BY FIKADU BELAY
Medicines are one of the critical elements of a well-functioning healthcare system, but their expiry remains one of the significant challenges to the healthcare sector and environmental protection. The essential drug classification is unique to each country, as what may be regarded as non-essential in one country may be critical in another country due to each country’s disease patterns and level of development.
An estimated one-third of the global population does not have regular access to medicines. Moreover, more than half of the population has no regular access to essential medicines. Some 10 million lives a year could be saved by improving access to essential medicines and vaccines, out of which around 4 million are in Africa and South-East Asia alone. Bedria Hussien, Director of health institutions’ qualification and Inspection in Addis Ababa’s Food and Drug Administration Authority, told the Ethiopian Press Agency that the organization conducts regular inspections twice a year to protect the public from becoming exposed to expired medications and the consequent serious health effects.
Expired medicines have a high likelihood of being re-circulated into the market. Expired products are not only ineffective but can also result in the emergence of resistance to antimicrobial agents and toxicity in humans and other animals. Expired medicines pose risks to food chains and water sources if not properly disposed of. She stated that in the last six months 78 private drug retail organizations and health institutions have discarded 80,620 kilograms of expired drugs from their stocks. The disposal of these expired drugs has incurred an expense of more than 103 million birr.
She explained that many medications have been kept in stock beyond their expiration dates instead of being disposed of due to scarcity of disposal facilities in the capital. She mentioned that some private hospitals currently have equipment for the disposal of expired drugs. Among the government run medical institutions, Yekatit 12 Hospital in Addis Ababa owns such facilities. Minimizing the expiration of drugs, especially the essential drugs, is also incorporated in the category of appropriate usage. In the poorest countries of Africa and Asia despite being purchased with an out lay of high cost, they are still vulnerable to expiration and poor availability due to problems in transportation and storage.
Other reasons for the alarming level of expiration of drugs could be the supply or presence of excessive stock in the hands of few drug stores or short expiry dates, among others, it was learnt. Drugs appearing to expire in public health center pharmacies before being given to patients seem to be a frequent issue that may be caused by a variety of reasons, like the health center’s inefficiency. Drug and Therapeutics Committee is responsible for identifying working mechanisms that lead to drug expiration like lack of first in first out (FIFO) and first expiry first out (FEFO) practices, large orders of rarely used medical products that have high likelihood of expiration, a lack of pharmacist oversight when placing pharmaceutical orders, a lack of stock rotation among hospital pharmacies, and the tendency of doctors to prescribe specific medications are all factors that contribute to the problem.
For a system that is already limited by a lack of access to treatments, the expiration of medications is an issue. Often, inefficient supply chains are a factor in drug expiration that results in higher costs or lower patient service levels. It is essential to determine the factors contributing to expiry at each stage of the supply cycle to design pragmatic strategies to reduce the problem. The administrative measures taken against drug retailers caught in possession of expired drugs includes suspension of their business licenses for three months to one year; Bedria, said adding that such administrative measures have been applied on some drug retailers in the metropolis.
Before Four years ago, people were gravely harmed by the disposal of outdated medications, which included burning and burying them. She noted that not only would this method of disposal pollute people and animals, but also the environment’s natural resources like soil, water bodies, and the climate. She said that now-a-days method of disposal varies according to the nature of the drugs, but solid drugs are disposed of by grinding and burning through machines. The ashes are buried to prevent the harmful impact on soil fertility and water pollution.
Medicines and their management are an important health system function in improving and maintaining health; however, the lack and wastage of essential medicines are still one of the most severe public health problems. All these issues result in a considerable amount of medicine expiring in Ethiopia. This problem requires urgent attention and mitigation. In Ethiopia, despite a high burden of disease, utilization of health services remains very low. They account for 20–60% of health spending in developing countries. Pharmacists and pharmacist assistants, as well as other involved healthcare professionals like nurses, must fully understand pharmaceutical inventory management to minimize the expiration of drugs.
She outlined that when the community buys medicines, they should get enough information from the health professional to confirm whether the period of service has passed or not. Also, urged them to take responsibility by pointing out crimes related to the use and disposal of medicines.
THE ETHIOPIAN HERALD WEDNESDAY 22 MARCH 2023
