Delays to complete the National Cancer Centre in Lilongwe have seen the Malawi Government facing a $1 million (about K1 billion) bill annually for international referrals of cancer patients due to laxity in project implementation.
The country’s first dedicated cancer treatment centre opened in April 2020 at Kamuzu Central Hospital in Lilongwe, but without radiotherapy bunkers for provision of specialised treatment. The works were part of the project scope, according to the project outlines.
The Cancer Centre project has made little progress since its launch
Ministry of Health accused the initial contractor of having failed to design and supervise construction of the bunkers due to alleged lack of expertise after losing an employee who was familiar with this kind of assignment.
In a written response last week, Ministry of Health head of infrastructure development Sanderson Kuyeli said construction of the radiotherapy bunkers will be completed by December this year.
He said: “Learning from what happened before, what we have done now is to ensure that the new consultant has all the expertise and we are also doing close monitoring with the International Atomic Energy Agency [IAEA] so that we do not go wrong again.”
The December 2023 deadline is but one of the many similar promises in the past years.
Minister of Health Khumbize Kandodo Chiponda told Parliament last November that construction would be completed by January this year while in 2019, the Ministry of Health indicated that construction of bunkers would be done by January 2020.
During the ground-breaking ceremony of the project in March in 2017, former president Peter Mutharika timed completion of construction of the hospital before end of 2018.
According to a Construction Sector Transparency Initiative (CoST) Assurance Report for 2020 after the Ministry of Health noted that the “consultant was struggling with the design”, a regional study tour was undertaken to help improve capacity of the consultant at a cost of about K59 million in travel expenses.
On why the consultant was not taken to task for shoddy works, Kuyeli said the Solicitor General advised them not to because at the time the substandard work was noted, the contract had already expired.
Project documents show that the original cost of the cancer centre, including bunkers, was estimated at $8.1 million, but the final cost, even without bunkers, was $10.3 million, representing a cost overrun of 28 percent.
Briefing Parliament last November, Chiponda said government spends up to $2 million every year for international referrals, half of whom are for cancer treatment.
The Nation analysis, based on budget documents, shows that $1 million annual expenditure on cancer referrals is worth 20 brandnew ambulances which the Ministry of Health plans to procure this financial year. The money can also sink 100 boreholes or can be use it to build a one-kilometre two lane tarmac road.
In an interview on Sunday, health rights activist Maziko Matemba said if the centre was completed on time in 2018 with all required structures, government could have saved money and use them to meet other needs.
National Cancer Centre head and oncologist Richard Nyasosera said there are at least 6 000 cancer patients seeking services in all central and private hospitals, but only five to 10 percent get the opportunity for international referral, depending on availability of funding.
Malawi Government obtained a $13 million loan from the Opec Fund for International Development for construction of the cancer centre, out of which about $4 million was deposited to IAEA for procurement of equipment.