Posted: Friday, October 25, 2019. 1:11 pm CST.
By Aaron Humes: The Public Service Union (PSU) says it plans to talk to the Ministry of Health and Community Pharmacists’ Association over the Ministry’s “quality assurance and procurement process” for the importation of medications while expressing a “lack of confidence” in the Ministry and Minister Pablo Marin for their handling of the situation and health services generally.
The Union was responding in a press statement to Director of Health Services Dr. Marvin Manzanero, who in turn was responding to activist Geovannie Brackett. On Tuesday of this week, Brackett raised alarm that the Ministry was not doing enough to test the “generic” medications it allows to be imported, and is driving off “name-brand” medications over concerns of cost.
The Union raised particular concern about the lack of certain essential medications and particularly HIV/AIDS antiretroviral medication, which it called “unacceptable, discriminatory and criminal.” It also cited alleged conflicts of interest between physicians, administrators and even ministerial financial relationships and pharmaceutical firms and suppliers, stating these were costing Belize millions of dollars and in some cases lives, and asking the Prime Minister to intervene.
Dr. Marvin Manzanero says stock of depleted particular anti-retroviral medications will arrive within “two to three weeks,” citing a combination of factors such as the Indian producers’ inability to source certain materials and downscaling of production, leading larger countries to be supplied first. More than 1,300 Belizeans use anti-retroviral medication, and the longer the country is out of stock, the greater risk there is of a flare-up of HIV-related symptoms.
Separately, Brackett criticized the Ministry’s reliance on approved certificates by importers coming directly from manufacturers, but Dr. Manzanero stated that the “open tender” process allows those who are registered to participate and a tender committee does the scrutinizing. In the case of the U.S., he added, the Food and Drug Administration (FDA) is directly responsible for approving medication for use there, but also grants approval for drugs made in the U.S. to be used elsewhere, though there is not a comprehensive list.
Because Belize does not have the capability to directly test imported drugs, says Dr. Manzanero, the certificates for good management practice (GMP)/certificate of pharmaceutical products (CPP)/certificate of analysis (COA) become even more important. In conjunction with cost and supplier reliability, these are the factors the tender committee uses to determine what drugs in what amounts will be imported. Importers order by the medical name of the drug (such as amoxicillin or ciprofloxacin, both antibiotics), rather than familiar trade names (such as Tylenol, Advil, or Pepto-Bismol).
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