Medicines not available for 1000s of hepatitis sufferers

HYDERABAD: A few thousand hepatitis sufferers are awaiting their treatment for want of medicines under Chief Minister’s Initiative for Hepatitis Prevention and Control Programme whereas near to 2, 900 vaccines of hepatitis-B meant for schoolchildren are to expire on June 30 in Larkana district and one more 2, 000 in Tharparkar. Information obtained by Dawn revealed that the programme — also known as the Hepatitis Free Sindh Programme — had a meagre allocation of funds for fiscal 2018-19 against its usual allocation, which resulted in inadequate supplies of medicine and vaccines for under-treatment hepatitis sufferers.

Budgetary allocations had disappointed everything for the program. As if this was not enough, produces under a final quarter of budget ( April-June 2019 ) was not made till filing of this report on June 17 to make matters worse for the program. No hepatitis-B vaccine could be purchased in the present fiscal year and hepatitis-C and D medicines would become unavailable shortly. Program coordinator Zulfiqar Dharejo said to Dawn that thanks to the efforts of Sindh Health Minister Dr. Azra Pechuho yearly budgetary allocations of Rs900m had been reflected in the provincial budget for 2019-20; otherwise, Rs300m were allotted for the 2018-19 budget for the program. He indicated the hope that in the final quarter of the continuing fiscal year the quantity would soon be launched.

The Pakistan Peoples Party ( PPP ) govt had begun the hepatitis program during the stint of Syed Qaim Ali Shah as chief minister. According to estimates, 1 .2m to 1 .4m vaccines of hepatitis-B were required each year for vaccination of people across Sindh. Figures showed that around 12, 000 people remained under treatment for hepatitis-B and another 8, 000-10, 000 for hepatitis-C. Medicines for hepatitis-B and C had almost done and authorities were trying to get them somehow, confided a source. “One month back around 4, 000 new hepatitis patients were detec­ted in routine screening. Their treatment is yet to begin.

However, this figure will increase as it was 1 month old. More people add up to the record of hepatitis patients who require treatment during screening at the designated centers of the program in various hospitals,” hinted a program source about a possible rise in a number of sufferers needing treatment. He declared that treatment of those 4, 000 people could not yet begin because of scant budgetary allocations coupled with belated relea­ses. “The medicines for that alre­ady under treatment remained short for want of funds,” he declared. Hepatitis-D sufferers required injection which is expensive.

“Treat­ment will start of 750 such sufferers when funds are available for this injection of Pegasus,” he added. The belated quarterly release of funds from the finance department was an additional hitch that affec­ted patients’ treatment. Sources declared that the program administration remained short of kits that were useful for checking. Only a limited quantity could be procured with the help of donations.

The Sindh Public Procurement Authority ( SPRA ) in the latest past had raised technical objections over procurement of medicines on the ground that drugs should be treated as ‘goods’, which the central procurement committee ( CPC ) had refused. Besides, a few organizations had also questioned procurement and had moved the court against the CPC that delayed the process. The medicines for the health department were purchased under the CPC headed by Dr. Saeed Qureshi, the vice chancellor of Dow University of Health Sciences ( DUHS). The CPC was formed under directives of the Supreme Court-mandated Judicial Commission on Water and Sanitation headed by retired apex court judge Amir Hani Muslim.

Dr. Qureshi said to Dawn that he had informed the Sindh health department in writing that medicines could not be treated as ‘goods’. He declared that the CPC was mandated to only oversee the procurement process of medicines to see the quality of medicines. “We are there to ensure transparency in the procurement process,” he disclosed. The CPC monitors the tendering process of medicines and other related items of the health department. Mr. Muslim had passed a detailed order after coming to know about a few discrepancies in the whole procurement process a year ago during his visit to various hospitals and court date before the commission. He reconstituted the committee.

Unused vaccines to expire

Around 2, 900 vaccines of hepatitis-B meant for schoolchildren in Larkana are going to expire on June 30 and they have not yet been used. This was revealed during an inquiry by a committee formed by health sciences director-general Dr. Masood Solangi. The Larkana district health officer ( DHO ) was supplied around 100, 000 vaccines in Nov 2017 by the then commissioner Abbas Baloch ( currently Hyderabad commissioner ) for vaccination of schoolchildren through the hepatitis program.

These were supplied in batches and used accordingly. Around 21, 000 vaccines were used before expiry and another set of 49, 000 vaccines were supplied with the expiry date of June 2019. Of them around 2, 900 are yet to be used. An additional set out of 100, 000 vaccines would expire in the upcoming October. According to one more report, around 2, 200 unused hepatitis-B vaccines were reported in Tharparkar during checking by the health authorities which were to expire this month.

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