry of Justice and Correctional Services and it should be taken to the Ministry of Health so that there can be treatment of the offender as opposed to incarceration of those people in the cells.

        Hon. Mataruse spoke quite eloquently about the deficiency of psychiatric attenders, doctors and the like. It is only prudent to house these people where they get enough and sufficient care.  To follow on that I am going to propose ways of getting resources in order to purchase the medication for not only these patients but also for the whole public health and care delivery system.  As we speak, there is no board that champions the care of those that are psychiatric patients in the

Correctional Services. So it also should enhance the expeditious transfer of that department to the Ministry of Health so that without only augmenting and complementing the supplies of the medication, we are also treating these people with due care and concern.

        Madam Speaker, the issue of special economic zones, the creation of a generic and non-generic drugs has been spoken about – [HON.

MEMBERS: Inaudible interjections.] –

         THE HON. DEPUTY SPEAKER: Order Hon. Members.

        HON. NDUNA: The issue that is before us of special economic zones speaks to the issue of foreign direct investors who can get the investment, 100%, capital, profit and can repatriate it to their places of origin.  Why do I say so? This is one of the conditions of establishment of the special economic zones. Madam Speaker, it is the creation of jobs using brains that is globally acceptable; for example as I have always said, the creation and manufacture of Adidas brand in Zimbabwe for the global market. We can use these geographical locations Madam Speaker to manufacture our drugs and give to these foreign investors 100% capital plus profit repatriation modus operandi so that we use what we have to get what we want. We have Madam Speaker a nation which is endowed with a lot of people that have a capacity in terms of literacy rate which is about 90 to 95 percent and which is just in Africa is just less than Mauritius.

        We need to use that capacity that we have to get what we want. Inside the special economic zones, an Hon. Member of this Committee alluded to the fact that we are getting a lot of our drugs from India, whereas the raw materials are coming from China and India, we can get that raw materials because China is our all weather friend. We need to create the right environment for them to invest.  Where do we get finances and where do we get the benefits as a country, jobs, the forwards the backwards, the linkages and ultimately we get the output which is the drugs and then we resource our public health care institutions.

        Madam Speaker the issue of Special Economic Zones as I conclude, we can get what is called health tourism in Victoria Falls. There was some traction once on this matter. If we get the tourist attracted to our health care institutions, this is going to attract a lot of finances towards our health care delivery system. So, let us get that traction ignited once again Madam Speaker so that we use what we have to get what we want.

    As I touch on Traffic Safety Council of Zimbabwe, Statutory

Instrument 45 of 2005 speaks to the remittances – [HON. MEMBERS:

Inaudible interjections.] –

         THE HON. DEPUTY SPEAKER: Order Hon. Members.

        HON. NDUNA: It speaks to the remittances of a 12 ½ percent from third party insurance. What does this mean? Out of the vehicular population 1.5 million, there is 150 then when insurance was not yet upped from 55 dollars to 295 dollars, third party insurance. The traffic Safety Council would get 20 million RTGs dollars annually because it has gone up 5-fold there is now about 100 million RTGs dollars accruing to Traffic Safety Council.  Its core mandate is for traffic safety tutorage to unsuspecting innocent citizens of Zimbabwe who both use vehicles and those that are pedestrians Madam Speaker.

It is my humble call and submission that that whole department is extracted from the Minister of Transport and is given to the Minister of Health so that we can take that US$100 million, if it is not used in the form, mould and weigh what I am proposing, that money is going to lend into the wrong hands and is going to be used for dangerous purposes as opposed to creating a lot of benefits to the health care delivery care system to procure the much needed medication in our health care institutions.

        I have just touched on a 157 million, five times which is half a billion RTGs annually that is accruing because of third party insurance to Government Madam Speaker, 12 ½ percent of that is going to Traffic Safety Council so it is RTGs100 million annually.  Let us use - put our money where our mouth is, currently that money because we have not proposed its usage is currently lying in the bank and losing value, but I am proposing to you today that that money be utilized for enhancing our health care delivery system.  This is just the third party insurance, there is also what is called passenger insurance which is RTGS15 per each seat charged for each public transport and arising from how many seats that vehicle or public transport has, you will find that the minimum currently is maybe about RTGS 5000 that is paid towards insurance and 12 ½ percent of that can also give you about US$100m.

There is more than 80 or 100 public service vehicles which are paying this money. Before the upward review of the insurance, there used to be about 150 million accruing to Government each annual period.  Currently there is about half a billion accruing because of passenger service vehicle insurance and now 100m is going towards Traffic Safety Council.  This is now a cash cow and this why I ask that out of this report we wrest that away...

    THE HON. DEPUTY SPEAKER: Hon. Nduna, you are left with

5 minutes.

     HON. NDUNA:  We wrestle this away from the Ministry of

Transport and Infrastructural Development and give it to the Ministry of Health and Child Care because at some point one of us will definitely

get ill.

