[e-drug] Uganda NMS re-selling discounted ARVs? (cont'd)

[Gichinga Ndirangu <gichinga@haiafrica.org>]

E-drug: Uganda NMS re-selling discounted ARVs? (cont'd)
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I am writing in response to Wilbert's request for an update on the
Lancet story of 31 May (Volume 361, Number 9372), "Uganda's
state-owned drug firm pressured to drop drug deal" and to his
question about the resale of discounted medicines.

We have been in contact with various well-placed government and
NGO sources in Uganda concerning this issue. The Ministry of Health
remains firm in the order issued last month against any export of
ARVs from the country by the National Medical Stores. That aspect of
the issue appears to be settled.

The NMS General Manager Robert Rutaagi maintains that the Lancet
and others distorted the facts of the matter. He insists that the
agency's plans to get involved only ARVs sourced through normal
commercial channels. We think that Mr. Rutaagi's point, even if true,
misses the point. NMS should not be purchasing essential medicines
with the primary view of making a profit through their resale to other
suppliers.

NMS was set up to serve the public sector. An estimated 1.5 to 2
million Ugandans need ARV treatment. To date, not more than
10,000 of them have access to the needed medicines. Therefore, it is
imperative for NMS to stay true to its original purpose to help meet
supply needs in the public sector. NMS should not put its own
commercial profit above the needs of Ugandans.

We urge the government to remain firm in preventing NMS from any
transactions that would result in its medicines being exported from
Uganda - including medicines bought through regular commercial
negotiations. All NMS sales should be done in a way that ensures that
the medicines can be traced.

NMS' attempted purchase and resale of ARVs to private suppliers
has been roundly condemned by government and the public. Most
discounted medicines agreements prohibit the types of actions NMS
was prepared to undertake until the ministry intervened. Within the
Ministry of Health, it has brought home important issues about
procurement, regulation and supply that the government must
prioritise.

No one wants diversion to high-income countries to threaten the
supply of discounted essential medicines. The European Union for
instance, has called for strict controls to ensure that medicines sold to
poor countries at discounted prices are not re-exported back to
Europe Concerns over resale provide a good excuse for companies
to limit their discounted pricing and to call for burdensome
conditionalities that strap poor countries' administrative capacities.

Gichinga Ndirangu
Advocacy and Communications Director
Health Action International (HAI)Africa
Regional Co-ordinating Office
P.O. Box 73860
00200 - Nairobi, Kenya
Tel: (254) 2 4444835
Fax: (254) 2 44441090
e-mail: gichinga@haiafrica.org
Website: haiweb.org
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