Deputy President William Ruto says he will scrap the Kenya Medical Supplies Authority (Kemsa) and give counties a free hand to purchase drugs, if elected President, in radical proposals aimed at revolutionising the health sector.

He said public healthcare is among the critical sectors that suffer trickle-down effects, yet needs a bottom-up economic model.

Addressing an economic health forum at the Catholic University of East Africa (CUEA), Ruto said almost 60 per cent of patients go to referral institutions instead of dispensaries, health centres, or Level 3 or 4 hospitals because their experience is that there are no health professionals at these medical facilities, or there are no drugs.

Bottom of pyramid

“We must figure out how to start at the bottom of the pyramid. Starting with the dispensary, while the community health worker will be empowered sufficiently to deal with challenges at the roots,” he said.

“If the dispensary is working, if the health centre is fine, that’s the only way Level 4-5 hospitals will work,” he added.

Despite health functions being devolved, the majority of medical centres in the 47 counties lack drugs and are dormant.

Similarly, he said, dispensaries are also not working because there are no personnel, while Level 4 and 5 hospitals are congested. “Everybody’s crowded there. If there is one thing we must figure out, (it’s how to) take health care to the bottom of the pyramid,” he stated.

To address health challenges, including the commodity supply chain, he said, if Kenya Kwanza Alliance assumes power, they will abolish Kemsa as it had muzzled counties and failed Kenyans.

“I don’t know about the wisdom of having a monopoly called Kemsa. Some people must persuade us if there is logic to have a monopoly called Kemsa,” Ruto said.

“There is no reason why we have a facility that doesn’t have drugs that are required at the right time,” he added.

The DP argued that Kemsa may have drugs but they stay in stores until they expire. “We simply must sort it out. Right now, if you go to any health facility, they will tell you they have very serious challenges with Kemsa,” he observed.

He claimed that as chairman of IBEC, alongside governors, he even tried to let counties appoint two directors to Kemsa, but two years later, this is yet to happen.

Ruto, who is making his first stab at the presidency, says he expedited the procurement of a digital health records system that would not only give Kenya portability of patient data but also help in telemedicine.

He regretted that because of conflict of interest, and what he termed “other things”, the Jubilee government did not succeed in procuring the system.

Poor health records

“We cannot continue to write on pieces of paper everywhere. And then the next day, that piece of paper disappears. You come back to the hospital, they write in another exercise book and then it disappears. So, health records become our biggest challenge and nightmare,” he said.

He regretted that for five years, the government led by President Uhuru Kenyatta never managed to procure a health system, saying that if there’s one urgent thing that must go into his 100-day delivery plan if elected is to figure out how to have a health system that will not only capture all the health data, it will also make patient data portable from one place to another without a lot of effort.

He said Kenya must do whatever it takes to sort out its health issues so that it can confidently speak to the words that “a healthy nation is a wealthy nation. This is the only way we can take our economy to the next level”, he said.

ANC leader Musalia Mudavadi promised that a Kenya Kwanza government would respect health professionals and hand them leading roles in government.

“No matter what we do, we cannot be saying that you need a banker to run banks. You need an oil expert to tell you about the petroleum industry and how to get it to become more efficient,” said Mudavadi.

Health professionals present pushed for the return of a health service commission to allow staffing, remuneration, allowance and salary challenges.