Medicine Monitoring Project

This project is managed by the National Citizen’s Movement for Free Elections (NAMFREL) volunteers, where it is tasked to monitor the delivery and inventory of medicines in all 72 DOH retained hospitals and 16 Centers for Health Development (CHDs) nationwide to prevent ‘ghost’ deliveries, fake deliveries, and overpricing. The objective is to ensure proper dispatch of priority medicines to improve the government’s delivery of health services.

On September 5, 2005, NAMFREL together with the DOH Resident Ombudsman and Transparency and Accountability Network (TAN) were included as permanent members of the Integrity Development Committee, an anti-corruption unit of DOH.

Last 12 May 2006, Health Secretary Francisco Duque and NAMFREL Chairman, Jose Concepcion Jr. amended the previous Memorandum of Agreement to expand the scope of the project to include the monitoring of supplies, equipment, and infrastructure in the hospitals.

View list of hospitals

18 April 2007 - NAMFREL, with the help of over 180 volunteers, monitored Department of Health’s 54 retained hospitals and 12 regional centers under the CAC’s Medicine Monitoring Project. A total of P525.3 million-worth of medicines, supplies, and equipment were monitored in 2006.

In the early phase of the project, Namfrel recommended to DOH the need for hospitals to use standard procurement forms, and to improve delivery and warehousing systems for medicines. Consequently, DOH conducted a nationwide training for Bids and Awards Committee members in the regional hospitals on the Government Procurement Reform Law (RA 9184).

The monitoring team is now building a database with contract prices of medicines procured by DOH-managed hospitals to allow comparative analysis and affordability checks across regions.

Wastage un-masked?

A total of P4.7 million worth of acid gas cartridges supposedly to line masks for oil spill clean up operations in Guimaras remain unused in a stockroom in the Department of Health Center for Health development (DOH-CHD) in Iloilo.  This was disclosed by a Commission on Audit report dated 19 January 2007.  These cartridges were purchased by DOH Central from supplier Gema Inc. and was sent to CHD Iloilo.  It was the CHD's duty to send this to the Provincial Health office in Guimaras, where the inter-agency task force conducted clean up operations from August to October 2006.  However, records prove that none of the 9,600 cartridges valued at P490 each were delivered and used. 

Early termination of the clean up operations was the reason given by DOH Regional Director for Iloilo Lydia Depra-Ramos, why the cartridges for the masks were not delivered to the site. This is uncanny when the cartridges were procured by special means, or through an emergency purchase that does not require competitive bidding in order to fast track the bidding and delivery process. 

The Department of Health has ordered an investigation through its Integrity Development Committee (IDC), to find out why CHD Iloilo failed to send the cartridges to Guimaras immediately after they were delivered by DOH Central. Sudden termination of the clean up operations could not have been reason to justify the wastage. Findings of the report must answer questions as, why were these masks not distributed when the CHD received them?  The procurement was made through emergency purchase which means the procurement process was in fact shorter than usual, so why were these masks not delivered before the termination of the clean up?  According to the COA's report, CHD for Western Visayas violated Presidential decree 1445 which states “all government resources shall be managed, expended, or utilized in accordance with law and regulations, and safeguarded against loss or wastage through illegal disposition.” 

A total of 19,200 cartridges worth P9.48 million were purchased by the DOH for the oil spill operations, 9,600 were sent to CHD Iloilo but were never used.  The remaining 6,400 are in a DOH Central warehouse in Manila.  DOH cancelled delivery of 3,200 cartridges from Gema Inc. after they discovered previous batches were never used.  It was required for all volunteers of the clean up operations to wear respirator masks to protect them from inhaling toxic fumes from the oil.  The cartridges for the masks need to be replaced every week to keep them effective. 

Coalition Against Corruption through Namfrel sits in the DOH-IDC reviewing cases and ensuring transparency in the DOH procurement and delivery system.  A report on the case is expected from the IDC based on their findings.

Commission on Audit reports expired medicines in DOH Centers

12 September 2006--In the course of its 2005 audit of the Health Department,  the Commission on Audit again discovered that P22.3-million worth of expired vaccines under the Expanded Program on Immunization (EPI) were still stored in 14 regional centers and in the DOH central office warehouse.

