Exposed: Sale of government drugs in foreign lands

The Standard

TB/HIV Intergration workshop

On 22nd July,2009 NZP+ Lusaka held a workshop where 22 NZP+ members attended ,the last session of the workshop was a presentation on the stop stock outs campaign ,the presentation was done by casco Mubanga one of he country team member, in his presentation Casco introduced the essential medicine concept and the stock out campaign, it was mentioned that availability of essential medicines in clinics was key for opportunistic infections for people living with HIV, a discussion was held to make people understand what was a stock out, the consequences of stock outs of essential medicines and the role of the community in the stop stock outs campaign,also in the presentation Banza Chela from TALC took part in the presentations, in the same workshop Claudio a fellow from New York made another presentation on the Pill SMS week.

Claudio talked about the SMS campaign and the feedback received from other district that participated and he also echoed that this data was very useful for advocacy, he said advocacy was more meaningful with such data from the ground, in the same presentation Claudio briefly mentioned about the technical part of the SMS system, at the end Claudio shared a video interview that was done with a patient that had suffered from Malaria unofrtunately experienced a stock out of anti malaria from Chipata clinic where she went to seek for treatment, she was forced to buy the drug from the private pharmacy. The campaign was welcomed by participates who showed a lot of interested in the project and pledged full support for the campaign. Fact sheets that have been produced for the campaign were also distributed in the workshop.

MeTA stakeholders workshop

NZP+ Lusaka is a member of the Zambia Medicine Alliance Transparency (MeTA) Civil Society Organizations Coalition, The coalition held a workshop on were 14 civil society organization attended, a presentation was made on the stop stock out campaign, the presented covered the concept and aims of the campaign, this presentation Casco the stop stock outs campaign country team member asked the presented to join the campaign and push government to increase access to essential medicines. All the civil society present pledged to support the campaign, in the presentation another presentation was made by Claudio Midolo the OSI fellow who was in the country to building capacity in the country team on SMS pill stock out system, website and video shooting and uploading the video on the website, in his presentation Claudio gave an overview of the technical part of the SMS system and how the data collected can used to in the media
and for advocacy. Most participate showed a lot of interested in the SMS and made suggestion on how the SMS can be improved, suggestion were noted and appreciated and some them suggestion made were incorporated in the System and data collection strategy. In this workshop the stop stock out concept was introduced and a strong networking was initiated with the 14 CSOs that were present. The stop stock outs campaign country team will continue to work these CSOs as stakeholders in the campaign

Kisumu residents demand for essential medicines

Tuesday 14 July 2009 Kisumu: People thronged the Pollyview Hotel in Kisumu, the third largest town in Kenya, to hear about stock-outs of essential medicines in the country. The overzealous crowd was composed of Kisumu residents from various walks of life including youth groups, health workers from communities and facilities around the city, peer educators, civil society organizations (CSOs) and non-governmental organizations (NGOs), patients and the general public.

The crowd was empowered, knowledgeable and mos of all knew their rights. A prompt from the Kenya Hospices and Palliative Care Association’s (KEHPCA) David Musyoki made them ready to take up the “stop the stock-outs” banner, march the streets and demand that essential medicines be made available to them.

“We have always thought these medicines for opportunistic infections must be bought by ourselves! But now we know that we have a right to get these medicines from public health facilities,” exclaimed Njoki Kimemia, a woman living with HIV in Kisumu.

Eunice Owino, who works for a local community based organization (CBO), said there are serious problems in hospitals in the region in regards to medicines. “As a CBO we are faced with a lot of challenges because patients who are sent away from public health facilities turn to us for medicines which we do not have.”

Patience Aoko, a nurse at New Nyanza Provincial General Hospital, said she has frequent contact with people who need medicines. “I am happy about this stop stock-outs campaign that will ensure access to medicine for all in the country,” she stated.

As a health worker in a government hospital she said the challenge of accessing medicines is real. She added that they turn a lot of patients away because a needed medicine is out-of-stock. “Most public health facilities lack medicines which are essential and treat common illnesses,” she observed.

