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SNAKEBITE SERUM SAGA PUTS HEALTH MINISTRY IN THE FIRING LINE

Health & Lifestyle

A fight over a multimillion-cedi contract for serum used to treat snakebites ‒ a common emergency in some of the poorest regions of Ghana ‒ is threatening to cause disarray in Ghana’s public health system, already under heavy pressure.

A fight over a multimillion-cedi contract for serum used to treat snakebites ‒ a common emergency in some of the poorest regions of Ghana ‒ is threatening to cause disarray in Ghana’s public health system, already under heavy pressure.

The tender for anti-snakebite serum closed in August 2018 and was followed by just one round of full competitive bidding between six companies. Five then dropped out, some of them complaining about what they say was special treatment for one company to review its tender document and offer.

The Ministry of Health later announced that this very company, Pharmanova Ltd, owned by the Indian businessman Dhananjay Tripathi, had won the tender, worth a cool GHC23 million on Pharmanova’s terms.

Individuals involved with the five losing companies raised red flags. They claim that Pharmanova deliberately underbid in the first round to secure the tender, knowing that it could not supply its anti-snakebite product, Vins, at the price it quoted. After the competitors cited industry experience and questioned Pharmanova’s offer, the company revised its quote downwards.

Pricing

An inside source close to one of the firms involved in the negotiations told the Daily Statesman, “During the bidding, Pharmanova offered the lowest price and was challenged by another company.

“The other companies thought the price they had quoted could be a mistake because there was no way they could have delivered the product at that price. They are all in the industry and know the product price range.

“They insisted that was their price but later went back to change it.”

Pharmanova’s initial offer to supply Vins for GHC2,333,500 increased to GHC23 million ‒ against bids for products by two rival firms at GHC20 million and GHC20.75 million.

Yet the rivals claim it was clear after the first round of bidding that the Ministry of Health’s interest lay in one direction, despite questions about pricing and how effective Vins might be against some kinds of snakebite common in Ghana.

Stocks run out

The competing firms began to murmur. For months after bids for the tender, there were no developments. Reports began to surface in the national press about a shortage of anti-snakebite treatments at hospitals in the North. In December, the Daily Graphic reported on its back page that Wa Regional Hospital had run out of serum and at least three people had died in the previous two months for lack of access to the right medicine.

The acting medical director for Wa hospital told the paper that in fact, the hospital had operated without the appropriate anti-snake serum for the previous four months. Stocks donated by international programmes had run out and there had been no sign of fresh supplies from the Ministry of Health.

A more recent report says that ten people in the same area have died after taking ineffective treatments for snakebites. Supplies of antidotes through the public health services are very low in this area and patients are directed to buy the drugs from private suppliers.

Losing patience with waiting for the Ministry of Health to resolve the matter and convinced that the ministry’s leadership were biased in favour of their rival, two companies that bid in the first round lodged a complaint with the Public Procurement Authority (PPA). On 8 January, AS-Tesco approached the PPA seeking a remedy. Kinapharma followed suit nine days later.

PPA investigating

On 18 January the PPA announced that it had launched an investigation into the tender after receiving two complaints.

Observers said the ministry had serious questions to answer. Within a week, it announced that it had cancelled the tender for anti-snakebite serum.

“What the Minister of Health has decided in effect is to cancel the contract and sweep the whole mess under the carpet,” a partner in one of the rival firms told the Daily Statesman. “We would like to see the supply agreement put out to offer as an emergency order, with everyone [except Pharmanova] able to apply on equal terms.

“Instead of allowing the PPA to do its work, the ministry went ahead and cancelled the tender … and Pharmanova has been treated with kid gloves throughout this business.”

AS-Tesco claims that Pharmanova engaged in double bidding: two Pharmanova companies bid in the first round, both apparently owned by the same person: Dhananjay Tripathi. This amounts to double bidding, which the source said is both unfair and borderline illegal.

He places blame for what he described as mismanagement of the tender squarely within the government department. “All mistakes lie at the door of the directorate of procurement at the Ministry of Health,” he said.

No comment

At the time of publication, senior officials at the ministry had declined several opportunities to comment. Pharmanova also failed to respond to attempts to get it to put its side of the story.

The head of the Public Procurement Authority, Dr A B Adjei, was tight-lipped about the matter but clear. “The tender is the subject of a complaint. As we speak, we have a petition before us. Within two weeks the PPA’s report will be out. Anything that is then reported will be on the basis of the outcome of that official investigation,” he said.

“We are the regulatory authority and the arbiter on all procurement contracts relating to the public domain. We will be conducting a full-scale investigation into the allegations made and when that is done, we will issue our report.

“We have written to the parties and ordered them to put the process on hold. Until that is done, we cannot and will not comment further on the matter.”

Dr Adjei also declined to expand on the specific allegation of double bidding by Pharmanova.

The problem of medical supplies in Ghana is not limited to anti-snakebite medicines, but there seem to have been significant lapses in this instance in restocking drugs to meet a sore need of taxpaying citizens in this country.

The Ministry of Health must answer questions about why the process has been so long drawn out, why it chose the most expensive valid option on the table, and why it has been seen to favour one party in a competitive bid on which it should have taken a neutral position of looking for the best value for money.

* Story updated 31 January to reflect approaches made to Pharmanova.