In order to ensure the availability of essential drugs throughout the year in state-run health facilities, the Ministry of Health and Population would work to produce drugs at low prices in the country.
For this, the ministry has offered financial support as well as other necessary support to Nepal Drugs Limited for the production of essential drugs.
“We have been working to prepare a proposal for support to produce at least 25 essential drugs at Nepal Drugs Limited first,” said Dr Roshan Pokhrel, Secretary in the Ministry of Health and Population.
“We can scale up the production of other drugs continuously, which means that with a small budget, we can ensure the availability of essential drugs in public health facilities throughout the year.”
The government provides more than 70 types of drugs for communicable and non-communicable diseases from all district hospitals. Patients receive over 60 types of essential drugs at primary health care centers and 35 types at health posts.
For the purchase of essential drugs distributed free of charge, the Ministry of Health grants a conditional subsidy to all 753 local authorities. Some local units allocate budgets from their own resources to purchase additional drugs and distribute them free of charge.
However, the availability of essential drugs has always been a problem.
“Although the three levels of government — local, provincial and federal — are spending huge amounts of money, people are not getting essential medicines all year round,” Pokhrel said. “We hope that if we can produce essential medicines at low cost, the problems of unavailability of medicines will be solved to some extent.”
Previously, the former district public health offices and the Department of Health Services purchased essential drugs and distributed them free of charge through state-run health facilities. There was a separate mechanism to check whether said drugs were provided or not.
But after the establishment of federalism, no agency monitors the supply of drugs and their quality.
“The budget for essential drugs has increased several times, but most of the health facilities in the country do not have all the essential drugs,” said Dr. Guna Raj Awasthi, former Chief Provincial Health Officer of the province of Sudurpashim. “No one monitors the quality of essential drugs distributed by health facilities across the country.”
As local governments are free to procure essential medicines of any brand and company themselves, it is impossible to regulate the quality of medicines. Prices for essential drugs may vary from one local federal unit to another, Awasthi said.
Health ministry officials said helping Nepal Drugs Limited to produce essential drugs is also in the national interest, especially given the health crises and to control prices.
“Production of essential drugs by the government agency will help control the market price of drugs,” said Pokhrel, the health secretary. “The government can buy more drugs from the limited budget allocated to the program. Drug shortage problems will be solved if we could purchase more drugs with the same amount of funds.
Nepal Drugs Limited produces Cetamol and Jeevan Jal (oral rehydration solution), which have helped health authorities secure their supply during the coronavirus pandemic.
Currently, Nepal Drugs Limited produces only six essential drugs, including paracetamol and oral rehydration solutions.
Meanwhile, the health ministry said it was working to set up seven provincial drug administration departments next year. For this, an investigation into the organization and management is underway, according to the Department of Drug Administration, the national regulator of the drug market.
“We will provide the organizational and management investigation report to the department,” said Santosh KC, the department’s spokesperson. “If approved by the Ministry of Finance and if the budget is allocated, the process of establishing provincial drug regulatory authorities will be launched.”
Currently, there are three branches of the department in Birgunj, Biratnagar and Nepalgunj.
According to KC, drug market regulation and quality control will be more effective with the provincial drug regulator.
Along with overseeing dispensaries, the department is responsible for ensuring the quality of drugs and regulating pharmaceutical companies to ensure they follow good manufacturing practices.