— says fast-tracking of critical drugs was necessary

THE Ministry of Public Health’s decision to fast track the procurement of critical drugs was necessary to safeguard the health of the nation, Public Health Minister, Volda Lawrence has said.

In an effort to minimise the negative effects the shortages of critical drugs were having on the health sector, the Public Health Ministry sought the approval of the National Procurement and Tender Administration Board (NPTAB) for ANSA McAl to supply drugs and pharmaceuticals to the tune of some $605M.

The Trinidadian conglomerate was among four companies, including New GPC, Health 2000 and ChirosynDiscovery from which these emergency supplies were procured.

“My priority is to ensure the nation’s health is given top priority. The health system will not be held hostage by unprincipled persons and therefore I made the decision to shortlist the critical but unavailable items and the suppliers with the ability to provide them on time to avert deepening the drug demand difficulties,” Minister Lawrence said in a statement on Saturday.

It was explained that other companies were not a part of this process, due to ongoing investigations into their late or non-delivery of critical drugs during 2016, to procure for the Georgetown Public Hospital Corporation (GPHC).

“Some of these pharmaceuticals were overdue by as much as six (6) months, which exacerbated the drugs shortage at the hospital. These are the same suppliers, who before May 2015, when all the pharmaceuticals for the nation was sole sourced from New GPC for billions of dollars, were given the opportunity under the Granger administration to become suppliers of pharmaceuticals to the Public Healthcare sector,” the Public Health Ministry pointed out.

It was noted that ANSA McAL is one of only two companies in Guyana that is able to provide the cold-chain storage necessary to maintain the integrity of a wide range of critical pharmaceuticals.

“ANSA McAL not only airfreighted the drugs (this helped spike the cost to import the items) for the public health sector, but also donated four refrigerators to GPHC to store the emergency supplies at the internationally acceptable temperature of 20 to 80 C,” the Ministry said.

It added that no other company in the history of the institution has provided cold storage facilities at the hospital, although one of them was the sole supplier of pharmaceuticals to the institution for over 20 years.

“All pharmaceuticals for the entire nation were sole-sourced from that company for billions of taxpayers’ dollars. During that period, GPHC used icepacks to store these sensitive drugs at the facility, because the main refrigerator was in poor condition and unable to maintain the correct temperature for these drugs endangering their efficacy, potency and integrity.”

It is alleged that moles involved in GPHC procurement system have been leaking information to the media with the aim of discrediting officials of the institution and often-times it is misinformation.

FAST-TRACKED
But the Ministry is maintaining that the tender process was never breached. The route to procure the emergency supplies was simply fast-tracked – a process which the National Procurement and Tender Board Act makes provision for.

The Public Health Minister had also said that a conspiracy among drug suppliers and ministry staff was responsible for the crisis in the sector.

When she moved from Social Protection to Public Health, Minister Lawrence said she was “greeted with the news of a shortage of drugs in the system” and immediately held talks with Material Management Unit (MMU) staff of the Ministry of Public health. Visits were made to several regional hospitals and the GPHC with the aim of correcting the problem.

Three months after taking up the post, Minister Lawrence said she is “still uncovering a combination of skullduggery, collusion, delinquency, deliberate breaching of established sector protocol by public health staff, manipulation of the of system by importers with the support of employees and fabrication of records, including evidence of bogus receipts.”

CROOKEDNESS
So pervasive is the practice that “we have had to call in the police to deal with staff who are selling drugs to private pharmacies,” Lawrence disclosed. According to her, the current drug shortage was a ploy manufactured by some unprincipled importers and crooked Public Health staff to enrich themselves.
“Without a shadow of doubt this shortage is manmade and created to cheat the country of medical supplies and cash… but I am not for sale,” Minister Lawrence said.

It was pointed out that some suppliers wait until the contractual delivery date is near and then indicate their inability to supply the items for which they have had been paid. Others, she said, supplied a few of the items then refuse to supply the remainder, blaming unexpected changes in the global market prices.

“This has created the supply gaps, creating acute shortage, especially in the outlying regions,” Lawrence said.

The Ministry said that while these companies are short-changing the Public Health Sector, the very items are available on the local market at very steep prices from the same suppliers and their pharmaceutical clients. As a result, private health institutions nationwide are forced to buy the now high-priced items in limited quantities to help meet the needs of their patients.

Based on the ongoing investigation, the Ministry said it is clear that the Public Health system needs urgent and massive overhaul.

The engineered shortage meant that drugs, which should have been in the Public Health System since 2016 to cater for demands in the first quarter of this year are not there, and this has far reaching implications for the tender process for drugs, Minister Lawrence said.

She is bracing for a fierce fight from suppliers and stiff staff opposition because they now feel threatened by the new course being chartered for the Public Health System.

“The fresh wind of change has brought open tender, a proper procurement policy which includes computerisation of information, storage of critical drugs under internationally acceptable conditions and the placement of pharmacists in wards of the GPHC,” the Ministry said.

In addition, the Pan American Health Organisation and World Health Organisation (PAHO/WHO) are throwing their support behind local efforts to help develop a proper and accountable public health system.

PAHO/WHO is helping to shape policy directions in the areas of procurement, distribution, storage and managing consumption levels of pharmaceuticals at the GPHC.