The Kenya Treatment Access Movement’s (KETAM) James Kamau told the gathering that he was saddened by the fact that people continued to die from preventable and treatable diseases. “Without a healthy nation you cannot achieve development. Our people are dying while letters we write to the Permanent Secretaries at the Ministries of Health regarding serious stock-outs of essential medicines countrywide have not been responded to. It’s been more than a month since we wrote them!” he lamented.

Some of the new issues that emerged form the forum included:
 Taxation on VCT test kits used by NGOs
 There are reported cases of medicines released from the central stores never reaching their intended destination. This calls for transparency and accountability along the supply chain and for full independence of the central medical supplies agency (KEMSA).
 Health workers at the grassroots level have a rich experience of unavailability of medicines in their facilities.

Emma Wanyonyi of the Consumer Information Network (CIN) noted that the public needs to be assertive and take responsibility for their health, including when they are unable to access medicines. From the experience of the health workers, the passive nature of many patients contributes to the inefficiency, negligence and corruption at health facilities. “The public needs to be empowered. This is part of what the “stop the stock-outs” campaign, and the public forum in particular, aims to achieve.”

[caption id="attachment_245" align="aligncenter" width="336" caption="James Kamau of KETAM stressing a point at the Kisumu public forum"][/caption]

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Material produced
Four fact sheets.
Essential medicines concept from WHO
Distribution system from the central medical stores
Campaign statements
Government commitments.

Media coverage
The stop stock outs campaign launch done on 8th April 2009 was covered by Radio 4, a national radio station, and Zambia National Broadcasting Corporation TV station.

Reports
World TB Day
On 24th March 2009, a joint participation of 15 Network of Zambian People Living with HIV/AIDS NZP+ members and 10 Treatment Advocacy and Literacy Campaign (TALC) members, participated in the World TB Day in Mongu district in western province of Zambia. At this event a speech was given by a TALC member who talked about the consequences of stock out of essential medicines specifically TB drugs and ARVs. Top government official present were the Deputy Minister of Health, the Provincial Minister and other top officials in the ministry.

World Health Day
The world health day took place on 7th April 2009 in Lusaka. There was another joint participation of 20 marchers of NZP+, TALC, churches, nurses, and members of the public who marched together with other line ministries and civil society organizations. The minister of health and his entourage was given the stop stock out leaflets and NZP+ Staff Casco Mubanga briefed the minister and WHO country representatives about the stock outs campaign.

Campaign Launch
The launch of the stop stock out campaign took place at Chrismar Hotel on 8th April 2009. It was attended by more than 30 people. TALC staff Chris Mumba spoke at the launch and revealed two events of stock outs of ARVs in the Eastern Province of Zambia. Casco Mubanga of NZP+ presented about essential medicines concept. The campaign was officially launched by the Director of Clinical Care Ministry of Health Dr. Simpungwe who represented the Permanent Secretary Ministry of Health.

Annual General Assembly
Casco Mubanga presented on the Stop Stock-Outs campaign at the NZP+ AGM 2009. The presentation touched on the concept of essential medicines, the stop stock out campaign and countries involved in the campaign. District coordinators from all 72 districts in Zambia were asked to support the campaign and also to take part in the SMS pill exercise scheduled for the week of 22nd to 26th of June 2009. The campaign was highly appreciated by participants including NZP+ partners.

Monitoring visits
One monitoring visits has been done in Chipata district in the Eastern province. During the visit a central provincial pharmacy was visited and the provincial pharmacist was interviewed. It was revealed that kits from medical stores are received once in a month at a given date, the real challenge being transportation to the local health facilities. Some two pharmacists interviewed from Chipata Central Hospital and at Mwami Mission hospital said that one of the causes of stock outs was lack of trained pharmacists in local health centers including the central provincial pharmacy.

Poor working conditions for rural pharmacists was said to have contributed to diversion of medicines by pharmacist which leads to stock outs. Also lack of refresher training by government in forecasting and data system management contributed to poor planning which leads to stock outs and over stocking of drugs.

The two pharmacists interviewed recommended that pharmacists in the province need to communicate in to order to have information on which facilities have stock-outs and also those that have over stocked specific medicines which can re-distributed to the facility with a stock out of that specific medicines.

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