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DRIVERS DISAPPEAR WITH COVID-19 VACCINES

20/08/2023 17:15:00 Welcome Dlamini

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MBABANE – The final destination of COVID-19 vaccine vials remains unknown as they reportedly disappeared allegedly in the hands of some drivers.

The drivers were transporting the vaccine, which was the Pfizer-BioNtech (cominarty), from the Central Medical Stores (CMS) to health facilities. This information is contained in the draft forensic investigation report into allegations of irregularities related to procurement, acquisition and distribution of medicines to public health facilities in Eswatini. The report has been seen by this publication but the information contained in it is not yet considered final and is subject to change.

During the peak of the COVID-19 pandemic in October 2021, Eswatini received 100 625 doses of the Pfizer vaccine through COVAX - a worldwide initiative aimed at equitable access to COVID-19 vaccines directed by the GAVI vaccine alliance, the Coalition for Epidemic Preparedness Innovations (CEPI), and the World Health (WHO), alongside the key delivery partner, the United Nations Children’s Emergency Fund (UNICEF). The Pfizer vaccine was the first candidate that Eswatini received that was to be administered to children between 12–17 years of age and was, therefore, prioritised for this age group. As said by Minister of Health Lizzie Nkosi, when the vaccine arrived, another order of Pfizer was on the way and as more Pfizer doses arrived, it was then provided to other groups.

preparation

The minister said Pfizer, unlike other candidates, has additional commodities required for its administration, which includes vaccine preparation commodities, etc. Minister Nkosi said then: “These commodities are yet to arrive in the country and we will update the nation once all commodities have arrived and we are ready to start the vaccination process with the Pfizer candidate. We continue to encourage the nation to get vaccinated against COVID-19.” Also present when the vaccine arrived was the then US Ambassador, Jeanne Maloney, who said she was especially happy that this donation opened vaccine delivery to younger people, which was a game changer. She said this would allow learners to go to school with an added layer of protection; and not only protect them but protect their parents, as well as grandparents. International health institutions had warned though that with the approval and coming in of the vaccines in different parts of the globe, the scale and complexity of their manufacture, allocation and distribution globally would be unprecedented and, as a result, there would be corruption risks that may threaten vital public health goals.

favouritism

The institutions said these risks included the entry of substandard and falsified vaccines into markets, theft of vaccines within the distribution systems, leakages in emergency funding designated for the development and distribution of vaccines, nepotism, favouritism, and corrupted procurement systems. “These corruption risks must be identified and mitigated by public institutions to help advance access to safe and effective COVID-19 vaccines by the population, including the most vulnerable and marginalised groups,” said the United Nations Office on Drugs and Crime (UNODC) in its policy paper titled ‘Covid-19 Vaccines And Corruption Risks: Preventing Corruption In The Manufacture, allocation and distribution of vaccines’.

A document that was produced as a summary of the webinar ‘COVID-19 vaccine and the threat of illicit trade’ organised by the OECD Task Force on countering illicit trade identified critical risks areas in rolling out COVID-19 vaccines. The document states that experts identified three areas of particular concern for illicit trade in COVID-19 vaccines and there are: theft and diversion of vaccines; logistical transportation risks; and misuse of the on-line environment. The risks outlined by the two institutions appear to have manifested themselves in Eswatini as found by the forensic investigation. Under the heading ‘products dispatched at CMS and never reached the health facilities centre’, the draft report reads: “We reviewed the medicines and drug list and identified that the following medical products were dispatched from the CMS but allegedly never reached the health facilities centres and the officials involved in the ordering, purchasing and delivery of the medical and drug supplies.” The names of three drivers have been included in the draft report as having been responsible for transporting different amounts of the vaccine vials that never reached their intended destination.

responsible

One of the drivers is said to have been responsible for transporting 585 vaccine vials; another was responsible for 290 vials and the third one was for 195 vials. One vial (0.45ml) contains six doses of 0.3ml after dilution and for individuals 12 years of age and older , the comirnaty is administered intramuscularly after dilution as a single dose of 0.3ml regardless of prior COVID-19 vaccination status. For individuals who have previously been vaccinated with a COVID-19 vaccine, comirnaty should be administered at least three months after the most recent dose of a COVID-19 vaccine. There are special precautions for disposal and other handling as it is stated that comirnaty should be prepared by a healthcare professional, using aseptic technique to ensure the sterility of the prepared dispersion. The draft report states that under the Medicines and Related Substances Control Act of 2016, there are sections that deal with who should be in possession of medicines. Section 39 (1) under ‘control of medicines and scheduled substances’ states that a person shall not sell, possess or manufacture any medicine or scheduled substance, except in accordance with the prescribed conditions.

schedule

Subsection (4) states that a person shall not sell a schedule 1 substance (a) unless that person is a pharmacist, pharmacist intern, pharmacy technician, pharmacy technologist, pharmacy assistant or a dispenser acting in the scope of that practice; (b) unless that person is a manufacturer, wholesaler, retail pharmacy or hospital pharmacy and is selling the substance to any person who may lawfully possess that substance; (c) unless that person is a medical practitioner or dentist, who is authorised (i) to prescribe that substance for use in humans; (ii) or licenced under section 47 to compound and dispense that substance; (d) unless that person is a veterinary surgeon who may prescribe, compound or dispense that substance for purposes of the treatment of an animal; (e) unless that person is a pharmacist or nurse (i) who may prescribe only the scheduled substances identified in the schedule for that purpose; (ii) who is a holder of a licence issued under section 47, to compound and dispense the scheduled substances referred to in paragraph (e) (i); (f) to any person under the age of fourteen years except upon a prescription issued by;
(i) an authorised prescriber and dispensed by a pharmacist, pharmacist intern, pharmacy technician, pharmacy technologist, pharmacy assistant, or dispenser acting in accordance the scope of such practice; (ii) a veterinary surgeon for use in animals;
(iii) a person who is the holder of a licence issued under section 47; or (iv) on a written order disclosing the purpose for which that substance is to be used and bears a signature known to the seller as the signature of a person known to that seller and who is above the age of fourteen years.