Zim runs out of health drugs 

Source: Zim runs out of health drugs – The Zimbabwe Independent October 5, 2018

MAJOR pharmaceutical wholesalers in the country suspended operations indefinitely on Monday after running out of stocks owing to a crippling foreign currency shortage, triggering a massive scarcity of life-saving drugs that is putting millions of lives at risk, the Zimbabwe Independent has established.

BY ANDREW KUNAMBURA

The foreign currency crisis has also affected drug manufacturers, who import most of their raw materials.

The Pharmaceutical Society of Zimbabwe (PSZ) said this week the majority of pharmaceutical wholesalers have stopped trading after failing to replenish their stocks due to forex shortages.

Reserve Bank of Zimbabwe (RBZ) governor John Mangudya admitted that due to the huge backlog of foreign currency allocations, the central bank has not been making timely allocations to priority areas, including the health sector.

The foreign currency shortages have crippled importation of essential drugs and raw materials, which account for between 70-90% of the country’s needs.

The suspension of operations by the suppliers of most of the country’s critical medications has turned the nation’s chronic drug shortage into a full-blown health crisis, threatening the lives of millions of Zimbabweans.

Investigations by the Independent show that essential drugs such as sodium valproate and lamotrigine for epilepsy were out of stock while drugs for hypertension (high blood pressure) such as tenoric, atenolol, nifedipine, cardura, bisoprolol, aldactone, valsartan and hydrochlorothiazide containing medicines were last supplied to some pharmacies three to four months ago. The pharmacies have now run out of stock, putting at risk millions of hypertensive patients.

According to the Ministry of Health, the number of new patients diagnosed of hypertension has been increasing with 718 648 cases reported in 2016. In Zimbabwe, the prevalence of hypertension is estimated at 30% of the total population, which is higher than HIV, tuberculosis and diabetes.

In addition, diabetes medications like ranophage, glimepiride and insulin are also in short supply.

Health sources also said pharmacies have run out of allergy medicines such as promethazine, chlorpheniramine cetirizine, anti-coagulant warfarin and xarelto as well as some basic medication like painkillers and anti-biotics. Slow-release morphine needed by cancer patients is also out of stock.

“Some of these medicines have been out of stock for the past three to four months. These are just a few of the essential drugs in short supply. The country is now sitting on a health time bomb, which cannot be wished away because people will die if nothing is done soonest,” one retailer said.

PSZ president Portifa Mwendera said despite an earlier commitment by the RBZ to prioritise the industry in the allocation of foreign currency, the central bank has, for the past six months, failed to honour its pledge of releasing US$4 million every week.

PSZ is the umbrella representative body for pharmaceutical manufacturers, wholesalers and retailers.

In terms of RBZ policies, companies willing to import request payment of specific amounts to their trading partners through their bank’s nostro accounts. These are accounts which banks hold in foreign currency with other banks outside the country.

The bank would then request approval from the RBZ, which then does its allocations depending on the available foreign currency reserves.

However, the central bank has been failing to make meaningful allocations.

Mwendera said the RBZ has allocated only US$7 million for the second quarter.

“They (wholesalers) don’t have stocks for most of the imported drugs. The country is now in serious trouble. We are not getting any foreign currency allocation. We require US$4 million per week and the RBZ committed itself to make those allocations but this has not happened,” Mwendera said.

“The last allocation was made in the second quarter for April to June where we got only US$7 million, the bulk of which went to public hospitals. There was no allocation at all in the third quarter and now this is the result.

“To make matters worse, we used to get drugs on credit from foreign suppliers, but since we started having these foreign currency issues, no one gives us anything on credit anymore. The coming weeks could be critical.”

He added that: “We have non-availability of some drugs such as insulin and oral anti-diabetic as well as salbutamol inhalers. Blood pressure drugs such as atenolol and nifedipine have been out of stock for months now. This is making the management of patients who need these chronic medications quite difficult and costly. It had been our hope that monetary authorities would move with haste to address the dire need that exists in the sector.”

Mangudya said the backlog was attributable to high demand for forex from various sectors.

“We shall be attending to this priority requirement with the objective to reduce the backlog and to meet current requirements,” he said.

Zimbabwe imports 70-90% of its drugs, hospital consumables and equipment at a total annual cost of US$400 million.
On Monday, one supplier notified its customers that it was rationing supplies due to dwindling stocks.
However, just hours later, the supplier said it was suspending all sales until further notice.

“Please note that our stock levels are now low and we do not have enough to meet current demand. We therefore will be rationing stocks to US$2 000 per customer per week. Please bear with us until the situation normalises,” reads a notice sent to a pharmaceutical chain.

Hours later, the same supplier wrote them stating that: “We regret to inform you we have suspended all sales with immediate effect. For those who had placed orders, please note we are holding them awaiting further instructions. We sincerely regret any inconveniences caused.”