{"id":522449,"date":"2026-04-10T01:01:15","date_gmt":"2026-04-10T01:01:15","guid":{"rendered":"https:\/\/www.newsbeep.com\/uk\/522449\/"},"modified":"2026-04-10T01:01:15","modified_gmt":"2026-04-10T01:01:15","slug":"how-a-single-administrative-error-sparked-10-months-of-critical-medication-shortages-in-eswatini","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/uk\/522449\/","title":{"rendered":"How a single administrative error sparked 10 months of critical medication shortages in Eswatini"},"content":{"rendered":"

Records and insider testimony from Eswatini\u2019s main pharmaceutical supplier have revealed how a simple, avoidable administrative error by the government in 2023 probably led to a months long stockout of several critical medicines.<\/p>\n

Following the error, the Ministry of Health suspended Fortunate Bhembe, the only official empowered to authorise controlled medicine imports, without preparing for the resulting disruption to the supply chain.<\/p>\n

Leaked high-schedule stock cards from SwaziPharm \u2014 the Eswatini government’s primary pharmaceutical supplier \u2014 reveal a dire shortage of essential medications between February and November 2024. During this period, stock levels for critical drugs used to manage pain, epilepsy, and psychiatric conditions remained at zero.<\/p>\n

The affected medications included:<\/p>\n

Analgesics: Morphine, fentanyl, pethidine, codeine and dihydrocodeine.Neurological\/Psychiatric: Phenobarbital and haloperidol.<\/p>\n

SwaziPharm employees attributed these life-threatening stockouts to an administrative paralysis following Bhembe\u2019s suspension. Because the ministry failed to appoint a successor or delegate her exclusive signing authority, the company was left without a valid pathway to secure import permits.<\/p>\n

Stockouts in context<\/p>\n

Since at least the mid-2010s, Eswatini\u2019s public health sector has battled with repeated drug shortages<\/a>. In recent years, this has led to civil society protests throughout the country.<\/p>\n

In late 2022, the government commissioned Funduzi Forensic Services to conduct an audit<\/a> into the country\u2019s acquisition and distribution of medicines to public health facilities.<\/p>\n

Drug stockouts in Eswatini have been attributed to non-payment of suppliers, weak procurement systems, and poor inventory control. The Funduzi report further highlighted procurement irregularities, evidence of possible fraud, and weak or ineffective internal controls across the supply chain.<\/p>\n

The report was not without controversy. Funduzi was accused<\/a> of having misled the government about its corporate identity and credentials. Some of the report\u2019s findings have also been disputed by the World Health Organization.<\/p>\n

Still, many of the findings and recommendations were accepted by the government.<\/p>\n

An unintended consequence<\/p>\n

Our investigation has uncovered a critical, unintended consequence of the Funduzi report\u2019s findings. The report implicated several officials \u2014 including Bhembe \u2014 for \u201cfruitless and wasteful expenditure\u201d, alleging they had ordered surplus medications that were not in high demand.<\/p>\n

Following these recommendations, the Eswatini government suspended Bhembe on November 7, 2023. However, this disciplinary action created an immediate systemic bottleneck: at the time of her removal, Bhembe was the sole official authorised to sign the import permits required for suppliers like SwaziPharm to bring controlled medicines into Eswatini.<\/p>\n

In the aftermath of the Funduzi report, SwaziPharm donated its reserve stocks of several medicines \u2014 including morphine, fentanyl, pethidine, phenobarbital and haloperidol \u2014 to the government.<\/p>\n

SwaziPharm spokesperson Shaun Morgan said, \u201cWe were dealing with the fallout from the leaked report, but with patients already suffering, we chose to act in the public interest.\u201d The donations meant that the stock levels for several medicines fell to zero in February 2024, as reflected in stock records.<\/p>\n

\u201cUnder normal conditions, closing stock never reaches (or stays at) zero because new deliveries continuously replace what is issued,\u201d said Morgan.<\/p>\n

\u201cIn a functioning system, stock cleared in January would be replaced through new imports. That did not happen, and that gap coincides with the suspension of Fortunate Bhembe.\u201d<\/p>\n

