Medicines unavailable for thousands of hepatitis patients

Updated June 18, 2019

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PPP government had started the hepatitis programme during the stint of Syed Qaim Ali Shah. — Dawn/File
PPP government had started the hepatitis programme during the stint of Syed Qaim Ali Shah. — Dawn/File

HYDERABAD: A few thousand hepatitis patients are awaiting their treatment for want of medicines under Chief Minister’s Initiative for Hepatitis Prevention and Control Programme whereas close to 2,900 vaccines of hepatitis-B meant for schoolchildren are to expire on June 30 in Larkana district and another 2,000 in Tharparkar.

Information obtained by Dawn revealed that the programme — also known as the Hepatitis Free Sindh Programme — had meagre allocation of funds for fiscal 2018-19 against its usual allocation, which resulted in inadequate supplies of medicines and vaccines for under-treatment hepatitis patients.

Budgetary allocations had upset everything for the programme. As if this was not enough, releases under last quarter of budget (April-June 2019) were not made till filing of this report on June 17 to make matters worse for the programme. No hepatitis-B vaccine could be purchased in the current fiscal year and hepatitis-C and D medicines would become unavailable shortly.

Programme coordinator Zulfiqar Dharejo told Dawn that thanks to the efforts of Sindh Health Minister Dr Azra Pechuho annual budgetary allocations of Rs900m had been reflected in the provincial budget for 2019-20; otherwise Rs300m were allocated for 2018-19 budget for the programme. He expressed the hope that in last quarter of the ongoing fiscal year the amount would soon be released.

The Pakistan Peoples Party (PPP) government had started the hepatitis programme during the stint of Syed Qaim Ali Shah as chief minister. According to estimates, 1.2m to 1.4m vaccines of hepatitis-B were needed every year for vaccination of people across Sindh. Figures showed that around 12,000 people remained under treatment for hepatitis-B and another 8,000-10,000 for hepatitis-C. Medicines for hepatitis-B and C had almost finished and authorities were trying to get them somehow, confided a source.

“One month back around 4,000 new hepatitis patients were detec­ted in routine screening. Their treatment is yet to begin.

However, this figure will increase as it was one month old. More people add up to the record of hepatitis patients who need treatment during screening at the designated centres of programme in different hospitals,” hinted a programme source about possible increase in number of patients needing treatment.

He said that treatment of those 4,000 people could not yet begin because of scant budgetary allocations coupled with belated relea­ses. “The medicines for those alre­ady under treatment remained short for want of funds,” he said. Hepatitis-D patients needed injection which is expensive.

“Treat­ment will start of 750 such patients when funds are available for this injection of Pegasus,” he added.

Belated quarterly release of funds from the finance department was another hitch that affec­ted patients’ treatment. Sources said that the programme management remained short of kits that were used for screening. Only a limited quantity could be procured with the help of donations.

SPRA’s reservations

The Sindh Public Procurement Authority (SPRA) in the recent past had raised technical objections over procurement of medicines on the ground that drugs should be treated as ‘goods’, which the central procurement committee (CPC) had refused. Besides, some companies had also questioned procurement and had moved the court against the CPC that delayed the process.

The medicines for the health department were purchased under the CPC headed by Dr Saeed Qureshi, the vice chancellor of Dow University of Health Sciences (DUHS). The CPC was formed under directives of the Supreme Court-mandated Judicial Commission on Water and Sanitation headed by retired apex court judge Amir Hani Muslim.

Dr Qureshi told Dawn that he had informed the Sindh health department in writing that medicines could not be treated as ‘goods’.

He said that the CPC was mandated to only oversee procurement process of medicines to see quality of medicines. “We are there to ensure transparency in the procurement process,” he disclosed.

The CPC monitors tendering process of medicines and other related items of the health department. Mr Muslim had passed a detailed order after coming to know about some discrepancies in the entire procurement process last year during his visit to different hospitals and hearing before the commission. He reconstituted the committee.

Unused vaccines to expire

Around 2,900 vaccines of hepatitis-B meant for schoolchildren in Larkana are going to expire on June 30 and they have not yet been used. This was revealed during inquiry by a committee formed by health sciences director general Dr Masood Solangi.

The Larkana district health officer (DHO) was provided around 100,000 vaccines in Nov 2017 by the then commissioner Abbas Baloch (currently Hyderabad commissioner) for vaccination of schoolchildren through the hepatitis programme.

These were supplied in batches and used accordingly.

Around 21,000 vaccines were used before expiry and another batch of 49,000 vaccines was provided with the expiry date of June 2019. Of them around 2,900 are yet to be used. Another batch out of 100,000 vaccines would expire in the forthcoming October.

According to another report, around 2,200 unused hepatitis-B vaccines were reported in Tharparkar during checking by the health authorities which were to expire this month.

Published in Dawn, June 18th, 2019