Scarcity of diabetes medicines in Malawi: A patient’s nightmare

A woman living with diabetes travels all the way from her home district of Dedza to the Kamuzu Central Hospital in Lilongwe only to be turned away as the health facility has no medicines for treating the disease, worse still she has to spend a hard earned income to pay bus fares. This is the current situation around the country, so how are the lives of patients with diabetes going to be safeguarded?

Diabetes is one of the non communicable diseases affecting the country’s productive population, results from a 2009 STEPS survey conducted by the World Health Organization shows that there is a prevalence of 5.6%, meaning that in every 100 people 6 of them have the disease, yet the disease has not received much attention unlike communicable diseases such as HIV and AIDS, whose drugs are found almost every where.

Malawi has a long history of drug stock outs with the Central Medical Stores leading the process of procuring drugs. Since the store was transformed into a trust, it still seems to continue struggling and cannot end the drug shortages hitting the country.

Diabetes Association of Malawi, president, Timothy Ntambalika speaking at the 2012 commemoration of World Diabetes Day called upon the Ministry of Health to act urgently on the shortages of various diabetic drugs such as Metformin, which now cannot be accessed from pharmacies at government health facilities both in Mzuzu, Kamuzu and Queen Elizabeth Central hospitals.

March of diabetes awareness in Malawi

“Our major concern as people living with diabetes is that there is an acute shortage of drugs in the country, some people have to buy drugs from pharmacies which are very expensive, while such people even have no money”, laments Ntambalika.

He adds that the shortage of diabetic drugs is further complicated by human resource constraints whereby during Tuesday which is a diabetes clinic day, most patients are frustrated to discover that health workers specialized in diabetic care have been shifted to other departments and often get attention from medical students who might not have expertise in diabetes management.

Emmanuel Khomani is a member of the Diabetes Association of Malawi and a patient, he agrees with Ntambalika that the country has a serious shortage of diabetic drugs and also appeals to government to do all it can to reduce this problem.

“ The biggest challenge to patients with diabetes right now is the shortage of diabetic drugs, now that we have a financial crisis, the medicines are very scarce and patients are going to die if no action is taken urgently”, he noted during the sidelines of the World Diabetes Day Commemoration.

He observed that the shortage of diabetes drugs in the country could be addressed if government quickly courts donors and other development partners to come in swiftly and take the issue as a matter of urgency, although there are other pressing disease burdens which also require attention.

According to the International Diabetes Federation, globally there are 4.6 million deaths annually attributable to diabetes and in some countries children and young people die for lack of insulin without ever being diagnosed. Diabetes ranks in the top 10 causes of disability worldwide and undermines productivity and human development.

The federation observes that if no action is taken, the number of people with diabetes is predicted to rise to from over 366 million in 2011 to 552 million by 2030, or one adult in ten.

Another patient, Charles Saidi who is the Central Region treasurer of the Diabetes Association of Malawi points out the need for health policy makers to refocus themselves and address NCDs such as diabetes by ensuring that medicines are in good supply.

“Just imagine diabetic drugs such as Metformin have completely stocked out in all government hospitals, in Lilongwe at Kamuzu Central Hospital, an American national who has diabetes donated Lentil some few weeks ago, but the drug run out in a few hours”, He says.

Saidi adds that the shortage of diabetic drugs in the country has reached a crisis level in which some unscrupulous vendors could find a loophole and capitalize on the shortage to sell diabetic drugs that have expired thereby put lives of patients on danger.

“ There is a danger that some vendors could have already started selling poor quality drugs for treating diabetes, which is now putting many of our lives as patients on great danger”, Warns Saidi.

Director of the Queen Elizabeth Central Hospital, Dr. Andrew Gonani acknowledges that the country is facing a critical shortage of diabetic drugs and assures diabetic patients not to panic as the government is working extra hard with the Central Medical Stores to reduce the drug stock outs.

“I can assure you that the Ministry of Health is working hard with the Central Medical Stores to increase the supply of diabetic drugs which will reduce stock outs from health facilities, we are also working towards an emergency procurement mechanism to get these drugs urgently”, He said.

Diabetes type 1 is caused by genetic factors such as lack of insulin which is secreted by the pancreas in a human body and leads to glucose intolerance, as blood sugar level rises and can damage body organs such as the feet, eyes and legs.

Many leg amputations are caused by the disease whose other risk factors also include physical inactivity and unhealthy diets. Type 2 of diabetes occurs when there is insulin resistance by cells, while gestational diabetes (GDM) commonly occurs in pregnant women and has not received enough attention in many Low Middle Income Countries, including Malawi.

The International Diabetes Federation in a recent study linking diabetes and climate change suggests that food insecurity in many developing countries caused by droughts and other other extreme weather events is fuelling diabetes as people cannot access a lot of fruit or vegetable diets which are very vital, while the habit of people in urban areas eating fast food is growing due to changing lifestyles.

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