About drug shortages ...

The Government of Uganda has made significant strides in recent years to enhance the National Medical Stores (NMS) budget, particularly for the fiscal year 2024/2025, which saw an increase of over Shs139 billion, significantly reducing the funding gap for essential medicines and health supplies.

This increase in budget would ideally increase the availability of medicines and medical supplies in government health facilities. Despite the substantial budget allocation, Uganda continues to grapple with chronic shortages of Essential Medicines and Health Supplies (EMHS) in government health facilities because due attention was not paid to the other inefficiencies within the medicines management cycle.

The medicine management cycle starts with the selection of the required medicines. If health facilities select medicines not aligned with the disease burden in the area or select medicines that are not on the essential medicines list, it will result in overstocking of non-vital medicines while vital medicines run out. 

The next step in the medicines management cycle is the quantification and procurement planning. The common gap in this step is the inadequate and inaccurate data on consumption or number of cases (morbidity). This leads to under estimation of demand resulting in stock outs.

After quantification, the next step is for health facilities to place their orders to NMS. If health facilities submit orders based on inaccurate consumption data, this will lead to inaccurate forecasting resulting into insufficient quantities required for use.

Poor stock management practices at health facilities such as lack of shelving, poor documentation and failure to observe First Expiry, First Out (FEFO), among others, could lead to wastage and expiry of medicines that are already available at the health facility hence causing stock out.

Under accountability and use of medicines, if there is insufficient tracking of consumption, there could be a possibility of pilferage or theft of government medicines. Under medicines use is also the chronic problem of irrational prescription for example overprescribing (polypharmacy), that would quickly deplete stock causing stock out of these medicines.

In order to deal with these inefficiencies and wastages within the medicines management cycle, NMS together with the Ministry of Health and partners, in 2022, revitalized Medicines and Therapeutic committees (MTCs) at health facilities across the country. A well-functioning MTC ensures the safe, effective and management of medicines in health facilities.

The committees comprise a diverse array of professionals, including nurses, pharmacists, physicians, and health facility administrators. Their core role is to guide on the appropriate management and use of medicines and health supplies, that will result in reduced or elimination of stock outs of medicines and health supplies in health facilities.

Over the past two years since their revitalization, MTCs have been critical in providing scientific, sound and cost effective evidence that guides intervention to support improvement in rational medicines use, addressing both the logistical and clinical aspects of medicines management.

Health facilities through their MTCs, as championed by NMS, the Ministry of Health and partners, should play a pivotal role in strengthening medicines management and use in their respective health facilities if we are to curb drug shortage in government health facilities.

The revitalization of these MTCs will strengthen medicines management and use, which will result in reduced stock outs.

Ms Sheila Nduhukire Principal Public Relations Officer of National Medical Stores. 
[email protected]