Insecurity has led Afghanistan to become a medicine importer country. Officials in the Afghan Ministry of Public Healthsay that Afghanistan spends 650 million US dollars annually on medicines, 180 million of which is spent for medicines in government sectors (Ministries of Interior, Defense and Public Health).
On the other hand, currently, the country imports 95% of its needed medicines from other countries, but the importation of poor quality, counterfeit, illegal and expired medicines has endangered Afghan’s health. The poor quality medicines have led many Afghan patients to seek cure outside the country.
The factors behind the importation of poor quality, counterfeit and illegal medicines in the country and its solutions are the issues that are addressed in this part of the weekly analysis.
The illegal import of medicines
In the past several years, hundred million dollars were spent to promote the health sector in the country. Hundreds of hospitals and clinics were either repaired or newly constructed in various parts of the country and their administrations were also promoted, but in association with the management and control of the medicines we have not had remarkable achievements; as the illegal supply of illegal and counterfeit medicinesby individuals and companies is increasing which indicates the poor management of relevant organs.
According to the officials in Ministry of Public Health, currently 40 to 55 percent of medicines are being smuggled, and as a result, poor quality and counterfeit medicinesare entering the country. Thus smuggling medicines is assumed to be a major challenge for the Ministry of Public health and the businessmen who import medicines through legal means.
There are several institutions monitoring the importation of medicines in the country, but lack of a mechanism of coordination and cooperation between government institutions such as Ministries of Interior, Finance and Health has resulted in smuggling of hundred thousand tons of medicines from neighboring countries.
Another pivotal factor is corruption in relevant administrations. From the moment that poor quality medicines enter Afghanistan till the completion of the control and custom processes and its supply to bazar there are the possibility of corruption everywhere.
Currently Afghanistan imports its 35% imported medicines from Pakistan, 25% from India, 15% from Iran, and the remaining from China, United Arab Emirates and etc. Around 300 companies are established in Pakistan in the past few years in order to produce poor quality medicines for Afghanistan which imports falsely labeled (using the label of reputable companies) medicinesthat are produced only to be used in Afghanistan.
Despite the control of Ministry of Interior, National Directorate of Security and Ministry of Health, due to the lack of coordination and cooperation among them these medicines make their way to Afghan markets.
Based on a survey conducted by the Ministry of Public Health in 1394, from 1000 companies registered in the Ministry of Public Health, only 200 companies import the essential qualified medicines. Besides that, according to the Joint Anti-Corruption Monitoring and Evaluation Committee, Afghanistan Investment Support Agency (AISA) or Ministry of Commerce and Industries, distributes licenses to the applicant companies irrespective of any criterion and does not monitor the licensed company then. On the other hand, after five years the list of legal medicines is not renewed, while 50 to 60 types of medicines are needed to be added to this list every year.
Lack of well-equipped and standard laboratories at the borders and coincided with that lack of professional and expert cadres who know how to use the new equipment of laboratories is another factor behind the importation of poor quality medicines in the country. It is said that recently, Ministry of Public Health has purchased modern medical machines but due to the lack of experts and professional cadres in medical technology, these machines are exploited in the capital and other cities of the country.
Another problem in this regard is that the transportation of these medicines from Iran and Pakistan takes place in 15 to 30 days in a containers that are not equipped with freezers and sometimes these medicines remain inside these containers for several days in over 40 ° Ctemperature.
The need to amend theProcurement Law
The Afghan Procurement Law is not implementable not only in medical sector but also in other trade and professional sectors such as “Da Afghanistan BreshnaSherkat- meaning the Afghan Electricity Company in Pashto), Ariana Afghan Airlines and etc. It is needed to prepare and approve particular regulations to each of these institutions in accord with its trading spirit. The 1387 Procurement Law does not describe the details about medicines importation and the 1386 Law has simplified the importation of medicinesvery much.
The rating system to provide goods and the specification of low prices in the Afghan Procurement Law is an important issueregarding the provision of medicines whichpushes the importing companies to seek the cheapestmedicines in the markets of the countriesthat produce medicines and competition between the importing companies also takes place based on these low prices.
This is a mean challenge and also an excuse for businessmen and also paves the way for institutionalization of corruption in respected administrations.
What to do?
In order to prevent the importation of poor quality medicines it is needed to implement the followingsteps:
- Imposing strict regulations on individuals and companies that are involved in smuggling and selling poor quality medicines;
- To make and implement regulations to produce, import and controlmedicines;
- Building the capacity of professional and expert cadres to utilize medical technology particularly in the provinces of the country;
- Building specific mechanism to promote coordination between organs associated to the importation and process of medicines;
- Supporting private investment in producing medicines inside the country;
- Confirmation of the medicines produced inside Afghanistan by reputable medicine companies of the world.