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India: Surge in Covid-19 cases may cause drug shortage in Zambia

[By Brian Muwanei Kabika ]

IN the last few days, international media such as the British Broadcasting Corporation (BBC) and others have reported a severe surge of the COVID-19 cases across Indian towns, although huge numbers are in Mumbai and New Delhi. The images that we have seen on these international news channels clearly bring to the fore a health system that is struggling to cope with the situation.

The number of cases being reported appears to triple almost every day. We are told there is a scarcity of oxygen, hospital beds and medicines, and graveyards are filling up. Health workers are overwhelmed. The second wave of the disease is spreading like wild fire, choking India, a country with a population of over 1.3 billion people.

India needs everyone’s compassion. This is a country that is a global leader in pharmaceutical production now experiencing medical supplies shortage. The country’s supremacy in drug manufacturing can be confirmed by the fact that one of the COVID-19 vaccine, Oxford-AstraZeneca is being manufactured in India at the Serum Institute of India. Founded in 1966, and specialising in biotechnology, the institute is the world’s largest vaccine manufacturer by doses it produces and sells globally.

While India may be too far from Zambia, the rising cases of the disease if not halted promptly may be of great concern. It may severely affect drug availability in Zambia and other nations.

A brief look at the Zambia Medicines Regulatory Authority (ZAMRA) Register of licensed drugs, comprising over 6,000 medicines for human beings and animals, around eighty-five per cent of the drugs come from India. If the situation in India worsens, it may force most companies in India to slow or shut down production of drugs or that country may restrict the exportation of drugs to Zambia and other countries so that local demand and supply is satisfied. This may trigger drug shortage in Zambia in the next few months, and eventually push up the cost of the medicines.

Although, section 39(2) of the medicines and allied substances Act (No. 3) of 2013 of the Laws of Zambia requires that all medicines that must circulate or be supplied to the public must be registered with ZAMRA, in difficult instances like the one that is about to befall us, the same law in subsection (4) permits the importation of unregistered (unlicensed) drugs or medicines provided the importer pays higher fees than for licensed ones for quality assurance.

The rationale for requiring medicines to be registered with ZAMRA before they are placed on the Zambian market is for safety, quality, and efficacy purposes. Despite unregistered medicines not being desirable for any country, they have the same effect as registered medicines. These unregistered medicines may not be registered in Zambia but licensed in countries of their origin where there maybe stringent regulatory mechanisms than in Zambia.
For example, if a drug is licensed (registered) by the Medicines and Healthcare products Regulatory Agency (MHRA) – United Kingdom (UK), there should be less to worry about by a consumer because MHRA is more advanced than ZAMRA when it comes to drug regulation. The Oxford-AstraZeneca vaccine is a good example of how a yet to be registered medicine in Zambia but licensed in other jurisdictions such as the United States of America, UK and Europe may save thousands if not millions of precious lives.

To avert the looming crisis, this is the time private sector (licensed pharmaceutical wholesale dealers’) who supply drugs and allied substances to pharmacies and hospitals must be encouraged by the government and ZAMRA to source drugs and allied substances from other countries like South Africa, United Kingdom, India – if there are willing suppliers and other European countries so that citizens can easily access their medical ailments and conditions.

These are critical epochs when the private sector in the pharmaceutical industry should play its pivotal role of supplementing governments’ efforts of making medicines available to the public. In a country like Zambia with a population of around 17 million, it is almost impossible to have all drugs placed on the market registered. There are several reasons for this and they include: population of Zambia being too small for the manufacturers to reap reasonable profits in a given period, subdued economic activities in recent years, disease prevalence and many more other reasons.

Whereas we do not know when India will come out of its dire COVID-19 crisis, we are nonetheless fortunate to know that their sad situation may affect drugs availability in Zambia and we can plan for it.

For any comments, please send them to: muwanei.kabika@gmail.com

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