President Duma Boko’s declaration of a state of public health emergency has failed to arrest worsening shortages of medicines, medical supplies and diagnostic services in public hospitals, an Ombudsman investigation has found.
According to the Ombudsman’s report, which exposed what it describes as a systemic crisis in health service delivery, public health facilities across the country continue to experience “persistent and critical shortages of medicines and non-drug commodities,” despite Central Medical Stores (CMS) reporting a target availability level of 97 percent for vital, essential and necessary items.
The investigation, however, found a stark disconnect between reported figures and realities on the ground. Health facilities told investigators that CMS supplies only between 25 and 30 percent of ordered items, with referral hospitals showing availability levels “well below acceptable thresholds.”
At Nyangabgwe Referral Hospital (NRH), drug availability averaged 66 percent as of August 2025, while non-drug commodities were far lower. General non-drug items stood at 56 percent, specialist items at 30 percent, and special-order items at 42 percent, resulting in an overall average availability of just 43 percent.
Princess Marina Hospital (PMH) fared worse on medicines, reporting drug availability of 54 percent in August 2025. Although non-drug availability was reported at 79 percent, the overall average availability stood at 48 percent.
“This practice effectively mortgaged future budgets, constrained available resources in the following financial year, and entrenched a recurring structural deficit,” the Ombudsman said.
“These shortages have persisted and, in fact, declined notwithstanding interventions by the Presidential Task Team appointed in August 2025,” the Ombudsman noted, warning that the situation continues to affect emergency and life-saving care. The report lists intravenous fluids, antibiotics, anaesthetic and intensive care medicines, blood products and basic medical consumables among items in short supply.
Financial pressures at CMS were also highlighted as a major driver of the crisis. In the 2025/2026 financial year, CMS was allocated P1.19 billion, an amount that was “fully exhausted by August 2025.” This forced the procurement of additional supplies through letters of commitment, with payment deferred to future budgets.
“This practice effectively mortgaged future budgets, constrained available resources in the following financial year, and entrenched a recurring structural deficit,” the Ombudsman said.
The report further attributes shortages to inflated costs of medical and non-medical commodities linked to the Reservation and Preferential Procurement Scheme under the Public Procurement Act. While the law prioritises local suppliers to promote citizen economic empowerment, investigators found that it has contributed to higher prices and supply constraints.
Laboratory services were identified as another’s critical area of failure. The investigation found serious concerns over poor accreditation levels and the state of laboratory equipment in government facilities. Persistent shortages of reagents, coupled with obsolete or non-functional equipment, have compromised diagnostic services and clinical decision-making.
Only five government medical laboratories were found to be accredited, including Athlone Primary Hospital, Nyangabgwe Referral Hospital Laboratory and Sekgoma Memorial Hospital. Scottish Livingstone Hospital’s accreditation was suspended in November 2025, alongside several private facilities.
The Ombudsman also criticised the Ministry of Health’s oversight, citing unsafe radiation levels from an X-ray machine at Hukuntsi Primary Hospital, the absence of functioning autoclaves in many facilities, and routine referrals of patients to distant hospitals for basic laboratory tests.
“In urgent cases, medical personnel frequently advised patients to procure essential medicines and non-medical commodities at their own expense,” the report stated, describing this as evidence of a “marked disconnection between policy-level governance and operational realities.”
