Drug Trade

Last week the Deputy Minister of Health Dr. Lwipa Puma launched the Pharmaceutical Awareness Week in the wake of global recognition that essential drugs for the treatment of common killer diseases such as Malaria, Tuberculosis and AIDS are manufactured with varying degrees of efficacy, efficiency and potency.

Reports indicate that the annual drug trade in Africa is worth over USD 20 billion. Of this business, estimates of between USD 4 billion and USD 6 billion are considered to be of sub standard production that either do not treat the diseases effectively, or actually promote the disease in the patient.

Further information shows that these sub standard drugs are marketed predominantly in poor or developing countries where the capacity of the regulatory authorities in respect to drug quality is weak, inefficient, or non existent.

The mere fact that poor and developing countries have a cash constraint on their ability to purchase quality drugs, presents the perfect trading environment for cheap, substandard drugs that buyers perceive to be better than having no drugs at all.

As a result, many people in Zambia and elsewhere die needlessly, diseases are prolonged due to insufficient drug treatment, many productive hours are wasted in hospitals and clinics, and there is a developing misery amongst sick people and those that are responsible for looking after the sick.

Basically, the misery affects us all. We all, in some way or another, care or look after some relative or friend that is afflicted by some sickness.

The drug trade in Africa has degenerated to a level where sick people are reduced to consumers of chemicals rather than drugs, and the medical and funeral professions are inundated with customers that follow the ‘death chain’ to the grave yard.

It may be useful to link the end of the Pharmaceutical Awareness Week with the beginning of a new Pharmaceutical Quality program across the nation. We are challenged to look at our capacity as a nation, to analyze and assess the quality of all drugs manufactured and imported into the country for public consumption.

If we cannot test the drugs adequately, then we must invest in new laboratory equipment and human resources to ensure that capacity is developed for this life saving public service.

We cannot count on morality and ethics to save lives. Effective regulation, monitoring, assessment, inspection, and quality control are paramount, and the only way of protecting the public from dangerous and sometimes poisonous administration of pseudo life saving drugs.

The Ministry of Health must immediately institute investigations into the quality of all drugs in the country. The private sector must be held accountable for quality of manufactured and imported drugs that constitute their business. In addition, the Government procurement system for drugs must be assessed and investigated for possibilities of harmful drugs being procured for public hospitals. Our collaborating partners must be held accountable for the quality of the drugs that they supply to the people of Zambia through the many health support programs in the country.

Too often, the culprits are the very ones that purport to be benevolent with an agenda for doing public good.

It is important to streamline the drug procurement and production processes such that opportunities for quality control checks are built in and mechanisms for halting dangerous drugs from entering our environment are put firmly in place.

We often swing from one extreme of totally liberalizing the drug trade without any enforceable inspections and assessments, to one of total control and single door management. In both cases people either die from poor quality drugs, or die due to lack of access to any drugs whatsoever. The end result is the same, death.

We must arrive at a workable mechanism of processes and regulations that support and facilitate the provision of quality drugs to our people in an efficient and timely manner.

The poor graciously consume whatever drugs are handed out to them, and take the drugs with hope and trust. The more affluent prefer to be given a prescription by the doctor and search for quality drugs in the many chemists and pharmacies because they know that there are varying qualities of drugs on the market. The rich that do not trust the local medical service industry, get on the first plane heading south and book themselves in at a hospital in Joburg.

The sad thing is that for every rich person there are 100 middle class people, and 10,000 poor people who are at the mercy of whatever drugs they can lay their hands on.

The equalizer comes when there is an emergency. At that point poor, well to do, and rich find themselves in the University Teaching Hospital or any other Government run Hospital. In that world there is no choice of drugs that will be administered. Everybody gets the same treatment.

Published 17 June 2008