Shock of expired drugs in public hospitals
Health Cabinet Secretary Aden Duale says that routine audits and inspections uncovered widespread storage of expired drugs.
Kenyans now face a dual challenge of inadequate drug supplies in public facilities and the risk of accessing expired medications, with a shock admission by Health Cabinet Secretary Aden Duale and a Nation assessment of county hospitals revealing a trend that poses risks to millions seeking healthcare services.
Mr Duale this week told the Senate that routine audits and inspections conducted by the Ministry of Health in over 300 public hospital pharmacies, including six national referral hospitals and 10 Kenya Medical Supplies Authority (Kemsa) depots, had uncovered widespread issues.
"A significant number of public health facilities, particularly at the county level, continue to retain large volumes of expired medicines —often beyond the allowable disposal period," Mr Duale told the House this week, attributing the crisis to budgetary constraints, logistical challenges, and inadequate prioritisation of pharmaceutical waste management at the devolved level.
The CS's admission comes as a Nation investigation reveals widespread stockpiling of expired drugs in county hospitals, with facilities in Nakuru, Trans Nzoia, Kilifi, and Lamu counties among those affected. The expired medications, some worth millions of shillings, have been found gathering dust in hospital stores while patients are turned away or forced to purchase medicine from private pharmacies.
Across the country, county governments have cited various reasons for the accumulation of expired drugs.
In Trans Nzoia County, Health Chief Officer Judith Simiyu explained that most expired medicines are donor-funded, with no clear direction on disposal from relevant agencies.
The county has admitted that limited local capacity to dispose of medicines within established disposal guidelines has contributed to the stockpiling of expired drugs until proper disposal mechanisms are approved by the government.
"The bulk of the expired drugs is a result of a change in management guidelines that are usually implemented immediately," Dr Simiyu said, noting that limited local capacity to dispose of medicines within established guidelines has contributed to the stockpiling.
In Kilifi County, Executive Committee Member for Health Peter Mwarogo revealed that the county has had expired drugs since pre-devolution, many from national programmes for tuberculosis, HIV/Aids, malaria, family planning, and neglected tropical diseases.
"When national programmes change arrangements and we get new consignments, the drugs in facilities are not used," Mr Mwarogo explained.
The county is set to operationalise a newly built incinerator for drug disposal, pending a Sh5 million three-phase power connection and environmental approvals.
Mr Mwarogo said facility use declined during the Covid-19 pandemic.
“Previously, the Senate Committee on Health found the problem, and the recommendation was that we get rid of the drugs. It is only that we have not been able to do that,” he said, adding that the county does not have an incinerator to destroy the drugs.
Lamu County Deputy Governor and Health Executive, Dr Mbarak Bahjaj, confirmed the presence of expired drugs in storage, particularly at Mpeketoni Sub-County Hospital, citing bureaucratic challenges in the disposal process.
“We have several boxes of expired drugs still in stores awaiting disposal,” he said.
The crisis has exposed critical weaknesses in Kenya's pharmaceutical supply chain management.
CS Duale told the Senate that the Health ministry has identified a suspicious pattern of private pharmacies clustering around public health facilities, which he said presents challenges, including unethical business practices and enabling systematic theft of public-sector medicines.
The Cabinet Secretary warned that this practice creates opportunities for illicit activities, encouraging county staff to steal fresh drugs meant for patients and divert them to private facilities, thereby denying Kenyans access to free medication in public hospitals.
In Nakuru County, an audit by Auditor-General Nancy Gathungu revealed that Nakuru Level Five Hospital had been storing expired drugs and medical supplies worth Sh1.8 million.
The facility, which serves as the largest referral hospital in the South Rift region, caters to patients from Nakuru and six neighbouring counties: Baringo, Nyandarua, Kericho, Narok, Laikipia, and Samburu.
The audit covering the 2023/2024 financial year found the expired drugs during a physical inspection on October 8, 2024. Despite the damning findings, hospital management defended their actions, with Medical Superintendent James Waweru claiming the expired drugs were primarily HIV/Aids antiretroviral medications and tuberculosis treatments supplied by international donors.
"We destroyed part of the drugs, but we are still waiting for authorisation to destroy the remaining supplies," Dr Waweru said, citing the need for approval from the Global Fund, which supplied some of the medications.
The Auditor-General faulted the hospital for lacking internal controls to monitor procurement and stock levels, warning that "procurement of drugs that are likely to expire in a short while leads to loss of public resources and, if used, exposes patients in public hospitals to risks."
However, some facilities have shown resilience. The Coast General Teaching and Referral Hospital in Mombasa has distanced itself from the crisis, with Chief Administrator Dr Iqbal Khandwalla stating they have strict systems ensuring only quality, long-shelf-life medicines are procured.
"We do not buy short-term expiry drugs. When drugs are at least six months to expiry, we give them out to our outreach health facilities to use them up," Dr Khandwalla said.
To address the crisis, the Cabinet Secretary said that Kemsa has implemented several measures, including developing a system that prevents the dispatch of commodities with less than six months' shelf life without formal clearance, the First Expiry, First Out (FEFO) protocol to prioritise drugs with the earliest expiry dates, and expiry tracking systems to recall expired drugs on time.
Reported by Mercy Chelangat, Eric Matara, Evans Jaola, Barnabas Bii, Sammy Lutta, Kalume Kazungu, Maureen Ongala, and Mishi Gongo.