MBABANE – Medical drug losses due to theft remain one of the continent’s headaches, but some countries have put measures in place to combat the situation.
Eswatini is one of the countries which loses drugs due to theft and the Auditor General (AG) Timothy Matsebula, revealed in the Forensic Investigation Proposal and Audit of Acquisition, Distribution and Management of Pharmaceuticals report that drugs worth E151.6 million were missing and unaccounted for in public health facilities around the country. He said this might be caused by theft and misuse for personal benefits, leading to a public outcry on the shortage of medicines. The audit focused on the acquisition and distribution of medicines to public health facilities, including the Central Medical Stores (CMS) under the administration of the ministry of health and covered the 2020/21 and 2021/22 financial years.
recommendation
During the ministry of Health portfolio committee annual performance report presentation last Thursday, Ndzingeni MP Lutfo Dlamini made a recommendation to Minister Lizzie Nkosi, stating that the ministry should benchmark with countries such as Ghana and Rwanda where drug theft had been combated by the introduction of drones to deliver the drugs. The Public Accounts Committee (PAC) of Rwanda’s Parliament in charge of investigating financial misconduct within public institutions, asked the Rwanda Biomedical Center (RBC) to fast-track the recovery of huge sum worth of drugs that were stolen by its employee in 2014. The report released by the Office of the AG indicated that between 2014 and 2018, Rwanda had continued not only to incur losses due to the increasing volumes of drugs expiring in RBC storage, but also the institution is responsible for the loss of Frw 370 million (About E7.5 million) in stolen drugs.
The embezzlement was allegedly carried out by two former employees of RBC, who were in charge of the management of drug stocks. Reports by the AG also indicated that in most cases, drugs were ordered without properly determining the quantities needed at a particular time, hence the stockpiling drugs which end up expiring. However, imaginative modes of transport were harnessed to transport vital medicines, blood tests and supplies in Rwanda, in a partnership that would facilitate care for the ill and the vulnerable. Californian start-up Zipline makes the deliveries by drone – the kind of operation that was once the stuff of science fiction. The same concept was adopted in Ghana where hundreds of drones are used to deliver life-saving vaccines, drugs and blood to multiple places in Ghana.
The robotics company, Zipline, based in California, started a new project to transport health supplements via drones. When vaccines, blood or medication are running out, doctors can order new supplies by sending a text message. After receiving the order, drones will fly to the place of interest and drop the deliveries using parachutes. Currently, four distribution centres are available. The idea is that these four centres are able to send about 600 deliveries a day. Over time, this number can expand up to 2 000 flights. According to reports, this has helped combat the drug theft problem in Ghana. In a bid to curb the theft of medicine at government health facilities for re-sale on a thriving black market, the Zimbabwe Anti-Corruption Commission has started monitoring public hospitals and clinics. It was reported that the government had been making strenuous efforts to supply medicines to these institutions, but there were suspicions some of the drugs were being diverted to the illicit market.
Zimbabwe’s largest public hospitals including Parirenyatwa, Chitungwiza and Sally Mugabe, formerly Harare Central, would be under the anti-corruption unit’s microscope. The commission, led by former High Court Judge Loice Matanda-Moyo, was last year given the power to arrest suspects. Theft and fraud in the south African pharmaceutical industry is reaching alarming proportions, with major consequences for both manufacturers and consumers. An estimated 750 million rand (US$210.2 million) worth of medicines (at retail price level) are stolen each year, both at manufacturing level and in transit, but mainly at state institutions.
Following investigations into cases of fraud and misconduct at provincial hospitals, the Gauteng Department of Health in South Africa dismissed six officials for various transgressions.
At Tembisa Tertiary Hospital, two officials were fired for stealing medicine valued at E36 000 last year. A pharmacist assistant and a laundry worker were caught stealing 48 boxes of Epilim CR (used for treatment of bipolar disorder, psychotic conditions, and for nerve related pain), 35 boxes of Sandoz-Co amoxyclov (used for treatment of community acquired pneumonia, upper and lower respiratory infection and otitis media), 40 boxes of lansoloc (used for treatment of epigastric pains and general ulcers) and 49 boxes of Loviri (used for treatment of herpes simplex and varicella-zoster viruses and genital infections).
The department also fired four other officials for other misdemeanours such as collusion in management of mortuary corpse at Bheki Mlangeni District Hospital; accepting a position for which the official had not applied for at the same facility (financial clerk); falsification of employer’s documents in order to mislead the employer to believe that the official was at work while he had not reported for duty. In Malawi, it was reported that theft of medicines had also cost the country and donors billions of dollars annually, with the government losing an estimated 30 per cent of drugs and medical supplies it purchases to theft. About 35 per cent of these stolen commodities end up in private health facilities.
evaluation
The country is embarking on an evaluation study which tests the impact of different informational interventions on reducing drug theft, including providing information to clinic officials about a government tracking programme to monitor drug supplies in each clinic and the penalties associated with stolen drugs; training communities to obtain information, monitor and report on drug delivery dates, drug availability and clinic responsibilities; and a combination intervention. Minister of Health Lizzie Nkosi said they had a plan to combat the drug theft in the country. She said the members of the ministry’s portfolio committee would be taken through a report that details the plan.