Posted by: rachelhampton | 02/12/2010

Past the expiration date: Drug wastage in Uganda

A myriad of factors prevent people from accessing life-saving medications in developing countries. Prohibitive drug costs, ineffective supply chains, mismanagement of drug supply, difficulties in forecasting local needs, and drug wastage all contribute to this problem. This week, an article published in the Bulletin of the World Health Organization examined the expiry of medicines in supply outlets in Uganda, identifying a number of factors that contribute to drug wastage. Consumption of expired drugs is extremely dangerous for the people taking them and their improper disposal can lead to both health and environmental hazards.

Recent evaluations of drug wastage in Uganda’s National Medical Stores by the Ugandan Ministry of Health and others have indicated 10 million does of antimalarials and US$550,000 worth of antiretrovirals (ARV) have expired. The problem of drug wastage includes not only public providers, but also extends to private wholesalers, hospitals, clinics and pharmacies. The study, which collected evidence through semi-structured questionnaires predominantly administered to pharmacists, supplies/store offices, and managers, identified a number of factors contributing to this problem:

  • Procurement of medicines with short shelf lives
  • Expiry due do treatment and policy change
  • Slow turnover of expensive medications
  • Slow turnover of medicines with unpleasant tastes
  • Slow turnover of medicines that treat rare diseases

How can the problem of expired drugs be mitigated? The report suggests a number of solutions that would help to prevent drug wastage.

  • Coordination between key stakeholders, including the national government and drug supplies, would reduce the expiration of drugs
  • Governments must work to curtail the entry of expired drugs, an issue often complicated by the donation of expired drugs, or drugs close to expiration dates.
  • Improved coordination between national governments and drug prescribers would help to reduce overstocking associated with poor communication of needs between these two parties about prescribing patterns and customer preferences.
  • National governments must also do a better job at forecasting drug needs and responding to population demand.
  • Supply chains and drug management must improve to prevent delivery bottlenecks.

These are just a few things that we can do to prevent drug wastage. Drug wastage is not only harmful to consumers, but leads to ineffective use of resources, including finances. It is important to squelch this problem to ensure the safety and efficacy of drug provision.

To read the full article, go to: http://www.who.int/bulletin/volumes/88/2/08-057471.pdf

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Responses

  1. Thanks for your effort to point out at those issues in my country Uganda where Ii live, Indeed drugs get expired while in stores and the most patient luck medicines when it is stocked the National stores getting expired thats when you here the line misitry reporting about them. Atleast they should donate them to Faith based Health Units where patients can get them effectively.

  2. I am not a medic but a social scientist.
    There was a time when MOH and WHO invested in training and re-tooling of all levels of staff on how to manage the various tasks on health delivery and management. There was a lot of that in PHC.

    What are MOHs and WHO doing to back up service delivery and ensure efficiency these days?


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