Why Kenyans could be consuming expired drugs
By Mercy Mwai, August 5, 2025Kenyans could be consuming expired drugs, after it emerged that some hospitals are still stocking instead of disposing of them, a new report shows.
The reports from Auditor General Nancy Gathungu for the year ending 2024, for various hospitals, have also painted a grim picture of the survival of some of the facilities as they lack basic amenities and equipment.
The situation is so bad that some of the hospitals do not have specialist doctors like paediatricians, radiologists and gynaecologists, while others lack Intensive Care Unit (ICU) beds, High Dependency Units (HDU) beds, maternity beds and newborn units.
The various audit reports also show that some of the hospitals do not have approved establishments and career progression guidelines for their staff, and thus do not meet the criteria of being recognised as Level Four facilities.
Level Four hospitals are supposed to be run by a medical professional and have more than one doctor, providing a higher level of care like theatres, occupational therapy, physiotherapy and larger inpatient capacity.
Among the hospitals in question are Kiambu Level Five, Lusingetti Level Four in Kiambu, Athi River Level Four in Machakos, Gatundu Level Five in Kiambu, Kimbewa County Level Four in Kisumu, Kabartonjo Level Four in Baringo and Mashuuru Level Four in Kajiado.
In Kiambu Level Five, the report has raised concerns that the hospital has expired drugs of undetermined value that were yet to be disposed of.
Equipment shortage
“Physical verification and review of records revealed expired drugs of undetermined value that were yet to be disposed of, as per the ‘Pharmacy department expired drugs book’. In the circumstances, the existence of effective internal controls in the management of inventories could not be confirmed,” the report reads.
In the case of Lusingetti, the report shows that the hospital is still holding products for periods against the National Environmental Management Authority (NEMA) Regulations, 2006, on the Disposal of Expired Pharmaceutical Supplies.
“ln the circumstances, Management was in breach of the law,” the report states.
In the case of Athi River, the report says that physical verification of the pharmaceutical stocks revealed the hospital was in possession of expired drugs received from 2019, whose value could not be determined.
According to the report, no explanation was provided for the failure to dispose of the expired drugs.
A review of records and interviews on verification of services offered, equipment used, and medical specialists revealed that the hospital did not meet the requirements of the Kenya Quality Model for Health Policy guidelines due to staff deficits by between 83 and 84 per cent.
The hospital has only one medical officer against a requirement of 16, one paediatrician, 15 nurses against a requirement of 75, and no radiologists, general surgeons, anaesthesiologists and gynaecologists.
“ln the circumstances, the Hospital may not be able to deliver on its mandate,” the report concludes.
In Gatundu Level Five, the report doubts the capability of the hospital to offer services to Kenyans due to a shortage of equipment.
Further, it has also revealed instances where some of the equipment were more than required, pointing to a situation where some of the equipment were left lying idle.
Among the excess equipment include drip stands, which are 150, yet the hospital requires only one, 10 wheelchairs, yet the expected number is five, 12 patient monitors against an expected number of five, eight infusion pumps against a requirement of five, and 20 BP machines against an expected number of five.
There are also concerns over gaps in employee costs amounting to Ksh8.1 million, as the Hospital does not have an approved staff establishment, does not have career progression guidelines, monthly payrolls for the casuals were not provided for review, and payment vouchers for the month of May and June 2024 were not provided for review.
In Kimbewa, the report has not only revealed a significant shortfall in the Hospital’s staffing capacity to meet the requirements of Universal Health Care (UHC) but also established that the Hospital is non-compliant with the Kenya Quality Model for Health (KQMH) policy guidelines.
Insurance shortfall
According to the report, the hospital has only two medical officers against a requirement of 16, one general surgeon, radiologist and gynaecologist, yet they require two of each, no paediatrician and 40 Kenya Registered Community Health Nurses against a requirement of 101.
“The deficiencies contravene the First Schedule of the Health Act 2017 and imply that accessing the highest attainable standards of health, which includes the right to health care services, including reproductive health care as required by Article 43(1) of the Constitution of Kenya, 2010, may not have been achieved,” the report warns.
The report has raised questions regarding reimbursement for services rendered for intended National Health Insurance Fund (NHIF)beneficiaries.
Although the hospital submitted claims amounting to Ksh19.6 million to NHIF for reimbursement for services rendered to intended NHIF beneficiaries. It was noted that they received only Ksh11.4 million.
The report also shows that the hospital took, on average, a minimum of six months to obtain refunds from claims from the Fund.
Kabartonjo Level 4 Hospital in Baringo lacks the necessary equipment and machines outlined in the Health Policy Guidelines.
For instance, they have 44 beds against a requirement of 150, one newborn unit incubator against a requirement of five, no functional ICU, no renal unit, no functional operational theatres, maternity and general, as well as no HDU.
With regards to medical specialists, the hospital has only two medical officers against a requirement of 16, no anaesthesiologist, general surgeons, gynaecologist and radiologists, yet there are supposed to be two for each, while the nurses are only nine against a requirement of 75.
In the case of Mashuuru Level 4 Hospital in Kajiado County, the report says that the store records on pharmaceuticals and non-pharmaceuticals revealed that 4,947 units of various drugs of undetermined value had expired.
Stock cards for controlling stores indicated that the Hospital experienced a stock-out of medical supplies of up to 30 days
The hospital has staff shortages and only offers minor surgery services, inpatient services, paediatric services, but no outpatient clinics and Tuberculosis management.
Out of the ten essential services, only 4 are offered at the hospital, and thus the hospital does not meet the level 4 hospital requirements.