Inside the fights rocking NDA

National Drug Authority (NDA) is at war, again. The battle, this time, involves former Mbarara Municipality MP Medard Bitekyerezo, the chairperson of the board, who has teamed up with embattled executive secretary Donna Kusemererwa on the one hand, and a number of members of staff on the other.
Several months after being interdicted, Mr Mark Kamanzi, the head of Legal Services at NDA, has petitioned MPs over what he calls rot and mismanagement at the drugs regulatory body.

NDA, according to the Act that founded it, is supposed to ensure “the availability of essential, efficacious and cost-effective drugs to the entire population of Uganda as a means of providing satisfactory healthcare and safeguarding the appropriate use of drugs.”
But the body has been involved in a number of fights over the years, many of them over money. At the beginning of 2015, for instance, Dr Gordon Katende Sematiko was fired from the position of executive secretary with the board accusing him of fixing NDA’s stash of cash on interest-earning bank accounts without its authority.

Fresh battles
Dr Sematiko and others that were accused of mismanaging NDA left, but the accusations remain, and the latest fallout has had Mr Kamanzi deeply involved.
Mr Kamanzi, whose role at NDA was to provide legal opinion on every decision the board was making and also act the secretary, is currently on interdiction on what he calls tramped-up charges.
He was recently charged in the Anti-Corruption Court over a benefit that the prosecutor says he enjoyed but was not entitled to. The benefit is annual membership to Maisha Health Club, which cost NDA about Shs7m a year.

Prosecution alleges that taking a benefit that is not prescribed in NDA’s human resources manual, Mr Kamanzi caused financial loss to the body. Mr Kamanzi denied the charges and was released on bail.
Mr Kamanzi has had a number of running battles with Ms Kusemererwa and the NDA Board, and at one point he pointed out to Ms Kusemererwa that her position as Executive Director was not provided for in the NDA Act. Ms Kusemererwa ignored his opinion until the High Court ruled as such.
Based on the rocky relationship Mr Kamanzi and his bosses had, he insists that he was just victimised, claiming that many of the benefits that Ms Kusememerwa enjoys, like travelling with her spouse at the cost of NDA, are not provided for in NDA’s HR manual.

He has since penned a petition to Parliament making a number of allegations against the NDA board and management, and calling for an inquiry into the conducting of affairs at the Authority.
Speaking to Sunday Monitor about the petition and his predicament, Mr Kamanzi, on Thursday said he was prepared to answer the charges in court, but that his petition to Parliament had nothing to do with his court case and everything to do with mismanagement at NDA.
“I am ready to be put on record for issuing this petition to whoever cares to investigate the mismanagement of tax payers’ money (at NDA). I have sent this petition to the Parliament of Uganda with the hope that they will interest themselves in this and bring NDA to order. I am ready to testify because a lot of money has been misappropriated,” Mr Kamanzi said.

The allegations
Mr Kamanzi makes a number of allegations against board chairman Dr Bitekyerezo, and Executive Secretary Donna Kusemererwa, who he says is in office illegally.
Sunday Monitor has seen a copy of a court judgment and order in the matter of Ms Florence Nakachwa Vs NDA and Donna Kusemererwa over “illegal operationalisation” of NDA’s macro organisation structure, among other issues in which the High Court ruled that Ms Kusemererwa was in office illegally.
Ms Nakacwa had sued NDA and Ms Kusemererwa, who had been hired as Executive Director yet such a position did not exist in the NDA Act, according to the High Court.
Ms Kusemererwa left office momentarily as a result of the court ruling but has since resumed work, although the court battles over her stay in office still linger.

In the same ruling, the court blocked NDA from implementing the new organisation structure it had come up with, but Mr Kamanzi says the same structure is still in force and a number of employees are on the payroll illegally. He says the payroll is bloated, costing the tax payer unnecessarily.
In fact, the issue of a bloated wage structure at NDA has been flagged elsewhere, particularly in an internal memo by the Director Health Services (Planning and Development) at the ministry of Health.
The official noted that out of the more than Shs108b that NDA has budgeted to spend in the coming financial year, Shs39.6b was planned to be spent on human resource, finance and administration.

