Malawi's public hospitals are struggling with a severe shortage of essential medicines, with 75% of required drugs currently out of stock. The Central Medical Stores Trust (CMST), which supplies public hospitals, is facing challenges in securing foreign exchange to import drugs, leading to a significant decline in medicine availability. This shortage has resulted in 62 items, representing 18% of essential medicines, being fully in stock, while 23 items, or 7%, are at low levels.
The medicine availability has steadily declined during the 2026/27 financial year, falling from 51% in April to 40% in September, well below CMST's target range of between 55 and 65%. Central hospitals are the worst affected, with availability dropping from 34% in April to 18% in September. The sharpest decline was recorded in August when availability fell from 30 to 19%. District health offices (DHOs) have also experienced a significant deterioration, with medicine availability declining from 66% in April to 53% in September.
The situation has prompted the Parliamentary Committee on Health to consider urgent interventions to prevent the crisis from deepening. The committee's chairperson, Anthony Masamba, stated that the committee is exploring options to address the shortage. He attributed the crisis to CMST's failure to secure foreign exchange, resulting in an $18 million debt to international suppliers. Masamba emphasized that the kwacha is available, but dollars are needed to import essential medicines.
The Health Services Managers Network (Hesnet) has expressed concern that the situation has crippled service delivery in public hospitals. Hesnet's affiliate, the Malawi Local Government Association (Malga), executive director Hadrod Mkandawire, stated that essential medicines, including paracetamol, Ibuprofen, and surgical gloves, are in short supply. He urged the government to address the situation immediately and suggested devolving 50% of the drug budget to local authorities to enable them to procure medicines independently.
Some of the essential medicines currently in short supply include Ciprofloxacin, Diclofenac, Doxycycline, Flucloxacillin, Adrenaline injection, Atropine injection, and Dexamethasone injection. Others include Benzathine Benzylpenicillin injection, Furosemide injection, Tranexamic Acid injection, disposable syringes, and surgical gloves. Human Resources for Health Coalition chairperson Solomon Chomba confirmed the shortages, stating that almost all health facilities nationwide are struggling to procure essential medicines.
The government has allocated K108.3 billion for the procurement of medicines and medical supplies in the 2026/27 fiscal year, representing a 13.1% increase from the 2025-26 revised provision of K95.8 billion. However, this allocation may not be sufficient to address the current shortage. Centre for Democracy and Economic Development Initiatives executive director Sylvester Namiwa wrote to the Parliamentary Health Committee, warning that the country is facing critical persistent drug stockouts that will shortly culminate into a full-blown crisis if not addressed.
The Parliamentary Committee on Health is set to formally summon CMST and consider engaging the Ministry of Finance, Economic Planning and Decentralisation to bring an unforeseen vote to Parliament to help address the shortage. The committee will explore all available options to prevent the crisis from deepening and ensure that public hospitals receive the essential medicines they need to provide quality healthcare services to patients.
Key points
- Malawi's public hospitals face a 75% shortage of essential medicines due to forex woes affecting the Central Medical Stores Trust.
- The shortage has resulted in a significant decline in medicine availability, with central hospitals being the worst affected.
- The Parliamentary Committee on Health is considering urgent interventions, including engaging the Ministry of Finance, to address the shortage.
