Invisible hand in drug shortages

By Derrick Silimina

In public health facilities in Zambia, there is an ongoing drug shortage and patients fear not getting vital medicine.

The country’s national drug stock levels currently stand at 53.1 %, way below the World Health Organization’s stipulated minimum threshold of 70 % to 80 %, according to the Zambia Medicines and Medical Supplies Agency (ZAMMSA).

“The ongoing shortage of medicine in all government health facilities is worrying. As a diabetic, I take injectable insulin regularly. When I go to the public facility, I am told they have run out and must opt for the expensive private drug stores,” Sarah Tembo, a Lusaka resident, says.

In many of these health facilities, several essential and life-saving medicines are in short supply. These include painkillers such as paracetamol, nifedipine for hypertensive patients and insulin used by diabetics. Health care workers in these facilities are helpless and cannot offer the needed care without the required drugs.

Critics have blamed corruption and embezzlement for the current drug shortage. As the drug and medicines supply chain continues to be a big business globally, some local pharmaceutical experts have hinted at the practice by individuals in the procurement and supply chain departments in public health facilities to steal medicines and sell them on the black market.

“There’s a very big cartel in the procurement and supply of medicines. The government has been procuring quite alright, but there’s an invisible hand, which is reselling drugs using government resources and that powerful syndicate went to an extent of bringing in expired drugs in the country,” Peter Makayi, a pharmaceutical expert, says.

Some stakeholders are calling on the government to declare a “State of Emergency” in the wake of this ongoing crisis. They argue that this will allow the invocation of disaster management procedures and accord the issue the much-needed attention it deserves.

The government is however hesitant to take up the recommendation. They have instead announced that they have procured enough essential medicines for health facilities to address the nationwide shortage of drugs.

Mutale Nalumango, Zambia’s vice president, acknowledges that the country faces the challenge of lack of essential drugs countrywide. She believes that part of the problem is the messy supply chain in the pharmaceutical industry which costs the state a lot of money. She also expresses frustration with unscrupulous individuals who steal drugs meant for public facilities. “When there is a middleman, there are challenges. My appeal is that we do away with most of these intermediaries,” she suggests.