19 March 2019

Namibia: Impounded Pills Are Antibiotics for HIV Patients

Health executive director Ben Nangombe last week said the drugs that were impounded by customs officials at the Walvis Bay port over the past seven months are antibiotics which are also used by HIV patients.

The Namibian reported last week that anti-retroviral drugs (ARVs) confiscated at the port could have contributed to the shortages that the Katutura Intermediate Hospital has been experiencing.

However, Nangombe said these were antibiotics, and did not contribute to the shortages that the hospital was experiencing.

Patients had complained that they were receiving different ARVs from what they were normally prescribed, with the hospital's superintended Dr Fady Ashmawy, giving an assurance that they are still equally effective, despite the difference in colour and brand name.

According to a matter registered with the Walvis Bay police - case CR01/10/2018 - the 1 300 cartons of N$8 million worth of antibiotics were confiscated by customs officials upon the consignment's arrival from China on 6 September 2018, nine days after the permit for their import had expired on 29 August.

According to the purchase order, which The Namibian has a copy of, the consignment contains co-trimoxazole 400mg tablets, itraconazole 100mg capsules, and sulphasalazine 500mg tablets.

"Co-trimoxazole is a normal antibiotic.

It can be used to treat infections just like amoxicillin, for example. The special thing about it is that for ARV patients, co-trimoxazole can treat bacteria called pneumocystis jiroveci pneumonias (PJP), which is opportunistic in ARV patients," explained Nangombe.

According to a 2018 Medical Journal titled - 'Development of a clinical prediction rule to diagnose pneumocystis jirovecii pneumonias in the World Health Organisation's algorithm for seriously ill HIV-infected patients' - PJP is a lung infection caused by the pneumocystis jiroveci fungus, and is often prevalent in people with weak immune systems. The Namibian also spoke to pharmacists and other medical specialists, who said these specific antibiotics were also used for treating invocations of the lungs, for instance.

BOUND FOR KENYA

The Namibian last week reported that the finance ministry had allegedly opened a case, which was later withdrawn, against the health ministry for bringing in goods without a valid permit, even though the permit had expired while the goods were in transit. The permit was valid until 29 August 2018, but the consignment only arrived at Walvis Bay on 6 September 2018.

The container (TCKU-6397750) has been held at Walvis Bay's bond yard since its arrival, and no answers were given as to why the expired permit has not been renewed.

Central Medical Services pharmaceutical chain director Ryno Badenhorst told The Namibian that they cancelled the order when customs confiscated the goods, and found other ways to salvage the situation.

As a result, The Namibian has learnt that NM Medicals CC and Lick Hang Engineering decided to have the consignment shipped to Kenya instead, but this has not happened yet as the goods are still impounded.

NM Medicals CC was contracted on 12 March 2018 to order the drugs on behalf of the government from Chinese supplier Lick Hang Engineering in Hong Kong. Sources told The Namibian that the clearing agent is currently running a bill of over N$200 000, and that this figure could increase the longer the container is held.

It could not be established why the container was not being released to the supplier so that the drugs could be sent elsewhere.

Additional questions sent to Nangombe were not answered.

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