Local pharmaceutical and medical suppliers have warned that the shortage of essential medicines in public health facilities was worsening because of prolonged payment delays, contractual uncertainties and a systemic breakdown in the country’s medical supply chain.
As a result they have since made a series of demands to government including, among others, a call for resolving long-outstanding debts from past emergency requisitions, aligning procurement practices with ESPPRA guidelines, especially during emergencies and publishing clear grading criteria for supplier performance and communicating these during contract implementation.
In a strongly-worded email dated 4 August 2025, addressed to Minister of Health Mduduzi Matsebula and copied to Prime Minister Russell Mmiso Dlamini, Minister of Finance Neal Rijkenberg, Senate President Lindiwe Dlamini, Speaker of the House of Assembly Jabulani Mabuza, Chairperson of the Public Accounts Committee (PAC) Madala Mhlanga, and Eswatini Public Procurement Regulatory Authority (ESPPRA) Chief Executive Officer Vusi Matsebula, the suppliers detailed a series of grievances that they say have directly contributed to the crisis.
The correspondence followed a joint suppliers’ meeting held on 30 July in Matsapha, convened to address what participants described as persistent and longstanding challenges in engaging with the ministry.
Attached to the letter are the minutes of the meeting and an attendance register of the companies represented.
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The suppliers’ intervention comes at a time when the ministry of health has repeatedly insisted that poor performance by suppliers is at the root of drug shortages.
In recent weeks, the ministry issued urgent requests to suppliers to fast-track deliveries, including airlifting certain orders from overseas in a bid to address stock gaps.
In their letter, the suppliers argue that the real problem lies in chronic procurement inefficiencies, regulatory bottlenecks and unpaid invoices dating back months.
They say these issues have left them financially exposed and unable to meet urgent orders without formal contracts or payment guarantees.
“While the minister of finance recently told the nation that all suppliers had been paid in full, this only applies to invoices already submitted to Treasury. In reality, more than E100 million in invoices remain pending at the Central Medical Stores (CMS), with some dating back months,” reads another part of the letter.
Many of these invoices, they say, are unpaid claims which stem from deliveries made under emergency conditions without formal purchase orders, as it happened during a 2023 crisis meeting at Cooper Centre in Mbabane, when suppliers were urged to provide goods against requisitions.
Some of those requisitions, the suppliers allege, were never converted into official orders, leaving them with no payment and no recourse.
The ministry has reportedly argued that partial deliveries indicate a lack of supplier capacity, but suppliers counter that partial fulfilment can result from global shortages of active pharmaceutical ingredients (APIs), manufacturer minimum order requirements or minor production losses, all beyond their control.
They add that government rarely adheres to the agreed 45-day payment period, while late payments to suppliers are not penalised in the same way late deliveries are.
According to the suppliers, the ministry shifted, around 2020/21, from traditional value-or quantum-based contracts to framework contracts.
While this approach is intended to provide flexibility, suppliers complained that it had introduced significant uncertainty because the ministry of health does not commit to minimum purchase quantities or clear delivery timelines.
This uncertainty, they claim, undermines their ability to negotiate competitive prices with manufacturers, secure financial backing from lenders and plan stock procurement effectively.
“Manufacturers will not give best pricing without guaranteed minimum orders. Without such commitments, they may cancel or refuse to process our orders when they finally come,” the letter reads.
Suppliers also cite repeated delays in finalising contracts, stating that tenders are typically released in late November or early December, a period when many global manufacturers are on shutdown, with bids due in early February.
They say government deliberations then stretch for four to five months, leaving a gap of several months without valid contracts after the financial year ends on 31 March.
“This year, the award schedules for Tender 2 (Pharmaceuticals and Vaccines) were only received in early June, and urgent orders were placed soon after, yet formal contracts had still not been signed by the end of July, despite some deliveries already having been made,” reads another part of the letter.
They further cite the recent incident of procurement officials emailing all suppliers, asking them to urgently airlift stock from overseas and fast-track deliveries without signed contracts in place.
The suppliers made it known that they raised strong objections, warning that delivering under such conditions leaves them with no legal recourse for payment.
They also point to discrepancies between tender documents and contract terms, particularly in delivery lead times, which could expose suppliers to penalties for delays beyond their control.
Further, they claim that suppliers are graded on past performance without being told the criteria, while government delays in paying invoices are not factored into those assessments.
The letter also highlights ongoing regulatory and importation challenges, despite what suppliers acknowledge as improved communication with the Medicines Regulatory Unit (MRU).
They cite confusion over the respective mandates of the MRU and the long-anticipated Medicines Regulatory Authority (MRA), no formal appeals process for rejected submissions and the absence of a single reference document outlining MRU guidelines and procedures.
According to the suppliers, MRU staff sometimes lack the training to verify compliance documents issued by overseas manufacturers and are unwilling to liaise with regulatory counterparts in exporting countries to resolve disputes.
Suppliers also called for MRU representation on the tender board to avoid awarding contracts for products that are later rejected at the listing stage, causing costly delays or cancellations.
They informed the minister that importation hurdles are another major concern as import permits are said to be reviewed only once a week, delaying procurement cycles and international payments, as banks require the permits to process transfers.
They also cite the financial strain of having to pay import taxes upfront on zero-rated goods, with VAT refunds often delayed for months.
On that account, the suppliers recommend digitising the permit process, increasing permit review frequency to at least twice weekly, clarifying MRU and MRA roles, and fast-tracking the formal establishment of the MRA as required under the Medicines and Related Substances Control Act of 2016.
The suppliers have formally requested a response from the ministry of health within 10 days and expressed their readiness to engage at any time to discuss the matters in detail.
However, according to sources yesterday, the ministry had yet to reply, despite the letter being sent on Monday.
The suppliers’ stance marks a rare moment of public confrontation in the country’s medical procurement sector, which has traditionally handled disputes behind closed doors.
Key recommendations include:
• Resolving long-outstanding debts from past emergency requisitions
• Aligning procurement practices with ESPPRA guidelines, especially during emergencies
• Publishing clear grading criteria for supplier performance and communicating these during contract implementation
• Establishing an appeal mechanism for rejected regulatory submissions
• Increasing frequency of import permit reviews and digitising the process
• Ensuring MRU participation in tender deliberations
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