Online Reporter
STOCKS of medicines and health consumables, especially the listed essential drugs, are being built up and should be reaching hospitals and clinics that need them as NatPharm orders more.
At the moment NatPharm, the State-owned National Pharmaceutical Company, can supply roughly half of all required items to the 1 700 or so hospitals and clinics within the public sector. However, it expects to increase this to between 60 percent and 80 percent within three months as it adds stocks of almost another 400 lines of medicines and consumables.
Some of the pressure, and resulting finances, can be attributed to the unscheduled visits to Parirenyatwa and Sally Mugabe Hospitals in Harare last month by President Mnangagwa, where he was able to see for himself there were obvious shortages.
The President was also able to talk to professional staff who were more than willing to fill him in on their needs.
During his visit, President Mnangagwa was briefed that NatPharm had fairly good stocks, some of which were admittedly acquired through development partners who controlled their use. What would have been less obvious would be the missing lines, things that were needed regularly but were not in stock. It appears that the latest orders are looking at both sets of shortages.
While a total of 7 496 product lines are listed as being required, many of these are needed in only very small quantities, which is why adding just 400 of the far more common items to the list of what is in stock can drive availability up by as much as 30 percent.
This was the thinking behind the essential drugs list put forward around 40 years ago, a list of around 100 or so drugs that were needed for up to 90 percent of all ailments. The idea then was to expand what was already a promising local pharmaceutical manufacturing industry to make all the drugs on the list with an ever-increasing local content.
We would like to assume that this list has been updated over the years. Certainly there are drugs used to control HIV and in many other cases there are continual improvements in what is available, and especially what more modern drugs have come off patent and can now be stocked as generics at usually much lower cost.
We might still be able to cope with 100 drugs for 90 percent of all needs, although some of these would be different from the 100 drugs needed in the 1980s.
But the concentration of essential drugs within a fairly short list means that local production can be expanded significantly and here NatPharm is building relationships with suitable partners in Iran, India, Indonesia, and China for adding 49 new drugs to the 35 or so already produced in Zimbabwe.
Obviously the local manufacturers have to be able to meet the high standards demanded by the Medicines Control Authority of Zimbabwe before they can supply NatPharm and the private sector. Zimbabwe, with something so important as medicine safety, has adopted the best practice of a totally independent regulator and issuer of licences.
The control authority does not make, import, stock or sell any medicines, but it does make sure that every dose of every medicine used in Zimbabwe meets proper standards, generally by licencing every type made or imported into Zimbabwe. This is one area where “simplifying” regulation is not really going to get much traction, since it is important that every medicine is both safe and effective.
Besides medicines, Zimbabwe should be making more of the most common consumables, things ranging from bandages and syringes to the chemicals needed for the most common tests done at clinics and in laboratories.
Again there are probably thousands of different consumables that will be needed at one time or another over a year, but again like medicines, more than 90 percent of demand can be met by a fairly short list, so the economies of scale work for local manufacturers, who can quite possibly build up export orders as well.
If we can get a couple of hundred lines of the bulk of our medicines and consumables made locally, that will free up the finance to import the far smaller quantities of the many thousand lines we need to keep in stock of the final 10 or 20 percent of total requirements. That modest range of local production would also ensure that most needs can be met locally, important when there could be global shortages during some pandemic.
This is why the careful concentration of effort by NatPharm into small new product ranges can pay large dividends.
At the same time we need to build up our ability to produce vaccines, both nationally and regionally. Already, the Department of Veterinary Services makes a handful of livestock vaccines, and some of our neighbours have similar capacity. While human vaccines have higher standards, it seems that it would not be that large a jump for the most common vaccines to be made locally.
The Government has also taken the required steps to ensure that all Zimbabweans living with HIV can continue obtaining their anti-retroviral drugs that are so important not just to keep those with the infection living a healthy life, but also to suppress viral loads so that new infections fall to zero. NatPharm placed the orders for the second half of this year in time and the new stocks are arriving at the warehouses.
NatPharm also runs a careful management system to ensure that hospitals and clinics can have what they need, but that there is no waste and no medicines sit on shelves somewhere until they expire.
We have come a long way since the worst of the shortages, but we still need to rebuild and then build up our local pharmaceutical and health products industries. In doing so, we need to maintain the highest global standards, with NatPharm moving forward after its own reorganisation and upgrade.
