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M2 million ARVs left to expire

Pascalinah Kabi

MINISTRY of health officials in the previous seven party administration and pharmacists sat on stocks of antiretroviral (ARV) medication resulting in the expiry of M2 million worth of the drugs that could have saved thousands of lives and boosted the country’s fight against the deadly pandemic, the Sunday Express has learnt.

The development has left senior Health Ministry officials in a quandary over how best to respond to the issue. The gravity of the situation was reflected in the ambiguous statements that the Health Ministry’s Principal Secretary, Monaphathi Maraka and Director Disease Control, Dr Mosilinyane Letsie, recently made to this publication over the issue.

Both officials suggested that there was negligence and said that some heads should have rolled over the debacle which they described as an “embarrassing development” for the ministry.

But within the same breathe, the duo suggested that the expiry of the drugs was an unavoidable consequence of the fact that health practitioners abandoned the old ARV regimen after the 2016 decision by the World Health Organisation (WHO) to recommend new ARV medication for children living with HIV.

In a recent interview with the Sunday Express, Mr Maraka owned up to the costly debacle, saying although the ARVs expired in May 2017 during the tenure of the previous government, they would take full ownership of the embarrassing and costly development. He said they were also making arrangements to safely dispose of the drugs which were currently stored in a warehouse in the Berea district.

The 2017 elections swept aside the former seven parties coalition that was led by Thomas Thabane and ushered in the four party administration headed by All Basotho convention leader, Thomas Thabane.

“It is true that approximately 200 boxes of antiretroviral medication estimated to be worth M2 million expired in May 2017,” Dr Letsie said, adding, “The syrup medication was for children living with HIV”.

Both officials speculated that the debacle could have been caused by the fact that that local health practitioners abandoned the old ARV regimen after the decision in 2016 by the World Health Organisation (WHO) to recommend new ARV medication for children living with HIV.

Dr Letsie however, conceded that the old regimen should have been fully utilised before moving on to the new regimen, adding it was not clear to them as the ministry why pharmacists simply abandoned the old stocks and let them expire.

The general medical practice is that once a patient begins taking prescribed medication, they must take the entire course before moving onto something else.

For his part, Mr Maraka suggested that there could have been negligence within the ministry resulting in the expiry of the medication as well as the attendant huge cost implications.

“I should have fired somebody over this because someone should have seen this coming and the ministry should have standardised the use of new regiment but we didn’t,” Mr Maraka said.

Former Health Minister, ‘Molotsi Monyamane, who was at the helm of the ministry at the time the drugs expired said he was this was the first time he heard of the issue.

He blamed the Ministry of Health workers for this development, saying Lesotho ordered ARVs every six months and that the children’s medication should have been consumed before placing the next order.

“This is a serious thing that needs to be addressed because we cannot just order new medication without consuming the one that is already in stock only to wait for it to expire and dispose of it,” Dr Monyamane said.

He also said civil servants in the ministry should stop dragging their feet and implement the electronic supply chain and logistics management programme which is aimed at assisting Lesotho to effectively manage its medicine supply chain.

“The Americans have given the government of Lesotho a lot of money to implement this programme but there has been a lot of resistance from the workers in the Ministry of Health.

“At the moment things are done manually and at the end of the day we don’t really order what we need, we either under or overstock,” he said.

He said 75 percent of the ARVs were distributed freely in Lesotho as they were paid for by taxpayers. He added that it was sad that it was “really sad” that the taxpayers’ hard-earned money had been wasted on purchasing ARVs which were then left to expire.

While conceding that the ministry could have erred, Mr Maraka however, said the expiry of the ARVs could also have been caused by the reduced demand for the medication after some of the patients  attained the legal age of majority which meant they had to move on to medication for adults.

He added that another factor could have been that the new drugs were cheaper with less side effects and this could have persuaded the clinicians to abandon the old regimen.

“When the WHO issued a statement saying that the new ARV drugs were cheaper and less toxic on the children, it became an ethical question of whether or not to continue to administer the old medication just so that it is consumed before it expires or to move on to safer medication,” Mr Maraka said.

He said the costs of the expired medication was not worth the side effects it had on the children.

Asked why they were only making arrangements to dispose of the medication when it expired early last year, Mr Maraka said they only after received a report that the medication had expired a month ago when a ministerial delegation toured the Berea Warehouse.

He said the ministry has since written a report which will soon be shared with development partners and the ministry’s environmental health department would soon advise them on how best to dispose of the medication.


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