Until a few months ago Rifaat Mahmud, a day labourer from Giza near the Egyptian capital Cairo, could afford to buy drugs for his 13-year-old daughter who has aortic stenosis, a condition which causes reduced blood flow between the left ventricle and the aorta.
"The medicine is nowhere to be found. Pharmacists tell me the drug companies stopped producing my daughter's medicine," Mahmud told IRIN.
The economic crisis in post-revolution Egypt, and deteriorating security conditions, seem to be affecting the nation's ability to produce or access medicines required by millions of patients. Pharmaceutical companies are unable to import the necessary quantities of medicines or the raw materials from which they are manufactured, say observers.
Egypt used to have 120 pharmaceutical companies importing medicines, but 80 of these have closed in the past few months, and other factories are expected to follow suit, according to Makram Mahana, chairman of the Pharmaceutical Industry Section of the Federation of Egyptian Industries (FEI).
"Revolution-induced economic and security deterioration caused a 50 percent drop in national medicine production at least," he said, adding that a fall in the value of the Egyptian pound combined with a rise in international raw material prices was making life difficult for importers.
Khalid Al Ruby, an independent drug expert, said the government needs to rescue the pharmaceutical industry to alleviate the suffering of eight million people with diabetes and four million with blood pressure problems, as well as those on medication for heart problems and cancer.
Leading medical experts at the 5th conference of the Egyptian Cardiology Society in Cairo on 1 August, said more than 250,000 people faced the threat of paralysis or premature death because cerebrovascular accident drugs were nowhere to be found. People with diabetes were finding it almost impossible to get insulin, and if they could get hold of it, it was very expensive.
Mahmud is helpless when his daughter gets chest pains or faints. On a monthly income of 500 Egyptian pounds (US$84), he depended on the state-run Heart Institute in Giza to give him his daughter's medicine for free. Now that the Institute is unable to provide the drugs, he has had to turn to private pharmacies. "Now, I have to pay almost a third of my income to buy the necessary drugs every month."
Prices set by government
The prices of locally produced drugs are set by the government, something that could be contributing to the current drug shortages, experts say. If the government gave manufacturers more freedom to set medicine prices, they might be able to offset some of their losses and remain in business.
"Drug pricing by the government causes many problems for manufacturers," said Al Ruby. "When the prices of raw materials rise on international markets, our local pharmaceutical companies cannot raise the prices of the drugs they produce. Some companies went bankrupt because of this."
Egyptian pharmaceutical companies import US$673 million worth of raw materials a year, according to FEI officials.
The government has promised to reconsider medicine prices. But for the roughly 20 percent of the population living in poverty medicines at any price are going to be too expensive.
The government blames the unavailability of some locally manufactured drugs on speculators and middlemen who have been hoarding certain drugs to force people to buy the more expensive imported varieties - from which they get a cut.
"These drugs are so expensive for a large number of patients," said Magdy Ameen, a member of the Health Ministry's Medicine Pricing Committee. "They are causing untold suffering for patients."
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions
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