Health sector exposed to massive losses, serious health risks due to poor drug storage practices - AG report

Health sector exposed to massive losses, serious health risks due to poor drug storage practices – AG report

Nov 09, 2022 News

Kaieteur News – Poor storage practices over the years has resulted in the Ministry of Health suffering massive losses while exposing the public to serious health risks due to expired drugs and medical supplies.

According to a performance report conducted by the Audit Office of Guyana, poor storage practices by the Ministry of Health have resulted in spoilt supplies.

The report documented that in 2018 at the Kingston Bond, Auditors found over 4,000 spoilt Hepatitis B vaccines stored in a walk-in freezer among usable supplies.

Boxes with medical supplies damages by termites.

“Our inquiries revealed the spoilage occurred because the vaccines were not stored at the right temperature during shipment to Guyana. However, the actions being taken by management to dispose of the vaccines and the strategies in place to correct the unsatisfactory situation, could not be determined,” the Auditors said.

The audit report stated that the management of Regional Health Facilities should comply with the World Health Organisation’s (WHO) storage guidelines.

However, there was a failure on the part of management to protect the areas against termites and other insects.

Over at the Ocean View International Hotel now renamed as the Covid Hospital, boxes of medical supplies were found stored on the floor and stacked against the wall in seven rooms. The Auditors could not count the items because of how the boxes were packed.

Another instance occurred during a visit to the Mibicuri Hospital in August 2018 where the Auditors also observed drugs and medical supplies stored on shelves that were damaged by termites.

Similarly, a visit to the Mahdia Hospital showed termites in the ceiling of the storage bond. The walls of the Lethem Hospital Pharmacy Bond showed evidence of mold and insects during a visit in August 2018.

As a result, the auditors could not validate the accuracy of $950M shown as the value of expired drugs and medical supplies from 2015 to 2017.

The value of the drugs was also unknown because none of the facilities presented a cost list to the Auditors. Further, there was a lack of accountability on the part of Health Facilities to keep records of expired drugs and medical supplies.

The Auditors said, “We found no system in place to promptly remove damaged and expired drugs and medical supplies at Health Facilities. At the West Demerara Regional Hospital, we noted items were on hand even though they had expired since 2010.”

As such, the auditors recommended that the Heads of Budget Agencies put measures in place to ensure that there is compliance for the accounting, storing, and removing of expired items of drugs and medical supplies.

The WHO guidelines require the issuing of products that will expire first after ensuring that they are not too close to or past their expiration date.

The WHO guidelines state that “The shelf life remaining must be sufficient for the product to be used before the expiry dates …so stocks can be sent to facilities at least 6 months before they expire.”

Meanwhile, the audit report said that stock counts are a fundamental aspect of inventory monitoring and are used to confirm the accuracy of stock levels in a warehouse.

“Frequent counts can assist in signaling impending stock outs of commodities. We found poor inventory management on the part of the Ministry and Regional Health Facilities to confirm the accuracy of stock levels and the balances in the records maintained,” the report said.

Additionally, the report noted that there was no evidence that Health Officials undertook inventory counts for the years 2015 to 2017.

“To test the accuracy of stocks on hand, we conducted independent stock counts during the period 28 September to 3 October 2017,”the report added.

Further, the audit report noted that agreements were not in place with warehouse owners for the storage of drugs.

The Ministry had in place two permanent sites for the storage of drugs and medical supplies. In addition to the two permanent sites, the Ministry operated six privately owned offsite warehouses. However, there was no agreement between the Ministry of Health and the owners of the warehouses for the proper storage of the drugs.

As a result, the auditors noted that the Ministry lost significant amounts of money from drugs and medical supplies that did not have the required shelf life.

The Audit Office has recommended that the Permanent Secretary review the system to ensure that drugs and medical supplies received from suppliers have the required shelf life.