Two years ago, COA found about P25-million worth of expired, about to expire, and slow-moving (seldom used) drugs and medicines. Regional EPI Coordinators said wrong estimates resulted in excessive purchases.

The Coalition Against Corruption urges the Department of Health to immediately implement periodic consultations with its regional hospital directors to review procurement, inventory, and delivery systems for medicines.

Under the Coalition Against Corruption's Medicine Monitoring Project implemented by NAMFREL in partnership with DOH, 186 volunteers monitor procurement, delivery, and inventory of medicines in 54 DOH hospitals and 12 regional centers. The project aims to ensure transparent bidding and prevent ghost deliveries of medicines in DOH-managed hospitals.

The Medicine Monitoring Project and the COA report had some similar findings and recommendations.

The project's key findings include the absence of standard procurement forms across hospitals, incomplete information in public bid advertisements or non-advertisement of a procurement project, delivery of medicines with short shelf life, and non-delivery of procured drugs.         

In one case, a volunteer in a regional hospital in Zamboanga said that even without a request from the central office, medicines were still delivered to the hospital, a practice that is prone to wastage. The Coalition advised DOH to compute procurement estimates based on actual medicine usage instead of projected population data.

In another case, a volunteer notified the Department of Health that a hospital in Zamboanga de Sur was about to award a contract for P11-million worth of medicines, supplies, and equipment even though it had failed to advertise the procurement project in a newspaper. DOH ordered a public rebidding of the contract.

I n the Visayas area, COA's 2005 audit report found that P30.1-million worth of medical, dental and laboratory supplies in the Center for Health Development of Central Visayas didn't go to intended recipients.  The same items worth P5 million were also found expired and overstocked in the Bureau of Food and Drugs, Bureau of Quarantine, Center for Health Development in Ilocos, and in six hospitals.

In 2005, expired medicines were also discovered under the DOH's Botika ng Barangay and Gamot na Mabisa at Abot Kaya programs amounting to P989,770 and P1.1 million, respectively.

The medicine monitoring project is supported by the Coalition Against Corruption with technical and training assistance from the Transparent Accountable Governance (TAG) project funded by the Asia Foundation and U.S. Agency for International Development.

Project assures more medicines available to moms and kids

15 August 2006- Medicines worth P16.9 million were confirmed delivered to three public hospitals and three regional centers by volunteers of Medicine Monitoring Project, a program of the Coalition Against Corruption (CAC) implemented by NAMFREL in partnership with the Department of Health.

A total of P12.8 million were monitored in Celestino Gallares Memorial Hospital (P755, 618.00) in Tagbilaran City, Bohol; Margosatubig Regional Hospital (P2.2 M) in Margosatubig, Zamboanga del Sur; and National Center for Mental Health (P 9.9 M) in Mandaluyong City. Procurement of these drugs was through public bidding conducted from May to November in 2005.

Volunteers also monitored deliveries of program drugs worth P4.1 million from January to June 2006 to Centers for Health Development (CHD). These drugs include vitamin A, ferrous sulfate, anti-TB kits, and blister sheets.

Under the Food Fortification Program, DOH supplies free vitamin A and ferrous sulfate to children under the age of 5 and to women of reproductive age.  Vitamin A increases children's survival chance from death caused by measles and diarrhea while ferrous sulfate or iron supplements is essential for bearing healthy children.

According to Dr. Rosalind Bianzon, Program Manager for DOH’s National Tuberculosis Program, the Philippines ranked 9th out of 22 countries this year in the World Health Organization (WHO) TB cases watch list. The 22 were identified high-burden countries having 100 or more TB cases for every 100,000 people.

Through the National TB Program, DOH provides free anti-TB Kits available in two types. Category I and III kit contains 4 types of drugs for 6 months medication. Category II kit has 5 types of drugs for 8 months medication. WHO donated the multibacillary (MB) blister sheets to the Philippines through the DOH for leprosy afflicted citizens.

Regional centers monitored include CHD for Western Mindanao in Zamboanga City, CHD for Central Luzon in Pampanga, and CHD for CARAGA in Agusan del Norte.

This project is supported by the Coalition Against Corruption with technical assistance from the Transparent Accountable Governance (TAG) Project funded by the Asia Foundation and U.S. Agency for International Development.