Bhembe\u2019s position as deputy director for pharmaceutical services was only filled in September 2024, with the appointment of Nomsa Shongwe. This means that no one in government was able to sign for imports for 10 months.<\/p>\n

The director of a medicines supplier, speaking on condition of anonymity, confirmed that there was no government signatory for the import of medicines during the 10 months. <\/p>\n

Prolonged pain<\/p>\n

Drug stockouts in Eswatini have a long and complicated history<\/a>. But, the suspension of Bhembe \u2014 and the government\u2019s apparent failure to mitigate against the dire impact that the removal of her signing power had on the country\u2019s medicines supply chain \u2014 shows that sometimes easily avoidable administrative mistakes can deepen the crisis.<\/p>\n

The impact is felt most by patients, often living in poverty, who are unable to access the medicines they needed to overcome debilitating pain and ailments.<\/p>\n

A doctor at a major government hospital spoke about not having access to fentanyl and morphine injections, used to control severe pain after surgery, trauma and advanced cancer.<\/p>\n

\u201cThere were times when patients who should have received proper injectable pain relief could not get it. We relied on weaker alternatives or asked families to source medicines privately,\u201d the doctor said.<\/p>\n

The result, he said, was prolonged pain and slower recovery.<\/p>\n

Stockouts of phenobarbital, another of the medicines affected by Bhembe\u2019s suspension, can have dire consequences for seizure patients.<\/p>\n

\u201cIn seizure cases, delays [in administering medication to the patient] matter. Seizures can last longer or recur, increasing the risk of complications and longer admissions,\u201d the doctor said.<\/p>\n

Psychiatric care can be similarly strained by the absence of the correct medicines. The physician noted that haloperidol \u2014 a critical drug used to stabilise patients experiencing acute psychosis \u2014 was frequently unavailable to both him and those under his care.<\/p>\n

\u201cWhen it is not there, patients remain unstable for longer, which affects both their safety and that of staff,\u201d he said.<\/p>\n

Ministry\u2019s right of reply<\/p>\n

The stock records and testimony from suppliers suggest that the Ministry of Health made a grave error when it suspended Bhembe without a contingency plan for the national medicine supply chain.<\/p>\n

However, the Ministry of Health spokesperson, Nsindiso Tsabedze, dismissed this and denied that the government was to blame for the stockout. <\/p>\n

Suppliers, however, were unequivocal in their assessment, squarely blaming the ministry.<\/p>\n

\u201cYou cannot remove a signatory without ensuring that the function continues,\u201d remarked one supplier. \u201cThat is a basic systems failure.\u201d DM<\/p>\n

Sibusiso Dlamini is an investigative journalist at the Eswatini Observer, where he reports on politics, the environment, public procurement and public health, with a sustained focus on the country\u2019s drug shortage crisis. He is the founder of The Open Word Podcast and is pursuing an honours degree in Journalism and Media Studies at the University of the Witwatersrand.<\/p>\n

This report was produced by the Southern Africa Accountability Journalism Project (SA | AJP), an initiative of the Henry Nxumalo Foundation, with the financial assistance of the European Union. Under no circumstances can it be regarded as reflecting the position of the European Union.<\/p>\n","protected":false},"excerpt":{"rendered":"Records and insider testimony from Eswatini\u2019s main pharmaceutical supplier have revealed how a simple, avoidable administrative error by…\n","protected":false},"author":2,"featured_media":522450,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[42],"tags":[181614,181272,102,6591,181613,146319,56,54,55],"class_list":{"0":"post-522449","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-medication","8":"tag-drug-stockouts-in-eswatini","9":"tag-eswatini","10":"tag-health","11":"tag-medication","12":"tag-medicine-stockouts","13":"tag-public-healthcare","14":"tag-uk","15":"tag-united-kingdom","16":"tag-unitedkingdom"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/522449","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/comments?post=522449"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/522449\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media\/522450"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media?parent=522449"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/categories?post=522449"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/tags?post=522449"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}