Coincidence or conspiracy?

LAFTER THOUGHTS GUESTWRITER

IFE is precious and sometimes all it needs to stay alive is a little dose of medication. In this country, such doses are no longer a guarantee at our public health institutions. This basically means life can no longer be assured. Get sick at your own risk is the warning to all who can’t afford to visit a pharmacy with a prescription letter. It is these letters that have led to the mushrooming of pharmacies around the country.

At first I had merely looked at the rise in pharmacies as an act of cunning business acumen by entrepreneurs who are quick to spot an opportunity emanating from repetitive drug shortages in hospitals and clinics. What then confused me was the Auditor General’s (AG) Office finding massive over-expenditure on drugs in several of our health facilities. In his Financial Audit Report for the year ended March 31, 2021, The AG reported an over-expenditure on medical drugs amounting to E13 072 215.85.

This amount, he said, was incurred by the Mental Hospital, Special Medical Care Unit, Central Laboratory, Manzini Region clinics, Shiselweni Region clinics, Matsanjeni Health Centre, Lubombo Region clinics, Dvokolwako Health Centre, and Pigg’s Peak Public Health Unit in the period under review. So what exactly is going on here? We have just been alerted to the fact that almost half of the pharmacies I thought were ‘life-savers’ in the country are operating illegally as they do not have registered pharmacists. According to the Ministry of Health, the number of pharmacists registered with the Eswatini Medical and Dental Council (EMDC) is 279 while trading licences issued by the Ministry of Commerce, Industry and Trade for pharmacies are 447.

The Director of Health Services, Dr Vusi Magagula, said the law stipulated that only a registered pharmacist should dispense medicines to the public. “No compromise there!” he told our investigative journalist Stanley Khumalo. Dr Magagula cited the Swaziland (Eswatini) Medicines Related Substances Control Act 9 of 2016 on Section 39 and further explained that one could only register with EMDC after proper vetting, which involves the applicant having to sit for a pre-registration examination (PRES).

Licences

The question then becomes, how did the excess 160 pharmacies get their trading licences? Could this be a case of the left hand not knowing what the right hand is doing, where the Commerce Ministry is dishing out licences without consulting the Health Ministry? Or could it be scrupulous qualified pharmacists establishing branches all over the country but break the law by not complying with the provisions of the law in dispensing medicines over the counter? There is no ruling out the possibility that these extra pharmacies are the dispatch centres for all the stolen drugs.

The Ministry of Health, which has a responsibility to ensure the health of the nation beyond the public health facilities, has set out to establish the legitimacy of these pharmacies and get to the bottom of the drug shortages as many people continue to lose lives in our health centres. The Principal Secretary (PS) in the Ministry of Health, Dr Simon Zwane, told this publication recently, that apart from possible theft, shortages could emanate from inaccurate forecasting of commodities leading to over or under supply. He also said some manufacturers would be deterred by unfavourable economies of scale due to our small quantity of commodities given the size of our population. He said manufacturers would wait for other countries to place orders so as to form reasonable batches.

He also mentioned the use of the United States of America Dollar (USD) against the local currency Lilangeni (SZL) as being a concern to suppliers.

That is understood, but it doesn’t excuse the fact that the ministry has always been aware of these issues which should have been resolved by now.

Investigated

He also alluded to the fact that his ministry and government have investigated the cause of the frequent stock-out of medicines in public health facilities back in 2017, through a commission led by the deceased former PS in the Ministry of Information, Communication and Technology (ICT) Prince Sikelela. A report was compiled which made specific recommendations. He said a number of the recommendations had been implemented while others have not. Why not? We deserve to know this because it could turn out that had all the recommendations been implemented, we wouldn’t be starting all over again and more tragically, would not have lost innocent lives.

It is good that the process of reconciling the pharmacy licence register with actual site visits is underway, but maybe these pharmacies wouldn’t exist had the stringent measures been taken and the health and licencing inspectors did what the taxpayer pays them to do. How do we find ourselves with a whole bunch of pharmacies that have all the drugs in stock, but are is serious shortage of proper licences, qualified pharmacists and proper records of drug purchases from their ‘suppliers’.

The controlling officer in the Ministry of Health Dr Zwane yesterday revealed that a month long notice for all the pharmacies to come forward with the relevant documentation that legitimises their business had only yielded 60 positive responses from the licenced 447. So where are the rest and what is holding them back? Who must die before this drug shortage issue comes to an end!