12 DOH hospitals published incomplete Bid Ads

27 July 2006—Namfrel found twelve (12) hospitals disregarding Section 21 of Republic Act 9184 or the Procurement Law on “Advertising and Contents of the Invitation to Bid” for government procurement activities.

Common deficiencies in the published Invitations to Bid were the absence of an Approved budget for the contract, duration of contract or delivery period, source of funding, time and place for pre-bid conference and contact persons. The newspaper ads were published during the period of February to July 2006.

The 12 hospitals include the Philippine Heart Center, Tondo Medical Center, San Lazaro Hospital, National Center for Mental Health, Rizal Medical Center, Las Pinas District Hospital, Mariano Marcos Memorial Medical Center in Ilocos Norte, Paulino Garcia Memorial Research and Medical Center in Nueva Ecija, Western Visayas Medical Center in Iloilo, Jose B. Lingad Memorial General Hospital in Pampanga, Bicol Medical Center in Naga City, and Bicol Regional Training and Teaching Hospital in Legaspi City.

Namfrel referred the matter to Department of Health Integrity Development Committee. The committee will bring this to the attention of Chief of Hospitals.

Namfrel and Coalition Against Corruption in partnership with the Department of Health is undertaking the Medicine Monitoring project to monitor procurement, delivery and inventory of medicines in DOH-retained hospitals and Centers for Health Development. The project’s objective is to ensure proper dispatch of priority medicines to improve the government’s delivery of health services.

Medicine monitoring project monitors P143.6M worth of drugs and medicines

30 May 2006 --The Medicine Monitoring Project, under the Coalition Against Corruption Program and through the National Citizens’ Movement for Free Election (NAMFREL), now has 170 volunteers monitoring 55 of the 72 Department of Health-managed hospitals and 12 of the 16 Centers for Health Development.

The volunteers were able to monitor 14 public biddings in 12 retained hospitals from January to April. Items bidded out include drugs and medicines worth P143.6 million; medical, surgical, and dental supplies worth P5.5 million; medical and laboratory equipment worth P58.8 million; and P6.6 million for janitorial and security services. Already, 3 of the 14 procurement projects have been awarded to bidders.

The Asia Foundation and the United States Agency for International Development provided technical funds to train 33 volunteers for the project. One training was held in Manila on 27 January and another on 11 February in Cagayan de Oro City.

Meanwhile, the Bids and Awards Committee (BAC) in Margosatubig Regional Hospital has declared a failure of bidding for their procurement of medicines, supplies, and equipment worth P11 million because of the failure to advertise the procurement project in a newspaper. This was after a NAMFREL volunteer-observer assigned to the said hospital reported it to the DOH Central Procurement office.

According to the Government Procurement Policy Board, although “failure to advertise a procurement project is not considered an actionable omission insofar as the Government Procurement Reform Act (RA 9184) is concerned, the BAC members may be subjected to administrative sanctions by existing laws particularly the Anti-Graft and Corrupt Practices Act (RA 3019) and Code of Conduct and Ethical Standards for Public Officials and Employees (RA 6713).” However, since the hospital BAC has declared a failure of bidding, they are now exonerated from possible administrative sanctions in relation to RAs 3019 and 6713.

Namfrel checks medicines in DOH hospitals

21 December 2005--Namfrel volunteers are not only counting votes but also medicines. About 123 volunteers were trained on Republic Act 9184 (Government Procurement Reform Act) and deployed to the nearest Department of Health managed hospital where they live.

Out of the 72 DOH-managed hospitals (RHs) and 16 Centers for Health Development (CHDs), Namfrel was able to send observers in 50 RHs and 14 CHDs. Observers monitored an initial P62.82 million worth of medicines in 8 RHs and P3.47 million worth of delivered items in 2 CHDs.

Observers expressed concern on the need to train new members of Bids and Awards Committees on RA 9184. There were occasional reports on cases violating the new procurement law due to lack of proper training. In comparing awarded prices of similar medicines among nearby hospitals, initial analysis seems to indicate “possible” overpricing of items sold by suppliers. While these reports are being verified, officials of the department have been informed so precautionary measures can be established.  

The project team also recommends the proper use of stock cards in the inventory system and to automate supply management at the national and regional hospitals.



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