        The last issue that I want touch on is the issue of an upward review of the royalties paid on gold or by gold suppliers.  The Minister of Finance and Economic Development was here not so long ago trying to up the stakes on those royalties so that he can supplement and augment the pittance budget to the tune of $10 billion deficit that he had on the $18 billion budget that he has proposed in terms of Supplementary

Budget. I propose therefore Madam Speaker Ma’am that there be a further point five percent charged on the royalties on gold deliveries so that this money is utilised as a platform to enhance the issue of the manufacturing sector in the drug delivery system.  Madam Speaker

Ma’am, these are the issues that I have been asked by the people of Chegutu West Constituency to come and completely ventilate so that no one dies whilst delivering in our public health hospitals, so, that no one dies of BP, sugar diabetes, headache, all the electorate who are unsuspecting, innocent citizens of Chegutu West Constituency in particular and Zimbabwe in general.  Thank you.

           *HON. MACHINGURA: The debate on drugs relies on Abuja

Declaration and other guidelines which guide us on the amount of drugs needed in a country.  As Zimbabwe, we should be in a position to know how much money we need to put aside for the drugs of the whole nation.  I am making this contribution because at the moment most of us are suffering from ailments one way or the other.

 I am saying this because Parliament has no water because we use toilets but do not wash our hands. In Chitungwiza, there is no water and the local authorities that are responsible for the sanitary systems of the country are not doing their job. As a result, people fall ill because of dirt.  In Chipinge, the urban area has no water. As a result, people are using and drinking unhygienic water from unprotected sources and end up falling sick.  The problem is when they go to the clinics there is no medication.  I wish these clinics had some tablets or those who would have failed to get access to the clinics would go to the hospitals and get the necessary drugs.

Unfortunately, clinics are no longer referring the sick to hospitals, but the sick are now going straight to the hospitals because these local clinics are not functioning properly.  We need to have a critical analysis as to why clinics run by local authorities are not operating efficiently.  I am saying the responsibility of national health is everybody’s business and it is up to us to look for ways and means of reducing these ailments.

I thank you.

*HON. JAJA: Thank you Mr. Speaker for giving me the opportunity to make my contribution on this report. I urge the

Government to ensure that Government hospitals are well equipped with medicines.  Let me give you an example. If you go to a hospital like Parirenyatwa, there is no medication and yet when you go to private hospitals there is plenty of medication bought using foreign currency.

You ask yourself why is it like that. I am calling upon Government to ensure that Government central hospitals be resourced with enough medication to withstand people’s ailments.  People are suffering. I thank you.

HON. MUSABAYANE:  I move that the debate do now adjourn.

HON. MATANGIRA:  I second.

Motion put and agreed to.

Debate to resume: Tuesday, 24th September, 2019.

MOTION

REPORT OF THE PORTFOLIO COMMITTEE ON DEFENCE,

HOME AFFAIRS AND SECURITY ON THE GWANDA

COMMUNITY YOUTH DEVELOPMENT TRUST PETITION ON

ACCESS TO PRIMARY DOCUMENTS

   Thirty-Fourth Order read: Adjourned debate on motion on the

Report of the Portfolio Committee on Defence, Home Affairs and Security on the Gwanda Community Youth Development Trust Petition on the access to primary documents.

         Question again proposed.

THE DEPUTY MINISTER OF HOME AFFAIRS AND

CULTURAL HERITAGE (HON. MADIRO): Thank you Hon.

Speaker.  The Ministry of Home Affairs and Cultural Heritage, through its department of the Registrar General is responsible for all vital civil registrations as well as production and issuance of travel documents.

The department is decentralised and represented in all the ten administrative provinces, 62 districts throughout the country and 206 sub offices.

The Ministry takes note of the report by the Committee and commits itself to implement the recommendations therein, particularly to improve access to and acquisition of civil registration and travel documents by every citizen in need of these essential documents.  The Ministry also undertakes to further decentralise its services, including

the office of the Registrar General in line with the Government thrust of ease of doing business.

Responses to recommendations 5.1 (a) Streamlining of requirement for obtaining primary documents

The department has developed operational manual to serve as standard operating procedures to guide officials in the performance of their duties including requirements obtaining primary documents.

(b) Public awareness on the importance of primary documents

In addition to static registration offices throughout the country as explained above, the department also conducts mobile registration exercises in an effort to bring services to the people and reach out to places that are far away from registration offices. The department participates in and exhibits annually at the Zimbabwe International Trade Fair, Zimbabwe Agricultural Show and takes part in television and radio programmes to encourage civil registration and explain the importance of having primary documents.

(c) Mobile registration exercises all year round

This exercise has since begun at provincial and district levels throughout the country on an on-going and permanent basis.

(d) Special dispensation for victims of natural disasters

A special exercise to replace and issue primary documents to victims of Cyclone Idai is due to commence on 9 September 2019 in

Chimanimani for 30 days after which the programme will be moved to

Chipinge for another 30 days.  As already has been directed by His

Excellency the President, Hon. E. D. Mnangangwa, these documents will be replaced and issued for free, that is at no charge to the affected citizens.

(e) Decentralisation of the office of the Registrar General to all parts of the country

The office of the Registrar General is already decentralised as already explained above through provincial, district and sub offices.

The process to establish more sub offices is ongoing, subject to availability of resources, that is infrastructure and staff.

