COA flags DOH’s vaccine wastage, disposal of used vials

MANILA, Philippines — The Commission on Audit has admonished the Department of Health (DOH) over lapses in the distribution and utilization of COVID vaccines, resulting in wastage and near expiration of thousands of doses.

In its 2021 audit report on the DOH, the COA said a total 32,724 vaccine doses have expired, while another 12,854 vials were nearing expiry as of Dec. 31, 2021.

These were based on ocular inspection and verification on vaccines sent to various DOH units in Metro Manila, Ilocos region, Cagayan Valley, Central Luzon, Zamboanga peninsula, Soccksargen and the Cordilleras.

Among the reasons identified for the wastage were underdose, broken vial or ampule, temperature excursion, defective syringe, lack of vaccinees, destruction by fire and beyond expiration date.

“The delays in the administration of these vaccines may increase the probability of losing its efficacy and ultimately may result in wastage of government resources. Losses arising from spoilages of vaccines will mean missed chances to those individuals who have yet to be inoculated,” the COA report said.

“Taking note of the delicate nature of COVID-19 vaccines, the DOH has to ensure that proper accountability is exacted from those responsible thereof. Losses arising from spoilages would otherwise be a missed chance to those individuals who have yet to get the needed inoculations as their protection against the virus that has continuously been plaguing the world,” it added.

State auditors recommended to heads of units receiving the vaccines to properly plan their utilization and distribution to prevent wastage.

The DOH explained the wastage involved new COVID vaccines with a shorter shelf life.

During a Senate hearing on Monday, the DOH confirmed that some 20.7 million doses of COVID vaccines, equivalent to more than P10 billion, were wasted as of this month.

It said the bulk of the vaccines that expired were those procured by the private sector.

Storage of used vials

In the same audit report, the COA also flagged the DOH over the improper storage and slow disposal of empty vaccine vials, which it said may expose people to infectious wastes and potential health risks.

“Reverse logistics is an important part of logistical tracking and distribution to ensure that all vaccine vials/ampules are properly accounted for and disposed of,” read the report.

“It also aims to protect the environment in terms of indiscriminate disposal of hazardous and infectious waste that could potentially damage the environment and pose a health risk to the people,” it added.

As of Dec. 31, 2021, state auditors said over 738,000 empty vials remain at the Center for Health Development (CHD) and Treatment and Rehabilitation Center in Eastern Visayas.

The COA noted lag times in the return of empty vials in Soccsksargen.

The DOH maintained that all of its CHDs are compliant with existing policy and best practices on the proper disposal of immunization waste, citing the results of the wall-to-wall inventory conducted from February to April.

But according to COA, the empty vials were still within the premises of the CHD in Eastern Visayas even after its management requested the central office to pick these up.

More PS-DBM transactions flagged

The COA raised more issues over transactions made by the Procurement Service of the Department of Budget and Management (PS-DBM), this time on the distribution of COVID items for DOH.

It its 2021 audit report on the DOH, the COA said over P185 million worth of COVID-19 supplies procured by PS-DBM were not properly distributed to intended beneficiaries.

The report was based on confirmation replies that state auditors received from DOH offices, local government units and hospitals identified as beneficiaries of the said supplies.

According to COA, six agencies identified as intended recipients said they did not receive the listed supplies worth P18.56 million.

COVID-19 items worth P166.21 million were delivered to agencies other than the intended recipients.

These included supplies worth P54 million delivered to the Office of Civil Defense (OCD) and another P108.6 million received by individuals “whose offices/agencies could not be identified.”

Meanwhile, items worth P835,402 were delivered to intended beneficiaries, but had discrepancies in the quantities reported in the distribution list and the actual number that arrived.

The discrepancies, state auditors said, could also indicate under-delivery by the PS-DBM, loss of items in transit or that there could be items diverted from the intended recipients.

“This condition denotes possibility of unauthorized and undocumented changes in the DL (distribution list), resulting in such discrepancies,” it added.

The COA recommended to the DOH to require the head of its Supply Chain Management Service to provide documentary proof or evidence that the items were delivered to intended beneficiaries and establish efficient distribution system for assets transferred by the agency to different health facilities.

In response, the DOH said it requested the OCD to provide an explanation regarding the supplies it received through the procurement.

“The OCD responded that deliveries of medical supplies, personal protective equipment and other related materials were successfully made,” the report noted.

State auditors, however, said that OCD’s response needed to be supported by pertinent documents as proof of deliveries to recipients.

From 2020 to 2021, the DOH had transferred over P47.6 billion to the PS-DBM for the procurement of various COVID-19 response supplies and equipment.