Dr Bheri Ramsaran’s counterfeit drugs pronouncement
The current raging controversy over the allegation made in another section of the media that hugely inflated prices were paid for drugs imported by the New Guyana Pharmaceutical Corporation (NGPC) for the Government of Guyana is not the first health sector-related controversy in which Dr Bheri Ramsaran has had to fight the administration’s corner. Two of the better-remembered recent instances are the spate of maternity deaths at state-run hospitals and the less than convivial learning environment at the Guyana School of Nursing.
In the former instance the combined efforts of the Health Minister and the rest of the government’s image management machinery have been insufficient to dispel the public view that many of the deaths were avoidable. In the matter of the deficiencies at the Nursing School Dr Ramsaran, rather than address what his ministry would do to improve conditions at the school, chose instead to direct a coarse and tasteless personal attack at Guyana Public Service Union President Patrick Yarde after Mr Yarde had echoed the concerns expressed by health professionals over the state of the institution.
Even making allowances for the fact that it has only been seven months or so since Dr Ramsaran was given full responsibility for the Health portfolio, his report card in defence of that portfolio leaves much to be desired. He appears to encounter, variously, problems associated either with an unnecessarily combative posture in the articulation of his public pronouncements, or else, with deficiencies in the substance of the pronouncements themselves.
In the instance of the NGPC brouhaha – a matter which has now become a political battlefront for the parliamentary opposition – the Health Minister is guilty of the latter shortcoming, demonstrating again that his image-management skills leave a great deal to be desired.
This, one might point out, is the last deficiency which the administration needs in its cabinet ministers given what, these days, is its frequent need to defend itself over one accusation or another.
Having recently returned from a conference of the World Health Organization (WHO) where the globally troubling issue of the use of counterfeit and expired drugs, particularly in poor countries was ventilated, it appears that Dr Ramsaran might have gotten it into his head to create a linkage between the NGPC drugs import controversy and what he says is his ministry’s concern to avoid the importation of counterfeit drugs. It is, to say the least, a disingenuous attempt at a linkage since, on the basis of the available evidence, Dr Ramsaran will be hard-pressed to persuade the public that counterfeit drugs is one of his ministry’s primary concerns.
In March this year, prior to the current NGPC brouhaha the Health Minister had expounded on the same issue in an article titled ‘Trade in counterfeit drugs giving Government a headache,’ published in the March 26 issue of the Guyana Times. Since then he has been quoted publicly on the matter in the June 12 issue of the Guyana Times and the June 20 issue of the Guyana Chronicle. In each instance he expounded elaborately on the issue, seeking to create the impression that protecting Guyana from the scourge of counterfeit and expired drugs was firmly positioned on his ministry’s front burner.
Even taking account of the vulnerability of our borders and the unchecked flow of drugs and other illegal imports which successive governments have done little to address, the reality of the present government’s track record on otherwise controlling the importation, sale and use of counterfeit and expired drugs is at variance with the posture taken by Dr Ramsaran. Indeed the extent of the current crisis associated with the administration and use of drugs, particularly in the interior, is mirrored in the recent pronouncement by APNU Shadow Health Minister Dr George Norton that the drug ampicillin, an antibiotic in the penicillin group of drugs used in the treatment of many different types of infections caused by bacteria, “is sold in sweetie jars in the interior.” This pronouncement has gone unchallenged by the Ministry of Health as has the widespread assertion that the expansion of the mining sector and the unchecked movement of foreign miners into the country have significantly increased the cross-border flow of illegal drugs.
Among the Health Minister’s various utterances on the issue of counterfeit drugs are assertions of “bribery” which presumably occurs in the policing of the counterfeit drug trade and what he says is the “sluggish and inefficient” nature of the monitoring system, a circumstance for which he appears to hold officials with monitoring responsibilities – presumably officials of the Food and Drugs Department – responsible.
Ironically, much more than the present Minister of Health or his predecessors – and as reportage in this newspaper over quite a few years will show – the Director of the Food and Drug Administration Depart-ment, Ms Marilyn Collins, has been forthright in articulating her concerns over the country’s vulnerability to counterfeit drugs. Recently she disclosed that the department is staffed with eight pharmacists, a circumstance which renders the effective monitoring of the various legal and illegal ports of entry well nigh impossible, and it is this weakness, it appears, that leads her to the conclusion that her department simply “cannot guarantee” that counterfeit drugs do not remain a serious problem in Guyana.
In public comments made to this newspaper previously Ms Collins had pronounced on the human resource limitations of her department that impede even the monitoring of drug imports at legitimate ports of entry, and snags associated with the efforts of the department to collaborate with the Customs Department to help monitor drug imports. Some years ago she told this newspaper that the effectiveness of the monitoring capabilities of the department depended to a large extent on the voluntary submission of imports for inspection. We have been unable to determine whether that state of affairs still exists.
While Dr Ramsaran may argue, as he does, that it will take time to arrest the importation of counterfeit drugs – particularly across the country’s open borders – he is yet to say, for example, whether or not the ministry has taken any action in what, by his own admission, have been cases of “bribery” of public officials, which cases are surely traceable, whether or not his ministry has been strengthening the human resource capacity of the Food and Drugs Department to allow for more effective monitoring operations outside the coastal areas, and what is being done to sanction those known cases of counterfeit drugs being openly offered for sale to the public. And given what we know about the increasing movement of people from coastal to interior areas, has the Ministry of Health been paying specific attention to those remote regions in order to raise drug administration standards above the status of the pedalling of ampicillin in “sweetie bottles”?
Dr Ramsaran ought surely to be aware by now that official pronouncements are not the only means by which information enters the public domain, and that in the particular instance of counterfeit drugs there are other sources from which verifiable information can be gleaned without a great deal of trouble. If he is not then such efforts as he makes to manage the image of his ministry remain vulnerable to derision and ridicule by a public that is far better informed than he appears to think.