A system of inefficienciesWhat ails medicine in Yemen [Archives:2003/629/Health]

March 31 2003

By Dr. Mohammed Al-Shuqa'a
For The Yemen Times

The quality of medical services is measured by the accessibility of basic medicines in a country. In Yemen, the medical services are quite inefficient and the medicine supplies system is quite ineffective.
The medical sector is one with huge income due to the great numbers of people attending hospitals and private clinics, but still the services provided to those people in return for their money is feeble for the following reasons:
Scarcity of basic medicines and medical equipment. Where hospitals and medical centers have a weak inefficient infrastructure and in most cases does not even have the basic medicines in the hospital storage or pharmacy. This is mostly evident in the suburbs.
No organized medical legislation until now. There are no medical legislation accurate and strict that would be responsible for distribution of the medicines after being responsible for importing them also there is no real regulatory supervision on the retailers and agents.
Weak national medical industry. The local industry is no where in comparison with the international one and is in no position to compete with the world manufacturers. Also this industry is not supported sufficiently by the government. In addition to the fact that some of the medicines are poorly made and so the local industry loses its credibility in the local market.
Registration of medicines without scientific standards and importing unnecessary medicines. The government imports unnecessary medicines just so as the private sector gains massive benefits. Sometimes the medicines are even toxic but because of insistent marketing they are bought by consumers.
Chaotic distribution of medicines without monitoring. The objective for organizing medicine distribution to allow the basic medicines to be available at anytime and at all levels to all. The agents, and medical centers should be responsible for providing these medicines to the patients according to the population density and need of the area.
But what actually happens in that the medicines are distributed per mood and with no regards to the actual need . Moreover, storage of the medicines takes place in unhealthy and inefficient ways, which causes the damage of the medicines or theft. The private sector which is encouraged by the benefit and high income would consequently be more efficient from the government sector, a problem faced in all the developing countries.
Smuggling. Through illegal means and routs unauthorized and untested medicines enter the local market, they cause harm and damage to the public health thorough usage for they might have expired already or untested. Sometimes those medicines become quite popular and the demand for them increases as they are rare, whereas the little resources dedicate for importing medicines are used for importing unnecessary ones.
Marketing of internationally barned medicines. Some barned medications or those withdrawn from the international market find their way to the country making it a trashcan for the worlds below the standards products. The only benefit is some companies who market those products and gain a lot of money from doing so causing many innocent people to get sick, and sometimes even die.
Wrong prescriptions from doctors. Many doctors are known to prescribe huge amounts of medicines without actual need for them. Either because they have a commission on the medicines bought or because they feel good sending patients with tons of medications back home.
What is worse is that in many occasions the prescription is totally wrong and the patient lands up with a new disease besides the original one. Moreover, when medicines are taken in a regular way the body forms immunity against them and when they are actually needed they lose effect.
Other problems include: selling of the wrong medicines by pharmacists, unwise consumption of medicines by the people, wrong self-medication, no post marketing quality monitoring, no studying of side effects, unethical marketing for medicines.