Pharmaceutical confusion in Yemen [Archives:2005/873/Health]

By Dr. Mohamed AlShaqa'a
Of the factors contributing to a sound and coherent health system, access to medicine is essential. Yemen's system of pharmaceutical distribution is notoriously bad, with irresponsible prescriptions, weak diagnosis and low volumes of affordable medicine. Some have blamed an unregulated private sector for over prescription and profiteering, but the essential issues facing the medical world today are as follows.

1- Scarcity in essential medicines and equipments

2- Lack of medical legislation.

3- A weal pharmaceutical manufacturing sector.

4- Lack of standard measures or medicine registration

5- Importation of unnecessary medicines

6- Lack of legal medicine distribution control

7- Smuggling

8- Marketing of internationally prohibited medicines or medicines that have been withdrawn from circulation in international markets.

9- Some doctors prescribe improper medicines.

10- Some pharmacies issue the wrong medicines

11- Incorrect use of medicines by some patients

12- Wrong self-medication

13- Lack of follow up of quality

14- Lack of monitoring of harmful side effects of medicines

15- Unethical merchandising of medicines

Shortage in basic medicines and supplies

Hospitals suffer from insufficient stocks of basic medicines because of weak medical supplying, planning, and funds. Medical equipment is often stolen, broken or old. This shortage is clear at a large scale in rural areas.

Lack of medical legislations

Up to now there are no serious medical legislations to regulate the process of, distribution, import or the prescription of medicines. There is also no real governmental control on agents, distributors, physicians and pharmacies.

Impuissance of national medicine manufacture

Local medicine manufacture cannot compete with corresponding international products. It receives no official support while some local medicines have lost their credibility.

Impor of unnecessary medicines

The private sector benefits from importing unsafe, inessential and unnecessary medicines that are merchandised and marketed by different means.

Uncontrolled medicine distribution

The aim of Planned medicine distribution is to meet the public health needs. Distribution of medicines through the agents and pharmacies should take in consideration the population density, the distance and transport factor.

Governmental medicines are distributed by the central stores to government clinics without the least consideration of real need. Storing conditions are subjected to the sun, the rain and theft.

There is no control over the private sector, which distributes medicines through pharmacies. Though the private sector is far more efficient than public sector in distribution, it is mainly motivated by gain. Sometimes doubtful and dangerous medicines are being distributed.

Smuggling of medicines

Medicines of doubted quality, origin, and expiry date are smuggled into the country through illegal channels. They poise serious threat on peoples' health. They exposed to heat, moisture and light during their transport into the country.

Marketing medicines that are banned or withdrawn from circulation in international markets:

Banned medicines or that are withdrawn from circulation in international markets, are also distributed endangering many lives of the Yemeni public. Examples of these are the analgine and lomotil.

Improper medicine prescription by physicians

Some physicians exaggerate in prescribing medicines that contain needless medicaments. Others prescribe medicines which are not the right ones or are not consistent with the diagnosis.

At other times unsafe medicines are prescribed for minor cases, either in consent to the patient's desire or out of the idea that the more the better.

At other times some physicians prescribe medicines without diagnosis when their clinics are crowded.

The improper prescription of medicines is the main reason for acquired iathergy to some medicines.
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