GOVT UNCOVERS SERIOUS ROT IN TRADE OF SOME PHARMACIES

MANZINI – Government has unearthed serious rot when it comes to the trade of some pharmacies in the country, as contained in Retail Pharmacy Survey in May 2022.

Some of the rot includes nurses working for government and then doing private work on the side, where they also moonlight using their ‘own’ medication, abortion pills being sold over the counter, expired drugs being administered to patients and refrigerators used to store drugs also used for domestic purposes. The Lizzie Nkosi-led Ministry of Health conducted a Retail Pharmacy Survey in May 2022, which has a litany of findings that are against the legislation set to safeguard public health system.

Among these findings is that expired medicines were found stored on the floor in some pharmacies and was in some instances not segregated from useable stock. This, the ministry reported, depicted that there was no proper record-keeping of expired medicines. The survey was conducted just after this publication had reported that there were allegations that some pharmaceuticals and medical supplies were allegedly stolen from government health facilities and sold in retail pharmacies.

Objectives

The survey had two primary objectives, which were to assess whether retail pharmacies in the kingdom complied with established legal provisions for such establishments in the country and 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 (the ministry), 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. In engaging in the study, the ministry sampled 150 retail pharmacies and of these, 66 were in the Manzini Region, 41 in the Hhohho Region, 26 from the Lubombo Region and 14 from the Shiselweni Region. This publication, in June, reported that there were 446 retail pharmacies licensed between 2009 and 2022. However, as of March 2022, of the 446, only 241 had been newly-licensed or had renewed their licences in 2022.

Consultation

During the survey, the ministry reported to have noted that some pharmacies had consultation rooms that had a nurse who was consulting patients on a regular basis. In fact, the report stated that one pharmacy that was visited in the Hhohho Region had a nurse consulting patients during the time of the visit, the consultation room was found to have many injectable medicines and had the appearance of a room that was constantly used as a treatment room.  “Another pharmacy in the northern Hhohho also reported to have a nurse that consulted patients. She was, however, said to be working in one of the government faciliites in the Hhohho Region and only came in on some weekends. She was said to bring her own medicines when she came in, especially injectable medicines,” reads the report in part.

Also, in its findings, the ministry reported to have discovered that pharmacy owners dictated on a number of the decisions related to the operations of the pharmacy. These were said to be inclusive of some technical decisions as well infrastructure, storage conditions and equipment needed, among many. Also, it was reported that the lockable cabinets for high schedule medicines were either absent or not always locked, while other pharmacy personnel had access to the medicines inside the cabinets. The report further states that refrigerators used for storing medicines were also used for domestic purposes and thus food was also found in them, during the visits, while some Schedule V items were stored in the normal shelves and Schedule VI medicines were stored in lockable cupboards.“Photocopies of prescriptions are kept but registers are not kept. There was no proper record-keeping of schedule medicines. No storage area was available. In one pharmacy, the bulk stock was kept at home; stock is brought in as and when it is needed,” reads the report in part.

The ministry also discovered that some pharmacies kept their stock on the floor, which was inclusive of various skin whitening creams. It was discovered that a bulk of the stock was in the storeroom. Also, the ministry found that in another retail pharmacy, there were two scripts listing that seven of 10 boxes containing 120 tablets of Cytotec 200mcg were received. However, the stock of the Cytotec 200mcg was not available during the visit and there were no records to support the dispensing of the stock. According to medicines.org.uk, a website for medical practitioners, states that the Cytotec 200 microgrammes induces uterine contractions and is associated with abortion, premature birth, foetal death and foetal malformations.

Meanwhile, the study further reported that another pharmacy had a storage room which presented high risk of infestation as it was connected to a butchery, where all kind of things were kept. In the report, the ministry states that proper storage of medicines assists in ensuring that medicines were safe and of quality are issued to the public and that it also helps to reduce wastage due to storage problems.

Assessment

When conducting the study, it was said one of the assessment indicators was to evaluate whether the pharmacies kept stock on the floor or not and  out of 150 pharmacies visited, 91 (60.6 per cent) of the pharmacies did not keep stock on the floor, while 58 (38.6 per cent) were found to have stock on the floor. It was also reported that 120 (80 per cent) had equipment and facilities for the proper storage of pharmaceutical products in the storage area and front shop, while 27 (18 per cent) of them did not. The ministry reported that according to the World Health Organisation (WHO) good storage practice guideline, materials and pharmaceutical products should be stored off the floor and should be suitably spaced to permit cleaning and inspection as well as to allow the circulation of air.

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