This week’s revelation that two million Kenyans are at risk of going blind because the Government has delayed to clear a consignment of life-saving drugs, worth Sh4 billion, has reigned the debate on donations in the pharmaceuticals sector. In the story by The Standard, it is reported that the consignment donated by Pfizer through the International Trachoma Initiative (ITI) has been held at the Jomo Kenyatta International Airport (JKIA) due to bureaucracy.
The concern, beyond the delays is that the blindness from trachoma – is irreversible. The consignment Zithromax to be distributed to 12 Counties has been lying at Trans Global Warehouse since last October.
It is not the first, neither will be the last consignment to raise concerns, especially regarding expiry of the drugs.
In April this year, the Kenya Medical Supplies Agency was on the spot following revelations that its employees have been colluding with rogue traders supply expired drugs to the market. The concerns emerged when police and the Pharmacy and Poisons Board found a consignment of surgical gloves, X-ray protective gowns, drugs, surgical syringes and sutures marked as government property at a house in Parklands, Nairobi.
Three weeks ago, the Senate’s Health Committee led by its Chairman Michael Malinga conducted a fact-finding mission to the Kenya Medical Supplies Agency to ascertain the allegations reported by sections of media. The mission did however not yield any information regarding the availability or otherwise of expired drugs at the agency.
In July 2015, Vihiga County government was in the spotlight after the Auditor General raised questions on how the they bought sh11 million worth of expired drugs for school children.
Experts in the health sector have affirmed that countries like Kenya will for a long time to come continue accepting drugs that are about to expire unless they sort out leadership. One such expert who preferred anonymity explained how it works.
He said that a pharmaceutical company in Europe or America will do its stock taking and learn that it has inventory that will expire in the next nine months or within a year. In the event the inventory expires, not only will it lose that money but will also incur huge expenditure to destroy those drugs through incineration and disposal.
The organization will then approach a government or regional body to help it dispose the drugs and still make some money. Such a plan would see the drugs being labeled as humanitarian or heavily subsidized to the recipient country. In most cases, health institutions including humanitarian organizations are given the drugs to distribute because certain communities are vulnerable and could die if the drugs do not reach them on time.
As the drugs leave the port of origin and often this has already taken some time and much less time remains before they expire, the recipients are disorganized. They lack a distribution plan, the beneficiaries are not identified, there is no money to clear the consignment or prior plans to waive the costs at the point of entry and no plans to hire logistical and medical personnel to oversee the transition. Often, the number of beneficiaries, their locations and distribution across a region or country and quantity of drugs needed is lacking.
Once the drugs have expired, it is the host government’s problem or the humanitarian agency’s problem. The pharmaceutical company will have been paid, it has cleared its inventory and made a profit. Their government will not take a back seat to see them suffer. In some instances, the drugs will have arrived already expired hence they re-batched with new dates and distributed to unsuspecting patients.
In all these scenarios, how the leadership explains the issues and also proactively investigates to find out these details, is what could save them from being lynched by the public and also further endangering lives of millions.