A considerable number of patients have been forced to put their lives on hold, and risk their conditions deteriorating as life-saving drugs run out across the country.
A drug problem caused by an array of manufacturing problems is leading local health care workers to treat patients with less effective alternatives ÔÇô The Telegraph investigations have revealed.
It is understood that the problem is so serious that hundreds of health facilities across the country cannot even treat basic conditions like cardiac arrest, pain management and seizures.
Vital medicines that health facilities are struggling to keep in stock include the Adrenaline drug used to resuscitate heart failure or cardiac arrest, Diazepam an anaesthetic used in pain management during surgery and for treatement of muscle spasms and Penicillin which is used for bacterial infections.
Responding to The Telegraph questionnaire, the Ministry of Health spokesperson, Doreen Motshegwa, said stock shortages are caused by increased global demand, delays in manufacturing, supplier failure among others.
The Telegraph has established that hundreds of health facilities around Botswana started feeling the effects of the global drug shortage about three months ago and International pharmaceutical industry experts predict that the problem may persist for some time.
The Telegraph has raised information suggesting that government failed to procure enough life saving drugs since 2012. Sources say by May, this year, it was apparent that the Central Medical Stores (CMS) would fall short of the required medications. Sources also revealed that the tendering for procurement should have been done a year before in 2011 “but the relevant authorities at the parastatal slept on their job”.
“Whenever such stock out occurs, Central Medical Stores utilizes The Public Procurement and Assert Disposal Board (PPADB) approved emergency procurement methods and fast-tracking delivery and distribution.┬á Other than this, alternatives are given where possible,” Motshegwa said.
She explained that CMS supplies drugs to about 700 health facilities throughout the country.
“A routine monthly distribution schedule is in place and facilities place orders according to the schedule.┬á When emergency orders are required, they are issued as priority by Central Medical Stores,” she said.
While she played down reports that the country was facing one of major setbacks in disease control programmes and facing live-saving drug crisis, Motshegwa assured members of the public that measures are being put in place to address the challenge.
“We cannot start talking of a national crisis when the current availability of vital drugs is approximately 85 percent at health facility level as at July 2013.┬á But we assure you that measures are put in place to ensure even better availability levels,” she said.
Independent investigations by The Telegraph, however, suggest that things may get worse before they get better. By January this year, most countries around the world, including the United States of America, were reeling from the global drug shortage crisis caused by delays at plants that make sterile injectable drugs, which account for about 80 percent of the global scarce medicines. Nearly a third of the global industry’s manufacturing capacity is not running because of plant closings or shutdowns to fix serious quality issues. Other shortages have been caused by supply disruptions of raw ingredients used to make drugs or by manufacturers exiting the market.
Indications are that the Ministry of Health may be trying to sweep the crisis under the carpet, and nurses have been advised to keep mum about the problem. The situation has snowballed into an industrial relations issue with the Botswana Landboards Local Authorities and Health Workers Union’s (BLLAWU) joining the fray.┬á The Union’s Secretary General, Ketlhalefile Motshegwa, said Health Minister Dr John Seakgosing and Assistant Minister Gaotlhaetse Matlhabaphiri were to blame for the looming health crisis.
“They are a bad combination. They have left their Permanent Secretary, Kolaatamo Malefho, to run the Ministry alone,” he said. Motshegwa said they were aware that Matlhabaphiri is reported to have threatened to dismiss nurses who turn away patients who cannot obtain medications at health facilities.
“We are not taking the threats lightly. Instead of dismissing the nurses, Matlhabaphiri should resign. Where will the nurses get the medications if they are not in health facilities?”
So serious is the situation that some medical officers at government facilities are advising patients to purchase drugs from pharmacies.
“It will be unfortunate for health employees to advice patients otherwise more so that the Ministry of Health does not have such a policy in place,” said Motshegwa.
She added that CMS has put in place several strategic measures, including but not limited to:┬á fast tracking the procurement plan, establishing drugs on framework contract and strengthening the logistics management information system.┬á
Some sources claimed that the situation is “spilling into critical programs such as ARVs drugs and TB medications”.
Motshegwa said CMS has specific management strategies in place for critical programs such as HIV, TB and vaccines.┬á
“Drugs for all these programs are carefully monitored to maintain high levels of availability,” she said.