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Drug theft woes

 

The Malawi government is still losing a third of its drug stocks through pilferage, 10 years after the Ministry of Health (MoH) suggested measures to curb theft.

Among other things, the report recommended that all health advisory committees in health facilities across the country-set up to safeguard the security of drugs-should be trained on how to monitor and report drug pilferage.

The report titled Assessment of Drugs and Medical Supplies Leakages from Medical Stores and Public Health Facilities’ was commissioned by the Ministry of Health.

The report also showed that 96 percent of the stolen drugs or a third of the ministry’s allocation for drugs are lost at health facility level while four percent are stolen while in the custody of the Central Medical Stores (CMST) every year.

But 10 years after the recommendations were made, the Ministry of Health is still losing a third of its drugs stocks at an estimated cost of K5 billion every year.

The budget for drugs in the 2015/16 budget was K17 billion.

Kumpalume: Acknowledged problem
Kumpalume: Acknowledged problem

The theft of drugs, mostly for malaria, tuberculosis and anti-retroviral therapy (ART), is contributing to stockouts in public health facilities across the country, resulting in unnecessary deaths of people.

Minister of Health Peter Kumpalume, in a telephone interview on Wednesday, noted that the committees were at different levels in terms of capacity building as some have made remarkable progress to ensure that drugs are secured.

Said Kumpalume: “Much as all things are not equal, we have resolved to ensure that these committees have to be trained and strengthened in order to safeguard the security of drugs at facility level. A few, however, have made huge strides which is very encouraging.”

National Police spokesperson Nicholas Gondwa told Weekend Nation on Wednesday that drug theft increased at the end of 2015 despite efforts to curb the vice which has had negative effects on the country’s health service delivery.

“The police have indeed been arresting people found in possession of drugs with Malawi Government seals. Towards the end 2015 there was an increase in theft of drugs, but we have seen a reduction since the beginning of 2016 despite registering some cases. Mostly, the suspects do not reveal how they get the drugs for fear of killing their business,’’ he said.

But Kumpalume insisted that the recent arrests show that his ministry is working together with the police to curb drug theft and other stakeholders.

“The fact that you are hearing about arrests means that we are working harder to flush out people who steal our drugs. We are working together with the police and other stakeholders including pharmacists, judiciary and communities to stop the drug thieves,” he said.

Kumpalume singled out the Chilomoni Health Centre committee as a shining example of the committees that have been trained to safeguard the safety of drugs.

Spokesperson for CMST, Herbert Chandilanga, said the organisation had introduced strong measures to seal the loopholes noted.

“We have instituted risk mitigation measures based on warehouse improvement plan standards and we are making progress. Currently, we have also instituted recommended best practices for  warehouse interior perimeter  protection and operations such as installed warehouse controlled access mechanisms and continuous surveillance of theft and identity theft control systems, plus vehicle tracking apparatus,” he said.

According to Chandilanga, CMST has intensified screening of employees prior to their engagement, through the country’s security systems and the instituting of a corruption and fraud prevention policy.

He added that there is also improved security rendered by the police and private security detail using overlap, integrated, multiple layer security systems to prevent intrusions.

The 2006 report prescribed that members of the committees whose responsibilities, among others, includes ensuring correct, efficient and cost-effective handling and prudent use of drugs within health centres should receive training to build their capacity to prevent drug theft.

Chandilanga: It is a precautionary measure
Chandilanga: Security has been enhanced

Currently, members of the committees are ward councillors, prominent members of the community such as a religious leaders or retired officers including some health workers.

He added that there is also improved security rendered by the police and private security detail using overlap, integrated, multiple layer security systems to prevent intrusions.

A report issued by the government of Norway in 2013 conducted by the Clinton Health Access Initiative (CHAI) Malawi quantified the extent of leakage on 13 health commodities identified as high value and at high risk of theft.

It concluded that malaria commodities Artemisinin-based combination therapy (ACT) and Rapid diagnostic tests (RDTs had the highest levels of leakage, with 52 percent and 47 percent, respectively.

The CHAI report also found that essential medicines were the poorest documented commodities, especially in health facilities both at in-patient and out-patient wards putting them at $11 572 886 worth, representing 18 percent of the total value of commodities assessed in the study unaccounted for.

Essential drugs include malarial kits, antibiotics, tuberculosis (TB) antiretroviral (ARVs), cholera and drugs that are used to treat maternal complications including Under-5 vaccines.

Unavailability of these drugs has had huge implications on the overall health delivery service in the MoH which threatens the rise in numbers of deaths from diseases such as malaria, HIV/Aids. TB, cholera and others.

On Wednesday the United States government through US Embassy public affairs officer Edward Monster expressed its worry, in an e-mailed response, especially for the continued theft of drugs that the US government has been procuring for the MoH.

“The Government of the United States (US) continues to be concerned over the theft and mismanagement of medicines and medical supplies provided by the US to benefit the people of Malawi, particularly life-saving malaria treatment drugs and related commodities such as bed nets. We have repeatedly conveyed our concerns to the MoH and other senior government officials,” he said.

While hailing some efforts that the ministry was making to improve the situation, Monster said the critical challenge in the security of drugs was not to do with infrastructure but some criminal minded civil servants.

“Indeed, infrastructure constraints render drugs and essential supplies more vulnerable, but ultimately it is individuals-often government employees-acting intentionally for personal profit, who are stealing these resources,” he said.

Last month, the Global Fund in collaboration with the MoH launched telephone and e-mail hotlines for Malawians to join in the battle by reporting theft of drugs.

Health rights activist Maziko Matemba on Wednesday described the failure by MoH to ensure that the drugs are well secured at health facility level as ‘‘systemic failure.’’

Said Matemba: “The health advisory committees are an important tool to track and ensure that drugs are safe at health facility level. We recommend MoH should work with other stakeholders such as the civil society organisations (CSOs) in building strong capacity and monitoring tools  to these committees in eradicating drug theft at facilities level.”

He also pointed out that the community involvement efforts which have been launched should be sustained in order to instill the culture of reporting drug theft by community members.

Parliamentary Committee on Health chairperson, Juliana Lunguzi, on Tuesday questioned the criteria used to constitute the monitoring committees.

“While indeed capacity could be an issue, we should also be careful in constituting these committees as to who should serve in these committees. Also the criteria used to identify them and indeed their mandate besides looking at issues of sustainability,” she said.

Lunguzi said manual systems have now outlived their usefulness and should be replaced by new technology.

Said Lunguzi: “We need to computerise the whole chain from ordering to the use of the drug by the patient. Introducing bar-coding on all medicines, coupled with introduction of national IDs could help a lot in establishing an audit trail which would make crooks think twice.”

The theft of drugs in public facilities sits well with the level of plunder of government resources where 30 percent of resources are looted. n

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