Patients complain of medicine shortage

Since the fall of the former regime, Hanifa Ali, 68, on several occasions, has not been able to find the hypertension medicine that she used to buy for about US $2 per month from the local pharmacy in batches of 100. Now she is forced to pay 30 times as much for the same medicine. But Ali is one of the lucky ones who can afford to pay the $2 per day for a dose of three from the private pharmacy, or about $60 per month, an astronomical rise in price. Others who need chronic disease medicines in Iraq have not fared as well in the last nine months, according to Faisal Abdul Jabar Hashi, general director of the 700 or so public clinics in Iraq. Under the former regime, health care, including medicine, was almost completely subsidised by the government. Patients paid less than a dollar to visit a doctor. Medicine cost only a few cents more. Much of the medicine is imported from Jordan through Kimadia, the state-run drug company. Other drugs are made at Kimadia’s main factory, which is not running at the moment. "Patients with diseases like epilepsy or diabetes can die without regular medication," Hashi told IRIN in Baghdad, estimating more than 30,000 patients in Iraq required some sort of regular medication. It is unclear if anyone has died from lack of medication in recent months, Hashi said, because record-keeping has been more sporadic since the US-led war in Iraq in April. For example, last month, only 10 percent of the amount of a key thyroid drug delivered before the war got to public health clinics, he said, although stocks of that drug exist in many places around the country. Workers at Medicins Sans Frontiers (MSF) are now investigating reports that there are no chronic disease drugs at all in some parts of the country. Information on this issue is sketchy as international staff declined to be interviewed, citing the poor security situation in central Iraq as the reason for their current low profile. Several Ministry of Health officials tried to explain the current situation. Distribution problems have popped up many times over recent years, but never as bad as they are now, according to Dr Nima Abed, director of preventive health care at the Iraq Ministry of Health. With an estimated 60 percent unemployment rate, many families now are selling valuable items in their homes just to be able to afford to pay for a few months of medicine, he explained. “At a private clinic, you might pay more than 10 times more than you would at the public clinic for 10 tablets of a drug. It’s a very big problem,” Abed told IRIN, adding that for some patients, doctors can prescribe similar but less costly medicine, or a lower dose. But chronic disease drugs cannot easily be changed. “I don’t know why the shortage is so bad now,” Abed noted. “There seems to be a transportation deficiency. Some times, distribution is to the wrong place.” Following the fall of Saddam, there were reports that many hospitals were looted and medicines were taken either for personal consumption or to sell onto the highest bidder. Health care and medicine falls under the former United Nations Oil-for-Food programme, a massive humanitarian effort that brought food and non-food aid into Iraq in exchange for oil since 1996 which is now being run by the Coalition Provisional Authority (CPA), with help from the World Food Programme (WFP), over the next few months. The programme, started to help counteract devastating international sanctions on the country, was never perfect, but there were rarely shortages like there are now, Abed complained. Meanwhile, Kimadia continues to purchase pharmaceuticals from other countries, said Dr. Wadood Talabi, who is heading up the procurement. But with no subsidies in place this is no help to the hundreds of thousands of Iraqi's who cannot afford basic medicine if they can get their hands on it. Without talking specifically about possible drug shortages, Talabi said he is trying to clean up the corruption plaguing the company.