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KCCA health centres receive expiring drugs, says report
Treatment. Patients await treatment at KCCA’s Kisenyi Health Centre IV in Kampala recently. PHOTO BY RACHEL MABALA.
What you need to know:
- Commenting on the report, Dr Jane Ruth Aceng, the minister of Health, said although donors are allowed to donate drugs to some health facilities, there are guidelines in place which ought to be followed.
- Dr David Serukka, the KCCA director of public health, acknowledged receipt of the report but said he was unable to comment because his contract has just expired.
Kampala. Health facilities in the city under the jurisdiction of Kampala Capital City Authority (KCCA) are receiving drugs from donors with a short shelve period, according to an internal audit report commissioned by KCCA’s executive director Jenifer Musisi.
The Statutory Internal Audit Report for the first quarter 2017/18, which is dated October 31, 2017, a copy of which Daily Monitor has seen, was compiled by Mr Moses Bwire, the Internal Audit director.
The report sought to review the inventories of expired drugs and establish the likely causes before use in various health centres in the city.
The aspects of the inquiry included; drug inventories, drug delivery notes, staff who received, verified and signed the delivery forms, when the drugs were requisitioned and the shelf life of the drugs, among others.
According to the report, the expiry of drugs within a short period upon delivery, leaves patients stranded, leading to deaths.
Examples
For instance, the report states that Bukoto Health Centre III received 2,000 Determine Test strips on July 29, 2015, as a donation from the Joint Medical Stores, which had a very short expiry period. By January 2016, 900 strips had expired.
In March 2014, M/S Steadman Pharmaceuticals Private Ltd supplied 400 Gusdee drops, which are used in the treatment of rickets, to Komamboga Health Centre III. However, in August the same year, 385 units of the same drug had expired.
On September 5, 2016, Kampala Pharmaceuticals Industries supplied 400 tubes of Umbi-gel, an antibiotic applied on fresh wounds or umbilical cords, with an expiry date of March 2017. But before March, 305 tubes had expired.
The report further states the same facility received 810 bottles of Nevirapine syrup from Joint Medical Stores on October 25, 2016, but after dispensing, 599 bottles expired on November 2016.
Nevirapine is an anti-viral medicine that prevents HIV from multiplying in one’s body.
In July, the National Medical Stores (NMS) supplied 36 units of Huma Count Cleaner, a laboratory reagent, to Kisugu Health Centre III, but only one unit was issued to the laboratory as 35 units were recorded to have expired.
But the report notes that although Kisugu Health Centre III management indicated that the usage of the reagent was minimal, NMS kept on delivering more units of the reagent.
According to the Medicines and Supplies Manual of 2012, donation of drugs should be based on expressed needs from users and obtained from a reliable source. Also, used or returned medicines are not supposed to be accepted as donations.
However, the report queries the manner in which donors supplied the drugs, tasking KCCA directorate of public health to ascertain how expired drugs get into city health facilities.
NMS is mandated to supply drugs to all government health centres, but other donors can as well supply drugs, especially if a particular health centre is in need.
The report further states that although the drugs expire, they are stored in the same store with unexpired drugs.
Mr Bwire recommended that there should be clear guidelines on supplies from donations to avoid the accumulation of expired drugs.
He also recommended that the disposal of the existing expired drugs and chemicals be authorised to create space for useful stocks and also deter negative consequences.
NMS on the spot
A spot check in some city health centres by Daily Monitor revealed that acute shortage of drugs is at its peak, breeding a wave of uncertainty among health workers and patients.
For instance at Kitebi Health Centre III, a health worker, who preferred anonymity because he is not authorised to speak to the media, intimated to us that although they make requisitions for drugs to NMS, they are never delivered on time.
“At times, NMS gives us drugs which have a short expiry period and just after few months, they expire, causing a big drug shortage. We have complained several times but the same mistakes are repeated,” she said.
Ms Caroline Nabatanzi, 34, a mother of two, who we found at Kitebi Health Centre III, told this newspaper she had been at the facility for the two previous days but she hadn’t got drugs for cough.
“My children and I need medication because we can’t afford the high charges on drugs in private clinics and pharmacies. We ask government to equip these facilities with drugs because it’s where people like us can access drugs,” she said.
Ms Alice Amony, the chairperson of KCCA’s health committee, acknowledged the widespread problem of expiry of drugs in KCCA health centres, but said they are engaging relevant bodies to improve the dispensation of drugs to city health centres.
“We are planning to meet NMS to ascertain why they supply drugs with a short expiry period. Drugs in many health centres expire yet patients need medication,” she said.
Dr David Serukka, the KCCA director of public health, acknowledged receipt of the report but said he was unable to comment because his contract has just expired.
By press time, Mr Dan Kimosho, the NMS spokesperson, couldn’t be reached to respond to queries raised in the report as he is reportedly out of the country.
Mr Moses Kamabare, the NMS managing director, couldn’t pick our repeated calls by press time.
Health ministry speaks out
Guidelines. Commenting on the report, Dr Jane Ruth Aceng, the minister of Health, said although donors are allowed to donate drugs to some health facilities, there are guidelines in place which ought to be followed.
“We have a donation guideline as a ministry regarding drugs and we don’t receive drugs with a period of less than three months expiry date. The reason why we recommend six months expiry period is that the three months are for negotiations, while the other three months are for the health facilities to use the donated drugs,” she said. But the minister said the problem is with enforcement on how the donation guidelines should be followed. She also explained that NMS stores only offer drug supplies to government facilities.
KCCA clinics
Health facilities under KCCA include Kisenyi Health Centre IV, Kiswa Health Centre III, Kawaala HC III, Kitebi Health Centre III, Komamboga Health Centre III, Kisugu Health Centre III, Bukoto Health Centre III, City Hall Health Centre II.
National Medial Stores Supplies the drugs to City Hall II clinic, which then distributes to other health centres.
Although Kiruddu and Kawempe are also under KCCA, they are currently managed by Mulago National Referral Hospital.
