Opening a new pharmacy, eliminating parallel systems, strengthening the public sector

Inside the new district pharmacy in Kayonza, Rwanda.

A new district pharmacy recently opened in the Kayonza district in eastern Rwanda, located near the Tanzanian border. The new facility, opened in a partnership between PIH’s Rwandan sister organization, Inshuti Mu Buzima (IMB), and the Rwandan Ministry of Health (MOH), marks a major step towards merging the MOH medical supply chain with the one IMB first established upon entering the country in 2005.

Run as a semi-autonomous organization, the new district pharmacy will supply the MOH hospital and health centers in the district with medicine and equipment. Different from our previous pharmacy, IMB staff will not manage this facility. Responsibility will instead be handed to MOH staff hired from the region surrounding the new district pharmacy, new employees trained by IMB to operate this independent facility.

When PIH launched Inshuti Mu Buzima —“Partners In Health” in the Rwandan national language, Kinyarwanda—in the spring of 2005 at the invitation of the Rwandan government, we established an independent supply chain and pharmacy system, one that primary dealt with PIH/IMB hospitals and health centers.

Over the last five years PIH/IMB has expanded services such that we are currently supporting or operating more than 20 hospitals and health centers in three of Rwanda’s thirty districts. As we grew larger, a problem arose. PIH/IMB and the Rwandan Ministry of Health were each developing their own health care-related supply chains—with separate providers, warehouses, and distribution systems.

To reduce redundancies, save money, and help streamline Rwanda’s health care system, the Ministry asked PIH/IMB to consolidate distribution systems with the government. The result is a new system that eliminates the parallel IMB system, which will in turn help strengthen the public sector system. Having a single system will allow for better forecasting and increased transparency.

Under the new system, the new district pharmacy orders medicines and consumables from the Ministry’s Drug, Consumables and Equipment Central Procurement Agency (CAMERWA), for PIH/IMB facilities. CAMERWA already supplies all of the Rwanda’s public hospitals and health centers, this expansion allows a single facility to procure drugs and supplies for the entire country. In essence, the country now has a single supply hierarchy, one owned and operated by the people of Rwanda.

If CAMERWA is unable to complete an order, PIH/IMB will act as a safety net, and step in and fill it. PIH/IMB also fills orders for drugs not supplied by CAMERWA.