Medicines running out

Public health centres in Guinea are facing a critical shortage of basic medicines and aid workers and health officials are urgently seeking a way to replenish stocks.



“This is a real problem. We do not have enough medicines for the needs of the population,” Mohamed Lamine Tounkara, regional health director in the Kindia region, 137km east of the capital Conakry, told IRIN.



A patient in a public hospital in Kindia today would have to seek most of the medicines he or she needs at a private pharmacy, where prices are far higher than in government health facilities, he said. Kindia – home to some two million people, with five major public hospitals and 51 health centres – is just one of many regions affected, according to UN and government officials.



The lack of medicines stems from a number of factors, including lack of government funds, rising drug prices and poor management, according to Mohamed Lamine Yansané, the Health Minister’s chief of staff.



Guinea has seen sporadic shortages in the past few years but the situation has worsened sharply in 2009, health experts said.



“We are currently facing enormous difficulties,” Yansané said, adding that the Health Ministry is appealing to the government and to donors to help tackle the problem. “But with the current situation in Guinea we do not have aid from the outside.”



Some donors have restricted assistance to Guinea since the coup d’état in December.



Yansané said the government recently announced it would free up 11 billion Guinean francs (US$2.2 million) to buy medicines, but it is not clear when the funds would be available, and nearly double that amount is needed.



Philippe Verstraeten, head of the UN Office for the Coordination of Humanitarian Affairs in Guinea, told IRIN: “This is an urgent problem. While many factors have brought this about the most important thing is that it is becoming increasingly difficult for people throughout Guinea – particularly the most vulnerable – to access basic medicines.”



He added: “This lack of medicines in public health centres and hospitals is part of a broader problem of Guinea’s health system. But while all actors work to address these problems we must act now to ensure that basic medicines are within reach for all Guineans.”









''It is becoming increasingly difficult for people throughout Guinea - particularly the most vulnerable - to access basic medicines''

A number of problems in the health system were identified during a joint UN, NGO and government evaluation mission in March in three prefectures – Boké, Gaoual and Koundara.



The evaluation revealed “frequent ruptures in medicine stocks” in public health centres, along with a lack of proper storage for medicines and vaccinations, many health facilities in a dilapidated state and lack of health personnel in public centres, according to the mission report.



Government officials recently met with representatives of UN aid agencies and donors to discuss health-related needs for 2009.



While private pharmacies have medicines in stock, rural populations have difficulty getting to the pharmacies and most Guineans cannot afford the prices, so more and more people will go without, UN and government officials said.



Shortages or not, for years Guineans have turned to questionable medicines sold by unregulated vendors; Guinea is one of many African countries where counterfeit pharmaceuticals pose a health problem. The government recently cracked down, arresting alleged manufacturers and ordering a stop to unregulated sales. It is unclear what impact new controls have had on the availability of legitimate medicines, aid workers said.



The current shortage could complicate the government's effort to eliminate dangerous fake drugs, the Health Ministry’s Yansané noted. “If there are not medicines in public health centres, the first place people turn to is the local market because they cannot afford to buy in pharmacies.”



The lack of medicines in the public system hits the poorest people hardest, André Enzanza of the World Health Organization in Guinea told IRIN.



“The situation is serious. The most vulnerable people in the poorest zones are most severely affected, because there are no medicines in the public hospitals and health centres.”



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