A growing number of citizens are raising concerns that the National Social Protection Agency (NSPA) is instructing patients to personally arrange the import of medicines that were previously provided by the government.

According to individuals familiar with the process, patients who submit requests through the VIRA portal, formerly used to source medicines via the State Trading Organization (STO), are now being informed that STO will no longer handle the import. Instead, patients are being directed to obtain the required medication themselves or through a third-party pharmacy, after which they can submit the invoice to NSPA for reimbursement.

This shift has added significant financial and logistical strain to already vulnerable patients. The process forces individuals to pay high prices up front and navigate foreign procurement independently, further driving demand in the black market for medicines, a sector that is rapidly expanding due to persistent shortages and delays.

In one case involving mental health treatment, a patient reported that a week after submitting the necessary forms, the promised medication had still not arrived. Upon inquiry, NSPA indicated that the matter was still under review, with no clear timeline for approval or delivery.

When contacted, NSPA confirmed that this policy is being applied in select cases. However, the agency has not provided any transparency regarding the criteria used to determine when patients must source medicines themselves and when the state will intervene.

Under President Dr. Mohamed Muizzu's administration, access to both Aasandha services and essential medicines has deteriorated. Despite increasing complaints from the public, there is little indication that meaningful efforts are being made to resolve the issue. The absence of a coordinated solution has left patients in a prolonged state of uncertainty, while further normalizing the shift of responsibility from the state to individuals in need of care.