Old problems persist in MoH
The case of an expired drug being supplied to a child with a rare heart problem from the JDWNRH once again brings to the fore the issue of safety and quality of drugs supplied by the Ministry of Health.
The fact that MoH officials agreed that expired drugs are being given after ‘tests’ is a cause for concern especially when the autonomous Drug Regulatory Authority itself under MoH says this goes against laws and good practices.
With Bhutan spending hundreds of millions of Ngultrums every year for procurement of drugs, one would expect that the MoH would take precautions to procure drugs that have a longer expiry date or procure them in regular intervals to avoid expiry of drugs.
The problem of supplying expired drugs to patients basically shows two major problems. One is that drugs are being purchased in such unnecessary bulk that they become expired and the second problem is that drugs with a short shelf-life are being purchased.
These issues were earlier highlighted in the 2008 June -2009 June financial year report by the Royal Audit Authority on the procurement of drugs by MoH.
The RAA found that in just one year there was Nu 127 mn in irregularities in the procurement of drugs which included purchasing drugs far in excess of what was needed and also purchasing drugs with very short lives or well on the way to expiry.
The current government cannot wash its hand of the corruption in the MoH procurement of both drugs and medical equipment. Though it is true that corruption in the procurement process in MoH started before the current government came in and as such was mainly a high level bureaucratic nexus, but it is also true that some of the biggest scams in medical procurement also took place under the watch of this government after 2008.
Though this current government did transfer and post some people it was only after much prodding and exposes from the Media, ACC and RAA.
Even the detailed and ongoing investigation of the MoH procurement scam was an ACC and RAA initiative after a series of media reports on irregularities in procurement and also of bidder funding the procurement committee member’s trips abroad.
In short the current government never asked for an investigation, never held people accountable, has still not come out open on the damage that institutionalized corruption in the MoH has done and clearly has issues to tackle in the MoH.
Though it must be acknowledged that MoH has made some structural adjustments real accountability and transparency on the whole issue is still lacking.
Instead the role of the MoH and its minister has been to unkindly blame the ACC and its investigation for cases of drug shortages in the past. The ACC had never suspended drug procurement but rather it was the shortsightedness on part of the MoH relying on a few suppliers and not bending its back that led to drug shortages.
The government’s response so far on problems in the MoH and health system has been to blame it on the ‘past’. This is a highly peculiar explanation from a government which has held the reins of power for so long with the next elections coming up soon.
The MoH and the government must acknowledge that it slipped in not cracking down on corruption in MoH fast enough and instead waited for the media and ACC to do it. This government’s role in the MoH procurement scams has been to let corruption thrive in the MoH in a helpless way for a few years and rather wait for the media and ACC to get cracking. The government’s role at best has been non-interference given that no political risk is involved but even that is questionable with constant and one sided media reports quoting MoH officials blaming shortage of medicines and doctors on corruption investigations.
In what can only be described as an ill thought out approach the MoH has instead spent all its energy in ensuring that medicine counters of nearly all private pharmacies supplying quality and branded international medicines are half empty putting up bureaucratic and unrealistic requirements. With government pharmacies having access to only limited brands and qualities of drugs, several patients in Bhutan living with anything from Asthma to heart problems have to face a harrowing time getting the drugs they need.
Though big promises were made and some changes have been made some of the big problems plaguing the MoH from wrong diagnosis to supply of expired medicines and many more still continue.