Wheels come off Zim health sector

By Nokuthaba Nkomo

Medical experts have warned the government that it is putting the lives of thousands of people at risk, after it  recently started dispensing expired drugs in hospitals — including life-prolonging anti-retroviral medication (ARVs).

This comes as the country’s health sector, which is beset by myriad problems — including a crippling strike by doctors — continues to fall apart precipitously.

At the same time, the government has seemingly dashed any hopes of ending its impasse with the striking doctors after it warned this week that it would soon introduce new legislation governing the hiring of medical staff, to thwart future industrial actions.

Medical experts told the Daily News yesterday that the recent decision by the Medicines Control Authority of Zimbabwe (MCAZ), to extend the shelf life of expired drugs, would put the lives of many patients at risk.

“This is quite shocking because expired drugs can’t be administered to patients, as their quality would be low. I don’t understand why the drugs are being used because they won’t be as effective as before they expired,” Mthabisi Bhebhe, secretary-general of the Zimbabwe Hospital Doctors Association (ZHDA), said.

But MCAZ spokesperson, Richard Rukwata, said they were allowed by the law to extend the shelf life of expired drugs.

“Shelf life and expiry dates are determined scientifically and MCAZ has the authority to extend expiry dates after doing some tests to see if the drugs in question can continue being used or not.

“The tests are expensive and are done over a long period of time for proper results,” he claimed.

The current furore follows MCAZ’s controversial December 20 decision to allow the ministry of Health to use in hospitals drugs which expired earlier this year.

The Health ministry had applied for the testing of several drugs, including ARVs, to find out if their shelf life could be extended.

“We refer to your application for quality testing and extension of shelf-life of products with the following batch numbers: E161588, E161587, E161290A (Hetero Labs Ltd) of the above product which had expiry dates of 06/2018 and 07/2018.

“The registration committee agreed at its 523rd meeting held on 14th November 2018, to extend the product shelf life to passing chemical testing.

“We advise that the product samples … have been analysed in our chemistry laboratory and they complied with the relevant chemical specifications,” MCAZ said.

“Based on the laboratory results obtained, the product is deemed fit for continued use.

“In accordance with the Authority’s policy on shelf life extension after testing of product samples and the results obtained, you are therefore authorised to use the product until July 2019,” it added in a letter in the possession of the Daily News.

The common ARV drug which is taken by most Zimbabweans, Tenofovir Disoproxil Fumarate/Lamivudine 300/300mg, was among the expired medication whose shelf life was extended to July next year.

However, international drug manufacturing firms say expired medications that contain preservatives may be unsafe past their expiration date, and warn further that outdated preservatives may allow bacterial growth in them.

“It’s always best to use medications that are not expired … the expiration date is the final day that the manufacturer guarantees the full potency and safety of a medication.

“For legal and liability reasons, manufacturers will not make recommendations about the stability of drugs past the original expiration date.

“If a medication is essential for a chronic and potentially life-threatening disease — for example, a heart condition, cancer treatment, seizure, or life-threatening allergy — it is probably wise to get a new prescription before it expires and keep up with refills as needed,” reputable United States of America drugs website, drugs.com, says.

Zimbabwe is currently in the middle of a mega economic crisis which, among other things, has seen doctors striking over severe shortages of pharmaceutical drugs at public hospitals, as well as the selling of available drugs in foreign currency by retail pharmacies, among a host of other grievances.

The government this week responded to the strike by suspending without pay 530 doctors — following a recent ruling by the Labour Court which declared the industrial action illegal.

On Thursday, acting President Constantino Chiwenga also warned that the government would soon introduce a new law regulating the hiring of doctors — after he came face-to-face with the dire situation at one of the hospitals affected by the on-going industrial action.

Chiwenga made the remarks after visiting the country’s biggest referral hospital, Parirenyatwa, where essential services have been severely crippled by the doctors’ strike. Daily News