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SOME PHARMACIES CANNOT IDENTIFY THEIR SUPPLIERS

20/09/2022 08:30:00 Stanley Khumalo

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MANZINI – The Ministry of Health’s fight against counterfeit, falsified and sub-standard medicines is facing a steep challenge as some pharmacies cannot identify their suppliers.

This is because some of the visited pharmacies reported to be getting products (male and female sex boosters) from a supplier operating out of a bag. This is despite that the traceability of pharmaceutical products is not only important in instances of product recall and withdrawals but also in verification of products in situation of medication error, and other adverse events.
These challenges came to the fore when the Lizzy Nkosi-led Ministry of Health conducted a Retail Pharmacy Survey in May 2022, which was conducted after this publication reported that there were allegations insinuating that some pharmaceuticals and medical supplies were purportedly stolen in government health facilities and sold in the private pharmacies.

The survey by the ministry had two primary objectives, which were to assess whether retail pharmacies in the Kingdom of Eswatini complied with established legal provisions for such establishments in the country and also to assess the status of human resource, licensing, storage practices of products, procurement practices and destruction of obsolete stock practices in retail pharmacies from the four regions. As secondary objectives, the ministry was also seeking to establish the gap between licensed retail pharmacies and those registered with it, to estimate the distribution or spread of retail pharmacy establishments in the four regions and to assess the transparency of the procurement system for retail pharmacies.

From a sample of 150 pharmacies, the report states that nine establishments, which are equivalent to six per cent, did not produce invoices due to various reasons. It was reported that the reasons ranged from their personnel claiming that they were not aware of the whereabouts of the invoices and the Medicines Regulatory Unit (MRU) team being declined the opportunity to review them. There was, according to the Retail Pharmacy Survey Report, one pharmacy that procured a number of its products from other retail pharmacies.

Traceability

The report states that traceability of the source of procurement for products proved to be the most difficult to assess. It was reported that only half of the 14 observed suppliers captured the products’ lot numbers. This act, it was said, presented a gap in the information that needed to be present in the documents in order to allow traceability in instances of recalls and withdrawals. “Some of the products reviewed, in three of the pharmacies, were found to have batch numbers that did not match the ones on the invoice. Four of the visited pharmacies reported to getting products (male and female sex boosters) from a supplier operating out of a bag, and this brought into question the quality of the commodities that are consumed,” reads the report in part.

On the other hand, the report states that well established pharmacies in and around the city centres had provisions for inventory management, which aid in tracing the products. It was reported that by contrast, pharmacies in rural areas were found wanting, which in turn exposed how difficult it might be to track and trace commodities once they left the supplier. The report states that there was need for this gap to be addressed as instituting a proper product recall system in the country would be hindered by it. According to the report, these findings in the supply and procurement of medicines exhibited the apparent danger that patients were potentially exposed to on a daily bases. On the other hand, it was reported that 127 (84 per cent) retail pharmacies were found to have invoices save for those with multiple branches 12 (eight per cent) such that where the main branch was responsible for the bulk procurement, it then distributed to the smaller branches.

It was further reported that three (two per cent) of the pharmacies reported that the invoices were with their proprietors for either filing or for audit purposes. It was the ministry’s conclusion that a number of challenges needed urgent intervention as they posed a direct threat on the safety of public health. It was also concluded that with some of the challenges identified, there was need for different stakeholders to work together and institute interventions, which would address the identified challenges. “This area of business is fast growing in Eswatini but is however heavily reliant on services that are provided by personnel with limited pharmacy training. It is obvious from the provisions of the Trading Licenses Order of 1975 that there are no provisions that accommodate licences that may require any specialised standards for the premise or the personnel for the establishment which the trading licence is required for,” reads the report in part.

On the other hand, the Director of Health Services Dr Vusi Magagula explained that for a prospective general medical practitioner to be registered with the Medical and Dental Council there was a need to apply proper vetting practices in regulating the medical cadre. He said there was a requirement for all medical graduates, who applied for registration as General Medical Practitioners, to sit for a pre-registration examination (PRES).

Competencies

He said the pre-registration examination was set to measure the basic medical knowledge and clinical competencies required to practice as a general medical practitioner in the Kingdom of Eswatini. Dr Magagula emphasised that this procedure was a common international practice among medical regulatory authorities. The director of health services was responding to questions which sought to establish if the pharmacies operating in the kingdom had registered pharmacists and also if there were chances of government incurring a long-term expenditure due to wrong prescriptions of medication. Worth noting is that this publication on Monday reported that some pharmacy owners claimed that they were dealing with the concerns raised by the Ministry of Health.

The pharmacists, who were first engaged by this publication in June 2022, supposed that they were dealing with refurbishing their outlets to be in line with the specifications aligned with the Medicines and Related Substances Act 9 of 2016. One of the pharmacists, who operate a retail outlet at Mbhuleni, said the biggest challenge she was experiencing was funding as the limitation of economic activity during the coronavirus pandemic had proved to be a setback. She admitted the ministry had engaged them to get their house in order as the manner in which medication was kept in her pharmacy was not in the expected specification. On the other hand, the Ministry of Health and the Swaziland Demcratic Nurses Union (SWADNU) were in unison that the law should take its course subsequent to the findings made during a survey.

Principal Secretary in the Ministry of Health Dr Simon Zwane said any government employed pharmacy personnel found to be working in private retail pharmacies without the employer’s approval will be subjected to disciplinary measures. Also, Secretary General of SWADNU Mayibongwe Masangane said the union advocated for transparency and accountability in the profession (nursing) and therefore, the law should take its course.