Procurement of drugs in public hospitals differs from private health facilities. All public health facilities (including quasi-government hospitals/clinics) are required to adhere to the public procurement law enshrined in the Public Procurement Act 2003 (Act 663). In this case, suppliers are required to register with the respective facility by paying the required registration fee together with company registration documents. Hence, suppliers are pre-qualified by most of the hospitals at the beginning of every year before they are invited to purchase the tender document to submit their bids. In the case of the Central and Regional Medical Stores, supplier registration is done together with the tendering process.

In the public health facility, procurement of medicines starts with the user unit placing a request to the head of entity through the procurement officer. These hospitals are required to obtain their medicines or drugs from the respective Regional Medical Stores. According to one Principal Pharmacist, the hospital obtains over 60% of their drugs from the Regional Medical Stores. The hospital only go through competitive tendering to procure drugs that are not available for supply in the Medical Stores. In this vein, the health facilities must obtain a non-availability certificate from the Regional Medical Store before they can invite suppliers to tender. The Regional Medical Stores on the other hand procure all their medicines through a competitive tendering with the exception of some injections and programmed medicines (e.g., anti-snake serum, poliomyelitis vaccine oral solution etc.), which are received from the central medical stores.

Invitation to tender (ITT) is advertised in the daily newspapers notably Daily Graphic and the Ghanaian Times. Once it is advertised, a period of time is specified during which eligible suppliers or tenderers may purchase and complete a set of tender documents from the facility. The completed tenders or bids are then submitted or deposited in the tender box provided by the healthcare facility on or before the closing date. The tender fee varies from one facility to the other, for instance, more recently, eligible tenderers had to pay GH¢500.00 for tender documents to be able to supply drugs to the Eastern Regional Health Directorate (Regional Medical Stores). Tenders are conducted through the national competitive tendering specified in the Public Procurement Act 2003 (Act 663) and the procurement manual of the Public Procurement Authority.

Suppliers should be legally registered to operate in Ghana by presenting the following:

·  Company registration documents from the Registrar General Department

·  Tax Clearance Certificate (TCC)

·  Social Security National Insurance Trust (SSNIT) clearance certificate

·  Pharmacy Council Certificate/License (Wholesale/Manufacturing)

·  Food and Drugs Authority certificate of registration of tendered drugs

·  Manufacturer’s authorization for the tenderer to supply the medicines.

Effectively, drugs to be supplied in Ghana should be registered and certified by the Foods and Drugs Authority. Hence, all drugs supplied to the public health system should be properly labelled in accordance with standards laid down by law or in accordance with  labelling  instructions  of  the  Food  and  Drugs  Authority  (Ghana National Drug Policy, 2004).

In the case of a Tenderer who is not doing business within Ghana (or for other reasons will not itself carry out service/maintenance obligations), the tenderer is or will be (if awarded the Contract) represented by a local service/maintenance provider in Ghana equipped and able to carry out the tenderer’s warranty obligations prescribed in the conditions of contract and/or technical specifications; and the tenderer meets the qualification criteria specified in the document. The following documents are required to be submitted in the case of foreign company tenderers:

·  Request for certification of incorporation in the country of manufacturing

·  Certification from the manufacturer’s home regulatory authority

·  An indication that the manufacturer has been manufacturing and marketing the specified medicines covered by the tender document for the last two years or similar ones for the past five years

·  Request  for  a  satisfactory  GMP  inspection  certificate  by  WHO  from  the manufacturer

·  Pre-shipment batch testing

·  Food  and  Drugs  Authority  (FDA,  Ghana)  certification  of  medicines.  This suggests that, new foreign entrants should contact the FDA on drug registration procedures to start the process in good time before the intended tender in order to be eligible.

Regarding  the  FDA  registration,  international  certifications  available  t o  the  new foreign entrant (e.g., GMP, China FDA, WHO PQ etc.) in addition to other technical documents will be required. Detailed information can obtained on the FDA’s website (www.fdaghana.gov.gh). On the evaluation of tenders, the respondents indicated that it is mainly based on quality – cost criteria and in some cases also takes into account the suppliers past history in relation to their ability to deliver all orders within the specified time frame. Here all the medicines that that met the specificatio ns are selected and ranked and the one with the lowest cost but of the same quality is selected. In determining quality of drugs in tender evaluation, a Pharmacist who is a member of the entity tender committee of a hospital indicated that, the committee firstly check if the product is registered and certified by the Food and Drugs Authority, then consider the country of origin (COO), knowledge of the brand, the company’s products, packaging, lowest bidding etc. In relation to price, most of the health facilities use the price list issued by the National Health Insurance Scheme (NHIS) as a guide.