EXPIRED DRUGS: Who is to blame?

NMS innovates as critics call for improved forecasting drug needs

Kampala, Uganda | FLAVIA NASSAKA | A Feb.12 Ministry of Health announcement that expired drugs to the tune of 1500 tons in stores at 6619 health facilities across the country would be incinerated has incensed many. Critics wonder how such a volume of drugs can expire in a country that suffers constant stock outs.

The previous month, Civil Society Organizations that advocate for people living with HIV had held a press briefing calling on government to provide people with Anti-retroviral drugs (ARVs) warning of a bigger danger of drug resistance.

Many patients were skipping their doses for they couldn’t find these lifesaving drugs at their facilities. Those in need of ARVs were perhaps the loudest. But many people continue going to especially public health facilities only to be given prescriptions to buy drugs from private pharmacies. The ministry’s announcement, therefore, has raised questions of why and what exact drugs were expiring in stores.

When asked, Moses Kamabare, the General Manager National Medical Stores (NMS), an entity that is mandated to procure and supply drugs to public health facilities across the country said they were not sure of what exact medicines had expired as they were yet to collect them from facilities.

“We are not sure,” he said, “They might be supplies like syringes, gauze or gloves. Medicines expire because they have an expiry date. Everything that has an expiry date is prone to expire and we just can’t have 100% consumption.”

Apart from Kamabare, Dr. Diana Atwiine, the Permanent Secretary in the Ministry of Health, also said it is naturally expected that about 5% of pharmaceuticals in the distribution chain end up expired.

But, a report released in January from an internal audit – Statutory Internal Audit Report for the first quarter 2017/18 commissioned by Kampala City Council Authority (KCCA), pointed to what tends to lead to these sorts of problems.

The study found that most of the drugs that were expiring in health facilities managed by the authority had been delivered to them just a few months from their expiry dates.

Some of the medicines that were found expired included a HIV drug – Nevirapine syrup that had been supplied to Komamboga Health Facility in October 2016. Of the 810 bottles supplied, 599 bottles had expired before use by November 2016.

Also, according to the report, NMS had supplied 36 units of a laboratory reagent HumaCount to Kisugu Health Center III but only one unit was used and the rest expired a few months later.

While appearing on a TV talk show, Kamabare said this continues to happen across the country because facilities cannot anticipate with exactness what they will need and, therefore, rely on their best estimates from previous experiences.