The official, in an internal memo issued on March 19, 2018, a copy of which Sunday Monitor has seen, wrote: “For instance, human resource and administration take Shs39,554,992,419, rent is Shs1.3b and laboratories (re-budgeted) is Shs3.3b. There is therefore a lot of rationalisation that can be done to free up resources that may be used for other sector activities.”
He recommended thus: “The above budget be rejected and the authority (NDA) asked to rationalise their planned expenditure for financial year 2018/19 with the objective of significantly bringing down the budget, especially under administration.”

Shs1bn to destroy drugs
Mr Kamanzi accuses NDA of entering an agreement with the National Medical Stores and spending Shs1bn on the destruction of expired drugs without the approval of the Solicitor General. He wants that transaction to be probed.
“This expenditure is not in the approved NDA budget and work plans. It is another issue of abuse of office and conflict of interest since the General Manager of NMS is a member of NDA Board and Commission,” Mr Kamanzi writes.

But NDA says medicines regulation is aimed ultimately at ensuring patients have safe efficacious and quality medicines.
“There was a big public outcry that expired medicines withdrawn from circulation were finding their way back on to the market especially in herbal preparations. The last time a massive exercise to dispose of unwanted and expired drugs from 6,619 private and public health facilities was carried out was in 2012,” Ms Kusemererwa writes.
She adds: “The Authority (board) in their 27th September 2017 meeting; concerned about the stock piles of expired, damaged and unwanted medicines in public health facilities with no budget in the Ministry of Health to dispose of them, resolved, as a onetime activity to have these medicines withdrawn from circulation and incinerated. The Authority further allocated a budget of UGX1,000,000,000 towards this cause.”

She says since then, a collaborative approach has been put in place between Ministry of Health, National Drug Authority (NDA), National Medical Stores (NMS) and Joint Medical Store (JMS) towards the successful implementation and execution of this exercise.
To date, she adds, 168 tonnes of expired drugs have been destroyed at National Environment Management Authority (NEMA) approved sites.
Sunday Monitor understands that NDA is also developing a long term strategy to ensure that expired/unwanted medicines are routinely safely and appropriately disposed of.

Settling private cases using NDA money
Mr Kamanzi accuses Dr Bitekyerezo and Ms Kusemererwa of using NDA money to settle their legal expenses after they were sued in their capacities as individuals.
He cites the case of Ms Kusemererwa who received Shs35m to pay her legal fees after she was sued in her private capacity, albeit jointly sued with NDA, by Ms Nakachwa.
“This is a clear case of abuse of office since Ms Kusemererwa, who is the beneficiary, is the accounting officer and the principal signatory of all NDA bank accounts. This expenditure ought to be investigated,” Mr Kamanzi writes.

NDA says the majority of the cases where fees have been paid in 2016/17 and 2017/18 preceded the current management of the Authority and CEO. The authority says it is interesting that one of the biggest awards made in this period relates to a matter handled by Mark Kamanzi following an arbitration that resulted in an arbitral award of USD38,350 and UGX 13,552,000 in loss of profit and general damages and cost of the award.
“It should also be noted that following the suspension by the Authority of Mr Mark Kamanzi, the then Head of Legal Services in June 2016 and his subsequent interdiction in February 2018, the Authority has found it necessary to outsource some key cases especially those requiring key expertise,” she writes.

Chairman accused
Dr Bitekyerezo, the board chair, is accused of abusing his position by personally going out of the country to inspect pharmaceutical facilities wanting to supply drugs to the Ugandan market, leaving behind the personnel legally recruited to do the work.
“Inspection of drug manufacturing facilities by unqualified persons. For instance, the Chairman traveled to Oman to inspect pharmaceutical facilities. This is a clear case of abuse of office and conflict of interest. The chairman cannot be held accountable by the management for approving a non-qualifying facility neither can NDA reject drugs from the facilities approved by the chairman,” Mr Kamanze writes.
The authority says: “The Chairman has never travelled on GMP inspection. All his foreign travel in the capacity of Chairman has been on request of the OPM, MoH or other government agencies. No decision on the certification of any factory has been made as a result of the Chairman’s trips.”