(f)  Reliable transport for operations

Admittedly, the department needs to be supported with vehicles suitable for all terrain to enable it to carry mobile registration in all areas of the country.  Plans are underway to include this in the 2020 departmental budget.

The Ministry would want to acknowledge the support by and express its gratitude to the United Nations High Commissioner

(UNHCR) for refugees in Zimbabwe for partnering the Registrar

General’s department in the mobile registration exercises to be conducted in Chimanimani and Chipinge districts. The office of the UNHCR is  assisting the department with among others, four wheel drive vehicles for this outreach programme.

(g) Ongoing training and refresher courses in customer care for officers

An exercise is underway by the department to develop an appropriate training programme and curriculum in customer care as part of continuous professional update and to address identified performance deficiencies.

(h) Establishment of birth registration at ECD centres

This idea will be considered.  However, the creation of facilities at ECD centres by 31 December 2020 depends on the availability of resources for the establishment of the necessary infrastructure and staffing suffice to say currently, the office of the Registrar General is represented through sub offices at all major hospitals and at some clinics for births and death registration.

Parents, through these sub offices can obtain birth registration of their newly born children even before they leave the maternity home.  Parents are therefore encouraged to take advantage of this facility as well as the free birth registration window for children up to the age of six and save themselves the inconvenience of late or non registration.

(i) Relaxation of search fees for lost documents

The search fee is currently RTGS$5.00.  It is submitted that this figure is both reasonable and necessary to motivate citizens to take care  and look after their documents.

(j) Parliamentary Oversight on the Registrar General’s

Department

The Ministry is ready to cooperate with and would appreciate any support by Parliament to ensure provision of an efficient service delivery that meets public expectation.  Thank you Hon. Speaker.

HON. MAYIHLOME:  Mr. Speaker Sir, on behalf of the Committee on Defence, Home Affairs and Security, we would like to express our gratitude to the Ministry of Home Affairs and Cultural

Heritage and the Registrar General’s Office for the prompt response to this petition and to our report.  We are very grateful that as we debated this report in this House, action on the ground had already started.

 We have heard reports that they have started to issue birth certificates and they are being issued until late in some parts of the country.  We have also been informed by the Registrar General’s office during our visit to the passport production centre that measures have been put in place to ensure that passports are issued out more promptly.  Foreign currency challenges that were encountered at the production centre are issues that are being addressed by the Ministry of Finance and that of Home Affairs.

It is our fervent hope that the issue of foreign currency generated at foreign embassies will be discussed amicably between the Ministry of Home Affairs and the Ministry of Finance so that an equitable share of that foreign currency could be given to the Registrar General’s Department so as to alleviate their plight on foreign currency requirements.

We however appeal to the Ministry of Home Affairs and the

Registrar General’s office to ensure that this exercise will not be just a response to the petition but an exercise that will continue throughout the country until the problem of delayed issuing of birth certificates is addressed once and for all.

  As part of our oversight role, we will continue to monitor the activities and service delivery in these departments and check developments over a period of time and during the life of the Eighth Parliament.

I must conclude by saying thank you to the Gwanda Community

Youth Development Trust, the Registrar General’s office, the Ministry of Home Affairs and Cultural Heritage and all who contributed to this exercise.  We believe that there is light at the end of the tunnel and such cooperation is what is we expect as your Committee.  I thank you.

I therefore move that the motion on the Report of the Portfolio

Committee on Defence, Home Affairs and Security on the Gwanda Community Youth Community Trust Petition on the access to primary documents be adopted.

Motion put and agreed to.

MOTION

BUSINESS OF THE HOUSE

HON. MUSABAYANE:  I move that the all the Orders of the Day be stood over until Order of the Day, Number 37 has been disposed of.

HON. TONGOFA:  I second.

Motion put and agreed to.

MOTION

FIRST REPORT OF THE PORTFOLIO COMMITTEE ON LOCAL

GOVERNMENT, PUBLIC WORKS AND NATIONAL HOUSING ON

GWANDA RESIDENTS’ PETITION ON VIOLATION OF RIGHTS

TO HUMAN DIGNITY, WATER AND CLEAN ENVIRONMENT

        Thirty-Seventh Order read:  Adjourned debate on motion on the first report of the Portfolio Committee on Local Government, Public

Works and National Housing on Gwanda Residents’ Petition on violation of rights to human dignity, water and clean environment.

Question again proposed.

HON. CHIKUKWA:  Mr. Speaker Sir, I would like to thank all the Hon. Members who contributed and we hope what is happening in Gwanda is an eye opener to other local authorities where we might not have gone to and we hope with our Committee we are going to pursue some of the local authorities in the same venture.

I therefore move that this House takes note of the first report of the

Portfolio Committee on Local Government, Public Works and National

Housing on Gwanda Residents’ Petition on violation of rights to human

dignity, water and clean environment, be adopted.

Motion put and adopted.

On the motion of THE DEPUTY MINISTER OF HOME

AFFAIRS AND CULTURAL HERITAGE (HON. MADIRO), the

House adjourned at Twenty One Minutes to Five o’clock p.m. until

Tuesday, 24th September, 2019.

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