Despite efforts used and put in place to prevent loss of much-needed medicines, there is still poor inventory management and big loss due to expiry of medicines at the Government’s Medical Procurement and Production Division (MPPD), the agency that handles medicine imports.
During five years from 2014 up to 2018, medicines valued at Rwf 6,046,778,655 expired before reaching the patients, according to study published in current issue of the Rwanda Journal of Medical and Health Sciences.
Expiry of medicines was recorded highest for medication treating HIV/Aids accounting for 53.3% of the total, followed Essential Medicines 22.5%, Malaria 13%, Maternal Child Health commodities 5.7%, Products used for Community health workers 4.5%, TB products 1% and 0.1% for Family Planning products.
The team of four Rwandan researchers found that the causes of expiry of medicines are varied. The study found that major contributing factors for expiry of health commodities at the government agency “were related to supply chain management (e.g: selection, ordering, and supply planning), poor storage management and Excessive drug supply”.
With excessive supply, the researchers discovered that Rwanda’s donors are importing or donating vast amounts of medical materials which the government’s medical materials supplier is unable to absorb.
Since there is huge donor involvement in HIV/Aids and malaria like the Global Fund, with millions of dollars involved, it appears the medicines are simply flowing into the country and ending up unused.
As of 2019, the Fund’s Auditor General report shows that the Global Fund has invested about US$1.4 billion in Rwanda since 2003. For the period from 2020 for the next three years, Rwanda will receive $210m.
This amount pays for different things including ARV medication for HIV patients, mosquito nets, malaria medicines, Tuberculosis treatments and directly funding government health systems.
See total annual value of expired medical materials
As seen from the table, in 2015 alone, medical items worth over Rwf 1.8billion were expired. The figure went down slightly in 2017, but again rose the following year.
To deal with this loss of essential medicines, the researchers propose: “….best coordination of government projects or vertical programs and public stores of health commodities can improve the problem of overstocking which is mainly associated with duplicated procurement, and of course, the harmonization of medicine quantification with habits in prescription and preferences of patients to ensure supply matches turnover.”
They add: “An attention should be kept when receiving donations because they sometimes near to expire. Products with short shelf life should be procured in quantities to direct distributed to the clients to be used before their expiration.”