Lusaka — "I had always associated corruption with politics and business," laments Chalwe Kabwesha. "When I failed to access ARVs and TB drugs at our clinic because of corruption, I got worried."
The 68-year old Kabwesha is a retired civil servant living with AIDS. He spent much of his energetic working life in the Zambian capital, Lusaka, before he retired. Now he has relocated back to his home village in Northern Zambia. Kabwesha has been preoccupied with either pursuing his retirement benefits in Lusaka or chasing ARVs and other essential drugs that help prolong his life.
He is however not alone in his predicament. Many other poor Zambians are also bearing the brunt of the nation's widespread corruption as they fail to access many necessities of life like their pensions and essential drugs.
But there is a ray of hope for Kabwesha and millions of other poor Zambians. This is thanks to the unwavering anti-corruption efforts of many organisations lik Transparency International Zambia (TIZ) and the Medicines Transparency Alliance (MeTA).
Supported by the UK's development agency DFiD, since 2008, the international initiatives have been spearheading a project aimed at helping to increase access to essential medicines by low income and disadvantaged people in Zambia. MeTA and TIZ want to improve transparency and accountability in the selection, procurement, sale and distribution of essential medicines in Zambia. And it involves the key sectors in government, the pharmaceutical industry, civil society and the donor community.
Goodwell Lungu, executive director of TIZ, said, "We have had constructive dialogue meetings with government, the private sector, civil society and the media on anti-corruption matters. This has been an important milestone in exchanging very practical experiences in combating corruption. Together we need to be more vigilant and intolerant to issues of corruption."
Since its inception, the project has offered the Zambian authorities and other stakeholders an opportunity to positively transform the pharmaceutical sector and the general healthcare landscape by adhering to the core international principles of MeTA. The principles, which Zambia has signed up to include the following.
The belief "that good health is crucial to human dignity and social and economic development. And the recognition that inefficient procurement, distribution and supply of medicines, coupled with weak regulation and supply chain management, can result in quality assured medicines being unaffordable or unavailable, especially for poor or disadvantaged people."
Unfortunately, the situation on the ground is a source of worry. The media is awash with cases of gross violations of the MeTA principles by both the public and private players in the health sector. Ironically, the Ministry of Health through which Zambia has signed up to the MeTA governing principles happens to be the major violator.
The Ministry of Health is generally perceived as the "Ministry of Wealth" because of the many financial and other related scandals that some of its officers have been linked to and for which they are facing prosecution.
In December last year, the Global Fund was forced to suspend aid to Zambia following the unearthing of a multi-million dollar scandal, which implicated the Ministry. The Zambia National Aids Network (ZNAN), the Principle Recipient of the Global Funds in Zambia, was also implicated.
There are many similar incidents highlighting the fact that the fight is not yet won against pilfering and general mismanagement of resources that have continued to rock the health sector in the country. For example, last year ARVs and other essential drugs went up in flames after a storage facility at a rural health centre caught fire in unexplained circumstances.
While appreciating the many strides that Zambia is making in ensuring that poor people have uninterrupted access to essential medicines and healthcare in general, many observers believe much more decisive measures are urgently needed to stem the tide of corruption.
The Zambia Medical Association (ZAM) says there is a need to put in place mechanisms that will help wean Zambia from over-dependency on donor support for her HIV/AIDS programmes.
ZAM spokesman, Dr Robert Zulu, says there is a need to introduce an AIDS and TB-specific national budget and establish a National Fund for ARVs.
"What will happen when the funds from the donors are not available? We want patients to have a sense of security on the availability of the drugs anytime anywhere in the country," he said.
The TIZ believes that transparency and accountability in the healthcare delivery system will only succeed with enhanced participation by citizens.
Despite all the odds, there is a glimmer of hope.
The Global Fund has announced that it has strengthened its capacity to prevent and detect fraud and the misuse of drugs by its aid recipient countries, including Zambia. Stringent measures include the appointment of a high-profile panel of international experts to regularly review the system and ensure tighter controls and oversight of its funding mechanisms.
Ministry of Health spokesman Dr Kamoto Mbewe has also announced Government's measures to order essential drugs worth USD 6 million, which have already started arriving in the country.
These measures by the two leading players in Zambia's healthcare system should inspire other stakeholders to do more to help the poor majority of Zambia.
And this brings a smile to Chalwe Kabwesha.