Given the hype that usually preceded the former Minister of Health, and followed him as well, the revelation in the 2010 Auditor General’s Report, tabled in Parliament last week, that nearly $40 million in expired drugs had to be destroyed was shocking, even more so when it was made clear that there was still a large quantity of expired stock on hand pending processing and destruction. What a shame!
There have been instances in the past where patients attending this country’s public hospitals were told that certain drugs for which doctors had written prescriptions were not available and would have to be purchased at private pharmacies. The financially-strapped average patient seeking medical attention at the Georgetown hospital and other public medical institutions around the country, would then be either seriously out of pocket if s/he purchased the drugs or in continued ill health if s/he did not. Reprehensible, when one considers the fact that over $40 million in drugs either as a result of over-purchasing or incorrect purchasing would have been lying in the ministry’s stores awaiting the arrival of their respective expiry dates. And of course, patients’ comments that the public hospitals were only able to dispense “pain killers” have always been stoutly denied.
One has to be fair and note that the free distribution of antiretroviral drugs—used to suppress HIV, the virus that causes AIDS—has been mostly trouble free. However, it is also worth noting that for a large part of Dr Leslie Ramsammy’s tenure as minister of health, AIDS was sexy – not literally of course. But it was the epidemic that, worldwide, attracted billions of dollars in funding for sensitization and awareness and care and treatment including medicines.
A sore point, particularly with donors who would have demanded transparency, would have been the Ministry of Health’s insistence on single sourcing antiretroviral drugs from the New GPC, which was manufacturing the generic form of the drugs here without patent and also without the necessary checks and balances that attend the making of these medicines at companies that developed them in the first place.
Dr Ramsammy’s staunch defence of this practice, which was part of his ‘finger in every pie’ style of managing his ministry, places the fallout for the $40 million in expired drugs squarely in his lap. Obviously, he would not have been personally responsible for minding the store, but in any case as the minister under whose tenure it occurred, the buck stops with him. The image Dr Ramsammy had projected of a busy minister behind a well-oiled machine of a ministry now seems a sham.
What should also be investigated is whether these expired drugs were purchased or gifted; the period when they were purchased or gifted and what efforts were made to send them to the public hospitals so they could be utilized. It would also be interesting to discover exactly what the ministry’s procurement process was; for instance, whether it used patient data and projections to place orders; and if that same system remains in force. The AG report said that the head of the budget agency had advised that the ministry was in the process of carrying out a 100% stock count after which it would move from maintaining a parallel manual system to a fully computerized inventory. Any business worth its salt does annual stock-taking, and the Ministry of Health, knowing that its stores hold perishable items ought to have been even more vigilant than the average business. And while the computerization of the inventory makes good sense, it will only work if the humans whose task it is to enter the data do their jobs. Their performance to date has been far from inspiring.