Hiv testing shortages in Morocco reveal flaws in public procurement

An alarming disconnect persists in Morocco’s public health system. While hospitals and clinics grapple with shortages of rapid HIV tests lasting over a year—leaving patients undiagnosed and untreated—local manufacturers stand ready with readily available, certified products. This paradox exposes a deeper systemic issue: the repeated sidestepping of national preference laws in public procurement, despite their legal foundation.

legal mandates ignored, local producers sidelined

The Moroccan legal framework is unequivocal. Decree No. 2.22.431 governs public procurement, explicitly prohibiting technical specifications that favor foreign brands or patents over domestic alternatives. According to Abdelhay Rhorba, a public law expert at Hassan II University of Casablanca, such requirements constitute a clear violation of fair competition principles and may amount to abuse of power.

«When technical criteria are crafted to exclude local producers—even unintentionally—it creates an unjustified exclusion effect, which is grounds for administrative challenge», Rhorba explains. Legal avenues exist: disputes can be filed with the National Public Procurement Commission before contract finalization, followed by court action within 60 days. In cases involving suspected corruption, Morocco’s penal code on influence peddling may also apply.

Yet, asserting these rights remains a daunting challenge for private manufacturers. The reality on the ground is stark: Technical bid specifications—the documents outlining market requirements—are frequently drafted using outdated foreign product references, perpetuating dependence on imports despite growing domestic capabilities.

A local medical device manufacturer, speaking anonymously, highlights the absurdity: «Our products meet international standards and are already exported across Africa, yet we hold less than 2% of the public sector market in our segment». The manufacturer points out that specifications should be designed around Moroccan-made alternatives—a requirement consistently overlooked.

When producers raise concerns about biased tenders favoring foreign suppliers, responses from contracting authorities are often met with silence or inaction, leaving procurement decisions unchanged.

government contradictions undermine national production

The inconsistency extends beyond the Ministry of Health. While the Ministry of Finance has raised tariffs on certain imported medical devices to bolster local production, the health sector continues purchasing higher-cost foreign alternatives—ignoring competitively priced domestic options. This contradiction raises serious questions about the government’s commitment to fostering a self-sufficient health sector.

The Ministry of Health defends its procurement strategy, asserting that all tenders comply with regulatory frameworks and remain open to qualified operators, with preference given to companies based in Morocco. However, this preference refers solely to business domicile—not product origin. Thus, a foreign-owned distributor operating locally is treated equally to a domestic manufacturer, even if the latter produces the actual medical device.

The case of rapid HIV tests is particularly glaring. Reports indicate stockouts lasting over a year in some health facilities. The Ministry acknowledges «occasional supply tensions», attributing them to «delays in public procurement procedures and global supply chain disruptions». It claims new tenders are underway to stabilize supply and studies are exploring «complementary alternatives».

This explanation leaves many in the sector unconvinced. If local manufacturers hold certified, ready-to-deliver stocks, why were they not engaged during prolonged shortages? The Ministry insists no direct procurement was used in these acquisitions, stating all 2025 purchases followed regulated tender processes. Yet this claim conflicts with information from multiple sources familiar with the procurement files.

Direct procurement is legally permitted only under strict conditions: extreme urgency, technical exclusivity, or failed tenders. Decree 2.22.431 requires written justification and proof of no alternative—failure to comply renders such procedures illegal, Rhorba warns.

sovereign health independence remains elusive

Behind the procurement issue lies a broader question: Morocco’s path to health sovereignty. Dr. Jaafar Heikel, a leading infectious disease specialist, emphasizes the critical role of rapid tests beyond diagnosis. Their value lies in accessibility, speed, and reaching populations that avoid traditional health facilities.

«NGOs like OPALS and ALCS rely on these tests to reach marginalized communities», he notes. «Disruptions in supply directly weaken Morocco’s HIV response at the community level». When local alternatives are available and validated, he argues, adopting them strengthens both financial sustainability and national autonomy.

This is especially urgent as Morocco pursues the 95-95-95 targets of UNAIDS: diagnosing 95% of people living with HIV, treating 95% of those diagnosed, and achieving viral suppression in 95% of treated individuals—aimed at ending AIDS as a public health threat by 2030. Rapid testing is central to achieving these goals.

«Without accessible tests, fewer people get tested, and the virus spreads unchecked», a manufacturer warns. Dr. Heikel agrees: «Achieving 95-95-95 will be far more attainable with a robust pipeline of validated local tests and a procurement system that prioritizes them».

The Ministry of Health insists it remains «fully committed to ensuring uninterrupted testing services». Yet industry actors await concrete action—not just assurances—particularly in revising technical specifications to include Moroccan-made alternatives.

Growing skepticism surrounds whether certain officials within compliance and validation committees may be protecting foreign suppliers’ interests, disregarding ministerial directives. For a manufacturer investing in validated products only to be systematically excluded, the message is clear: the current system discourages domestic innovation precisely when Morocco needs it most. The result? Continuous reliance on imports for goods the country is fully capable of producing.