CSOs challenge govt to list expired drugs for incineration

PIC: Executive Director Civil Society Budget Advocacy Group (CSBAG) Julius Mukunda addressing the press on destruction of expired drugs at CSBAG offices in Ntinda Kampala on 09 March 2018, as the  Budget Policy Specialist CSBAG John Mark Agong looks on. (Credit: Godiver Asege)

HEALTH | ACCOUNTABILITY

KAMPALA - Civil Society Organisations (CSOs) under the Civil Society Budget Advocacy Group (CSBAG) have challenged the Ministry of Health (MoH) to list the types of drugs that expired and are scheduled for incineration.

According to the advocacy group, giving a breakdown of these drugs is essential as it will guide on the future supply of drugs to respective health centres based on the commonly diagnosed diseases in the area. 

The health ministry on February 12 launched a drive to dispose of 1,500 tonnes of expired and obsolete medicines and other health supplies countrywide.

The move, according to the permanent secretary, Dr Diana Atwine, is aimed at cleaning and creating space in the 6,617 health facilities, including government owned and private not for profit centres.

Noting that expired pharmaceuticals are a growing concern in the country, Atwine said they can also result in a risk to national security, adding that the last massive exercise was carried out in 2012.

However, speaking at their offices in Ntinda on Friday, Julius Mukunda, the CSBAG executive director, said although the destruction of expired drugs is good, destroying them with existing challenges creates issues of concern at the expense of service provision and is an indication of wastage of public resources.

"Why are they destroying drugs with the increased cry of drug stock outs and expense to service provision? For the last four years, the Government has been faced with challenges of drug stock outs at various health centres," Mukunda said.

He said for a long time, there have been drug stock outs of anti-malarials, cotrimoxale (used to treat adults with HIV/AIDS), measles vaccines, sulphadoxine/pyramethamine (treatment for malaria), depoprovera (contraceptive) and oral rehydration salts.

Although incinerating of drugs is a common practice, Kenneth Mwehonge (Pictured left), the programme manager Health Policy Advocacy, said destroying tonnes of drugs is massive wastage.

"We are currently experiencing stock outs of key medicines for people living with HIV, mainly Cotrimoxale, which is used for treatment of opportunistic infections among people living with HIV and Neverapine that is used to treat children with HIV. This has been going on for four months in the Rwenzori region and districts like Kiboga."

"This has been going on and even in the latest cycle of supplies, the particular drugs have not been provided. This means that people meant to take these tablets are literally left to die as the poor may not afford buying the drugs," Mwehonge said.

Mukunda, on the other hand, also questioned the cost implication of destroying drugs in terms of monies required, with a clear categorisation of the donor and tax payers' money, given that most of the funding to the health sector is from donors.

"Do National Medical Stores (NMS) and MoH have any shelf guidelines to follow when procuring drugs? The destruction of drugs is a sign of poor planning and it implies that NMS procures drugs with a short shelf life. But had the procurement process been efficient, the drugs procured would have factored in the drugs' expiry, ensuring that the drugs are consumed within the specified and anticipated time," Mukunda stated.

It is against the above background that the Advocacy Group tasked the ministry with listing both the health centres whose drugs expired and the types of drugs.

In the 2016 Auditor General's report, mama kits were out of stock for 320 days and coartem for 285 days at sampled health facilities mainly due to failure of the NMS to supply drugs in the quantities requested by the health centres and lack of reliable information on drug usage.