Illegal massive recruitment of staff
Mr Kamanzi says NDA’s wage bill was for the last five years at an average of Shs500m per month before the new board came in place.
He alleges that the board came with an organogram which was annulled by the High Court in the case of Florence Nakacwa Vs NDA and Donna Kusemererwa but despite the annulment of the organogram, the board went on a massive recruitment exercise and the wage bill shot from Shs500m to Shs1.58b per month without any clear justification or value for money.
“Why do we have a lot counterfeit drugs on the market yet NDA staff were increased from 80 to 230? What will happen to the staff recruited illegally of the Court of Appeal upholds the Nakacwa decision on annulment of the organogram? This will result in multiple litigation and a wastage of public resources,” he says.

In response, NDA says: “NDA has been chronically understaffed over a decade and unable to deliver on its mandate. The 4th and 5th Authority committed to resolving this but were unable to complete the exercise due to lack of an organogram. Once the organogram was finalised and the establishment defined, NDA began recruitments which process is still ongoing. All recruitments are in line with the approved establishment and approved budgets.”

Illegal payments to abroad trips
He says the ED illegally approved funds for the travel of her husband who is not a staff of NDA to travel to Canada with other board members to attend official medicines regulation meeting.
NDA says Ms Kusemererwa as SA to the Authority is provided with a contractual benefit- a Business Class travel of self and spouse once a year.
“Ironically, this contract was witnessed by Mark Kamanzi, the then legal counsel for NDA, who is now calling the expenditure illegal,” she writes.

Renting of office premises owned by pharmaceutical company.
NDA entered into a tenancy agreement with Rume House on Lumumba Avenue for ‘showy’ office premises at close to Shs500m per month yet NDA owns three plots with office blocks on the same Lumumba Avenue. Clearly this is collusion and a wastage of public resources.
NDA buildings are vacant and wasting away as it dishes out millions of tax payers’ money to its partner and clients. Moreover, the tenancy agreement does not cover parking which may be charged separately in the near future.
But NDA responds that the allegation “is absolutely not true and the offices were lawfully and competitively procured as show below. NDA ran an advert for procurement of 1,200 square metres of office space in The New Vision of December 13, 2016, inviting all interested bidders.”

Conflict of interest
Mr Kamanzi alleges that NDA’s mandate is drug regulation while NMS (National Medical Stores) is mandated to procure drugs approved by NDA on behalf of government and that the General Manager NMS is a member of the NDA Board, Commission and chairs the HR Committee which deals with appointment, appraisals, promotion/demotion and termination.
He says: “Clearly no staff at NDA can question the quality of medicines procured by NMS.”
The authority says: “The petitioner as a lawyer ought to make himself conversant with the National Drug Policy and Authority (NDP/A) Act on the appointment of the board. The representation of National Medical Stores on the board is statutory as contained in Section 3(2)i of the Act.”

Illegal and selective giving of credit to private entities.
Mr Kamanzi also accuses NDA that regulations on fees require that all fees due to the authority be paid in advance.
“However, contrary to this law, the ED has in a clear conflict of interest and in abuse of office since 2016 when she assumed office extended credit to (company name withheld), a private company owned by the same person who recommended her for the NDA job. This exposes NDA to serious risk of financial loss as there is no legal framework for such credit, no loan agreements on interest on the credit and no security. In the event of default NDA’s exposure is uncovered.

The authority says: “The only credit given is to Ministry of Health and Ministry of Health Partners implementing Government of Uganda programs. Medical Access is implementing a U.S Government funded program to supply ARVs to the Ugandan population and that is the only reason they get credit which they pay off within 30 days.”