– Dr. Ramsammy warns
-53 per cent of medicines sourced from private sector failed quality assurance test
HEALH Minister Dr. Leslie Ramsammy is warning that the practice of self-medicating for suspected malaria is a dangerous one. He added that because of this practice the sale of malaria medicines in the private sector has become a thriving business in the hinterland areas and in Regions Two (Pomeroon/ Supenaam), Four (Demerara/ Mahaica) and 10 (Upper Demerara/ Upper Berbice).
“With the help of PAHO/WHO and USAID, the Ministry of Health conducted a survey of 45 pharmacies and shops in Regions One (Barima/ Waini), Two, Four, Seven (Cuyuni/ Mazaruni), Eight (Potaro/ Siparuni), Nine (Upper Takutu/ Upper Essequibo) and 10…77 specimens of anti-malarial artemesinin-based medicines were examined and 53 per cent failed one or more quality assurance tests done,” he said.
According to him, the tests were done in the USA and stressed that for people who prefer to merely buy malaria medicines from these places, instead of going to the health care facilities, they should note that the medicines they buy might be useless.
“All these medicines are available from the public health sector and they are free. However, they can only be dispensed after a diagnosis is made. I must emphasize that all the medicines procured by the Ministry of Health are from manufacturers licensed to manufacture these medicines and all the medicines have undergone rigid quality assurance testing before we procure them,” Dr Ramsammy said.

USELESS

The Health Minister explained that in all instances the medicines were found to be stored in inappropriate conditions which might make them less effective and in that way even when the medicines passed the quality assurance test, the storage conditions would have rendered them ineffective in curing malaria.
“This practice of self-medication is dangerous and is presently affecting the fight against malaria,” he stressed.
However, Dr Ramsammy noted that one of the encouraging signs from the study is that the previous practice of importing mono-therapy artemesinin has seemingly reduced, as more than 64 per cent of the pills were combination pills, with artemesinin and other malaria medicines in a single pill.
“The Ministry of Health continues to encourage importers of medicine not to bring in artemesinin mono-therapy into Guyana. We urge importers to discuss with us and seek advice as to where to buy medicines and what kind of medicines to bring in. It should be noted that the anti-malaria medicines found in these shops do not adhere to the National Treatment Guidelines for Malaria,” he said.

REAL THREAT

“The threat is real and while the health sector is doing as much as is possible, control of malaria depends on the cooperation of all stakeholders,” Dr. Ramsammy cautioned.
He pointed out that presently more than 90 per cent of the malaria cases come from Regions One, Seven and Eight.
“There are some malaria cases in parts of Regions Two, Nine and 10.” “Malaria cases in other Regions are rare. The cases treated at the GPHC are almost always coming from one of the regions prone to malaria,” he said,
The Health Minister added that Guyana continues to fight against malaria, but noted that it has been a struggle.
“While this public health scourge is one Guyana has been able to reduce in recent years, going from 92,000 cases annually to about 10,000 cases, we have had to struggle to ensure malaria does not get out of control again,” he said.

BRING BACK DDT

Dr Ramsammy is of the view that Guyana and the world over need what he describes as the ‘knock out punch’ to eliminate the malaria scourge plaguing the health sector and causing unjustifiable deaths.
In the 1940s malaria was rampant, particularly on the coast, at which time DDT was introduced by an Italian doctor George Giglioli.
By 1951, malaria and its principal carrier had been completely eliminated from the coastal areas, including Georgetown, by means of a highly focused house spraying campaign.
In the interior, where settlements were widely scattered and difficult to get to, it was impossible to completely eliminate the disease since the mosquito lived in the forest there, not in houses.
However, in 1962, American biologist Rachel Carson wrote the book Silent Spring which catalogued the environmental impacts of indiscriminate DDT use in the USA and questioned the logic of releasing large amounts of chemicals into the environment without fully understanding their effects on the environment or human health. The book suggested that DDT and other pesticides cause cancer and that their agricultural use was a threat to wildlife, particularly birds.
The book produced a large public outcry that led to a 1972 ban in the US and the use of DDT was subsequently virtually banned.
Dr Ramsammy is of the opinion that there needs to be a review of the perceptions surrounding the use of DDT and pointed out that the non-use of DDT was based on the effects its use had in the agricultural sector – since DDT had a dual purpose, for agriculture and for vector control.
The Health Minister noted that there is not sound evidence which indicates that DDT as a vector control agent is a hazard, but agreed that the use of DDT in the agricultural sector will have negative impacts.
“It seems an unwise decision not to consider wider use of DDT in a controlled manner,” he said.
The disease continues to be a major contributing factor to the death toll; be the cause of disability; be the cause of impoverishment in families and within communities; impact national economies; and impact productivity, especially in mining and forestry sectors.
Malaria is caused by a parasite called plasmodium, which is transmitted via the bites of infected mosquitoes. In the human body, the parasites multiply in the liver, and then infect red blood cells. Symptoms of malaria include fever, headache, and vomiting, and usually appear between 10 and 15 days after the mosquito bite. If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs. In many parts of the world, the parasites have developed resistance to a number of malaria medicines.