How pharmacies are putting lives of patients in danger

The pills bought from a pharmacy student for abortion. [Jonah Onyango, Standard]

As more Kenyans turn from hospitals to dispensing chemists for medical needs, new evidence shows patients may be jumping from the frying pan into the fire.

Reports published since June by the government, donors, and scientists portray a sector exposing Kenyans to grave dangers in pursuit for profits.

Cumulatively, the reports show Kenyans are exposed to counterfeit medicines, illegal drug outlets, higher unethical drug trade practices and downright dangerous drugs more than ever before.

One of the studies assessing the sale of antibiotics found more than half of sampled retail chemists in Nairobi and 100 per cent of veterinary drug outlets sell the products without a prescription as required. But even more worrying, says the study, is the sale of medicine according to customer preference instead of insisting on a doctor’s prescription or disease symptoms.

The study by the Nairobi based International Livestock Research Institute, University of Edinburg, University of Liverpool and the University of Oxford, all of UK suggest drug retailers are putting the lives of patients at risk while fueling loss of crucial medicines to bacterial resistance.

“For example, we found all sampled veterinary and 53 per cent of human drug stores selling antibiotics without a prescription. We also noted that customer preference was an important factor when prescribing antibiotics in half of the drug stores.”

Without prescription

The study published in the Journal of Global Health last month (August 25) had investigated 40 human and 19 veterinary drug stores in Nairobi and recorded numerous unethical practices which put the health of Kenyans in extreme danger.

“Our finding that WHO-classified highest priority critically important antibiotics were being sold over the counter and potentially without prescription in human drugs stores is of great public health concern.”

These findings, the authors say, highlight the need for immediate strategies to improve prescribing practices across the pharmacists in Nairobi and elsewhere.

In the same vein, the Kenya Health System Assessment (KHSA) report published in June by the Ministry of Health and USAID estimated about 90 per cent of Kenyans prefer chemists to hospitals when sick.

“Interviews with stakeholders and various household surveys corroborated that the first contact of about 90 per cent of patients or consumers, when confronted with illness, was a chemist,” said the report.

In an interview with our sister paper, The Nairobian, Patrick Adera, the president of the Pharmaceutical Association of Kenya agreed most patients prefer chemists to hospitals.

“Unlike hospitals, pharmacies don’t have long waiting times, are convenient and do not charge consultation fees,” said Adera.

But there lies the problem, says the KHSA report. “There is need to develop guidelines to ensure pharmacies work within acceptable boundaries,” suggested the study.

The report also wants the Kenya Pharmacy and Poisons Board (KPPB) to ensure safety and quality of health products and technologies are maintained.

Adera regretted that the majority of Kenyans venturing into the pharmacy profession look at it as a cash cow instead of professional service delivery.

Because of these loopholes and poor surveillance, the KHSA report says counterfeit medicines in Kenya, which accounted for about Sh9 billion in 2017 are on the increase with serious consequences. “Kenya has the fourth highest Adverse Drug Reactions (ADR) reporting rate in Africa,” says the report.

Health providers are supposed to monitor their patients for any unwanted reaction to a medical product, or ADR, and report to KPPB for onward recording with the World Health Organisation.

ADR can be caused by drug misuse, substandard or counterfeits, expired medicines or prescription errors.

But according to the Kenya Health Facility Assessment 2018 report released by the Ministry of Health, last month poor drug handling is also widespread in majority of hospitals.

Only 22 per cent of the about 10,000 health facilities in the country are storing pharmaceuticals in good conditions. Only a third of public hospitals and 10 per cent of private facilities are storing medicines in safe conditions.