JB must act on shortage of diabetes drugs and Malawi health crisis

Introduction

Malawi is experiencing soaring inflation which has now hit a 35% mark and the profound effects have spread to the whole health sector thereby creating a huge crisis. JournAIDS in an article dated 8th January, 2013 published on Nyasa Times also lamented the inaction from the Central Medical Stores to deal with stock outs of diabetes drugs.

The Ministry of Health through its 2011-2016 Health Sector Strategic Plan has included non communicable diseases an one of the most important priorities, however sadly diabetes drugs continue to be in an acute shortage and is exposing lives of diabetic patients on danger.

The Nation newspaper of 28 January, 2013 published an open letter to the state president from staff of Kamuzu Central Hospital in which 15 signatures were appended to the letter. JournAIDS which also works with diabetic patients at the hospital is saddened by the current crisis.

The referral hospital is lacking essential supplies and drugs and the situation has worsened a scenario which should not be allowed to happen at all cost, as this is a hospital considered to be of high standards.

President Banda at  Mangochi hospital pharmacy

President Banda at Mangochi hospital pharmacy

It is also shocking to note that the stealing of essential drugs which are in the Essential Health Package (EHP) has worsened, while the courts are offering lenient sentences to offenders involved in drug pilferage. As doctors at Kamuzu Central Hospital continue to struggle with shortage of drugs, JournAIDS is of the view that it is only the state president who can end the crisis, as all avenues have failed to address drug stock outs.

According to a 2009 survey on Non Communicable Diseases (NCDs) conducted by the World Health Organization (WHO) in Malawi, it shows that 17% of deaths in males and 14% of females were attributed to NCDs, this list consists of diseases such as Diabetes, high blood pressure in people with increased levels on Cholesterol. Globally WHO estimates that 70% of all deaths are due to NCDs with cardiovascular (heart diseases) complications leading the list and 2% for Diabetes in 2009.

Summary

The shortage of diabetes drugs in Malawi is not a surprise, as many hospitals have run out of essential drug supplies thereby putting many lives of patients on a high risk of death. The scenario points to a policy failure in the country’s health system, as it seems the Ministry of Health and the Central Medical Stores are not coordinating properly to end drug stock outs. The Daily Times of January 29, 2013 has carried out two stories “Crisis takes toll at KCH”.

Another article was also published “ 57 percent of total health budget used”. The analysis of these two news articles clearly shows that the Ministry of health is struggling to provide quality basic health care to the people, which is also a health right of all citizens.

Shockingly the spending of the health budget raises a lot of questions as to how 68% of the 2012/2013 health budget could be spent on personal emoluments, while not giving special attention to drug procurement. The drug budget which got approved at a figure of K4.5 billion, K2.1 billion has already been spent, while drug stock outs on diabetes drugs and other communicable and non communicable diseases continue to rise at the expense of people’s lives.

The failure to deal with drug stock outs shows that there is weak implementation of the 2011-2016 Health Sector Strategic Plan. Her Excellency, President Joyce Banda must intervene to examine the crisis which should not be ignored any longer.

Contrary to popular belief NCDs do not only impact the elderly in high-income countries: In the developing world, NCDs such as diabetes and hypertension often affect individuals in their mid-forties and early fifties-during the most productive part of their lives-contributing to loss of productivity and higher rates of premature morbidity and mortality.

The explosive rise of NCDs attributed to aging populations, epidemiological transition, obesity and harmful lifestyles and environments against a background of rapid, unplanned urbanization and globalization requires multi-sectoral intervention.

Recommendations

  • We      therefore call upon the state president, Joyce Banda to urgently convene a      meeting for all health stakeholders to discuss the shortages of diabetes      drugs and supplies affecting other areas in both communicable and non      communicable diseases as an emergency. The meeting should also ensure that      all donors involved in procurement of drugs are present. At this meeting      we want officials from the Central Medical Stores Trust to appear in the      meeting and explain as to why drug stock outs are continuing, yet previously      it has misprocured POPs and bandages worth millions of Kwachas, instead of      giving priority to essential drugs.
  • We call      upon donors in the Health Donors Group and also officials in the Health      Sector Wide Approach and the Ministry of Health to draw a plan of action      for 2013-2015 to deal with drug stock outs, and put in place mechanisms to      curb drug pilferage and hold the Central Medical Stores Trust accountable.      It is also important that the Malawi Police Service and the courts be      present at this meeting explain on the progress they have made on dealing      with cases of drug stealing.
  • We appeal      to the State President, Joyce Banda to also consider putting in place a      special commission of inquiry on drug stock outs and ensure that a group      of independent investigators conduct a quick investigation into the      stealing of drugs at the Central Medical Stores Trust and the general      failure in the provision of drug supplies, such as at the Kamuzu Central      Hospital.
  • It is      also critical for the local media to also conduct their own investigation      on drug stock outs and ensure that the Central Medical Stores is held      accountable for drug shortages in the country.

Conclusion

Drug stock outs are continuing to pile misery on the lives of Malawians who are already affected by the economic crisis. The situation cannot be ignored any longer and the indications are pointing to a disaster situation and must be addressed urgently without any political interference. Hence it is the duty of the civil society and the local media to hold government and the Central Medical Stores Trust accountable to ensure that people enjoy their right to health.

*Dingaan Mithi is  Programme Manager  of  Journalists Association Against AIDS (JournAIDS)

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