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Millions risk blindness in Sh4b drug stand-off

Reproductive Health - By Dr Mercy Korir

Two million Kenyans are at risk of going blind because the Government has delayed to clear a consignment of life-saving drugs, worth Sh4 billion, donated by a US-based organisation.

The drugs, intended for vulnerable communities in 12 counties, have been held for 10 months at the Jomo Kenyatta International Airport, during which clearance fees has doubled.

Constant appeals to relevant authorities to have the consignment of Zithromax – which has been lying at Trans Global Warehouse since last October – released have been unsuccessful with the donors contemplating seeking intervention of President Uhuru Kenyatta.

There are fears the drugs may expire because of the Ministry of Health’s failure to pay storage charges, accruing daily, now at almost Sh70 million, up from Sh34 million in February.

The donors have said they cannot give out the drugs and be expected to pay demurrage charges. Questions have arisen why authorities have not waived fees for such a donation; for a noble cause.

It is worrying that bureaucracy should keep crucial drugs away from their beneficiaries given the severity of the disease – blindness from trachoma – is irreversible.

The drugs are estimated to have a market value of Sh4 billion. The donation was made by Pfizer through the International Trachoma Initiative (ITI) that has been doing so for the past 10 years.

In a letter dated March 21 by Peter Tum, Health principal secretary, to Dr Paul Emerson, the director of ITI, the ministry acknowledged receipt of 10,104 bottles of 500 tablets and 93,408 bottles of 1200mg powdered oral suspension of the drugs, all totalling to two million doses.

Cause of delays

The PS cited challenges in the process of payment as the cause of delays and committed to making payments for the drugs to be released, something that is yet to happen.

The ministry had requested ITI to assist in resolving the challenges in clearing the Zithromax.

“There are no circumstances under which ITI will pay fees to clear Zithromax donated to the Kenya MoH,“ said a letter by Dr Emerson to Health Cabinet Secretary Sicily Kariuki in March.

This is a statement reiterated by the Queen Elizabeth Diamond Jubilee Trust Chief Executive, Dr Astrid Bonfield, in a letter to the Cabinet Secretary in April, as they requested for her intervention in the matter.

“Should the situation remain unresolved, there would be little option for us but to bring the matter to the attention of our Chairman, former UK Prime Minister Sir John Major, who would doubtless wish to raise it with His Excellency the President,” the letter by Dr Bonfield, further stated.

The Trachoma Expert Committee (TEC), in one of its bi-annual meetings in June, gave the Trust the green light to reach out to the President.

“ITI, work with Sightsavers to support The Trust in sending a letter to the President of Kenya, with copy to the MoH, Ministry of Finance, and Ministry of Foreign Affairs.”

TEC is an independent body that reviews country applications for donations of Zithromax.

“Their trustees hope that the clearance issue will be resolved, but they are losing patience as the funds they have allocated to Kenya, in excess of Sh100 million will be lost if not used to distribute the donated medicine,” Dr Emerson said.

The drugs are for Kenya’s Trachoma programme under the Ophthalmic Services Unit headed by Dr Michael Gichangi at the ministry. The programme’s aim is to eliminate trachoma by 2020, something that may not happen as the Trachoma Expert Committee has also recommended suspension of future donations to Kenya due to this quagmire.

“TEC recommends additional drug (2018 shipment) is not sent until the clearance issues of the 2017 shipment are resolved and they further defer consideration of the 2019 Zithromax application pending resolution of the 2017 clearance issues.”

Dr Gichangi indicated that the cargo handlers were new to handling medicines and hence the delays.

“The medicines were received at the airport between 13th and 18th October 2017, from the Lufthansa airline, and warehoused at the Transglobal Cargo Centre. The cargo handlers were new to this and the timing was the electioneering period. These two were special challenges. It was recommended that we reemphasise the need to use Kenya Airways or KLM as the preferred carrier vessels for the medicines so that they can be handled by African Cargo Handling,” he stated in a brief after a meeting by various stakeholders in the Trachoma Programme on May 29.

The Regional Director of ITI, Dr Teshome Gebre, and Dr Emerson had earlier made attempts to meet with the Cabinet Secretary for Health in July to resolve this issue, but have not been able to get audience.

Health PS Peter Tum at a past parliamentary probe in June 2018. He maintains the matter is being addressed and will be given priority. [File, Standard]

Health PS

The principal secretary for Health said the matter was being addressed, and would be given priority.

“We had issues with the Exchequer because you know we were closing the financial year and opening a new one. Those are among the first payments we will do this week,” said the PS said.

The medicines are now past the mass drug administration date that was scheduled for distribution in October-November 2017, but provided they are stored appropriately and released in time, there is still hope for those depending on this donation.

All the efforts and strides that the country had made in the past 10 years towards elimination of trachoma will be negated, as these medicines should be consistently delivered every year.

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