While the government scrounges for funds to make healthcare and medicines accessible to all Filipinos, the Commission on Audit, or CoA, found that more than P7.43 billion worth of drugs, medicines, and vaccines were wasted after the Department of Health failed to distribute them in 2022.

The DoH was then under Secretary Francisco Duque III, covering the period when the pandemic was on the wane.

The Universal Health Care law took effect in 2019, but PhilHealth members still have to pay for more than half of their medical needs due to the lack of funds to implement the measure fully, according to state think tank Philippine Institute for Development Studies, or PIDS.

“Despite modest improvements in health outcomes, inequities continue to exist due to unresolved challenges in access to healthcare,” according to PIDS.

State auditors said the overstocking and the slow-moving inventory indicated “excessive spending” as the procured items exceeded the current requirements of the Centers for Health Development.

“These deficiencies were also caused by a breakdown in the inventory/supply management system, such as inadequate procurement planning; laxity in creating adequate monitoring and reporting system; absence of periodic assessment of inventory movements; identified weakness in internal controls; acceptance of drugs and medicines not in accordance with the standard requirement pertaining to shelf life; and failure to formulate and take necessary corrective measures and poor distribution system,” CoA said.

In the DoH’s annual report, state auditors discovered that the department had P7.43 billion worth of drugs, medicines, and vaccines that were expired, damaged, excessive, overstocked, understocked, slow-moving, undistributed, distributed late and accepted below 19 months before expiration.

CoA attributed the enormous spoilage to deficient procurement planning, poor distribution and monitoring systems, and weaknesses in internal controls.

Citing Section 2 of Presidential Decree 1445, the CoA said the DoH should have safeguarded the government resources against loss or wastage through illegal or improper disposition.

Under DoH Administrative Order 2016-0008, medicines and drugs beyond their expiration date should be disposed of as these may be unsuitable for use, and there is no guarantee that the quality of the products is maintained.

According to the World Health Organization, drugs do not become toxic or ineffective on expiry but may slowly deteriorate over time depending on the product, formulation and storage conditions. Some become toxic, but most simply lose their efficacy.

According to CoA, the National Capital Region and Ilocos and Tacloban regions had the highest recorded slow-moving medicines and drugs, totaling P5.6 billion.

Expired vaccines were found at the Mariano Marcos Memorial Hospital & Medical Center or MMMMHMC (361 expired vials); Central Luzon (261,138 vials); Easter Visayas (1,671,878 doses); and Caraga (104,962 vials).

DoH-Western Visayas had 5,551 vials nearing their expiration date and 6,425 at MMMHMC.

Moreover, the CoA said the expirations could be attributed to various factors, including the reluctance of local government units and other implementing agencies to accept vaccines they doubted they would use up.

The lack of cold room storage, low demand for vaccination, operational wastage/thawed but not used, and late deliveries from DoH, CoA said, all contributed to the expiry of vaccines.

“Overall, the problem exposed an inability to safeguard, manage, and utilize health funds and resources economically and effectively,” CoA said.

“Overstocked or slow-moving drugs and medicines are exposed to the risk of possible wastage due to the poor condition of the warehouses, and the maintenance of excessive supplies entails additional costs in terms of manpower and warehouse space, which could have benefited the government’s health programs for the poor,” it added.

Nevertheless, the CoA directed the DoH to impose appropriate sanctions and to expedite the issuance and distribution of near-expiry vaccines to stave off future wastage of government funds.

The DoH agreed to the CoA’s recommendations and informed auditors that it had initiated the necessary actions.

Meanwhile, the Dr. Jose N. Rodriguez Memorial Hospital informed DoH that drugs, particularly Remdesivir, were fully utilized before their expiration date, and the FEFO (first to expire, first out) policy was implemented to avoid wastage of state resources.

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