Namibia: High Blood Pressure Medicine Out of Stock

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The ministry of health is experiencing a shortage of amlodipine medication used to treat high blood pressure and coronary artery disease.

The Namibian last week visited the Katutura Intermediate Hospital, the Windhoek Central Hospital and the Khomasdal Clinic, with staff at the pharmacies saying they did not have the drug in stock.

Several hospitals in the Erongo and Oshana regions also confirmed that they do not have amlodipine, although they said patients are being given alternative medication.

In March this year, health minister Kalumbi Shangula stated that the ministry faces a persistent struggle to procure medicine and other pharmaceutical products. He added that the ministry was struggling to supply medicine to institutions throughout the country.

A Windhoek patient, who spoke to The Namibian on condition of anonymity, last week complained that he has been going to the Katutura Intermediate Hospital for the past three months for his amlodipine prescription, but is sent away every time because there is no medicine.

The patient noted that every time he goes to the doctor, he is told that his blood pressure is high, but whenever he enquires about the medication, he is referred to private pharmacies.

"I am not on medical aid since I am unemployed, so I cannot afford the medicine at private pharmacies," the patient said, explaining that at the state hospital, they pay as little as N$10, but around N$150 at private pharmacies for the drug.

A staff member at one state pharmacy told The Namibian last week that they receive medicine in batches, which usually run out before the end of the day.

Erongo's acting health director Dr Amir Shaker told The Namibian on Tuesday that the region has also been out of stock for amlodipine for the past two months because the Central Medical Stores (CMS) had run out of the medication. He said new stock is expected next month.

"That does not mean patients don't have medicine for hypertension. There are alternatives, which we have in stock," he said.

The Oshakati State Hospital's medical superintendent, Dr Korbinian Vizkaya Amutenya, confirmed the shortage to The Namibian on Tuesday.

He said amlodipine has been out of stock for close to a month now. He, however, was quick to add that they have been informed that it is now available at the CMS, and will soon be delivered to the hospital.

"In the meantime, we have been giving our patients the alternatives - a perindopril dosage and amiloride," Amutenya added.

Although the Onandjokwe State Hospital's acting medical superintendent, Dr Siraji Saad Rwehumbiza, could not confirm whether amlodipine is out of stock, a doctor at the hospital told The Namibian that it has been out of stock for close to six months, and patients have been buying their own medication.

Rwehumbiza explained that should the hospital run out of a certain type of medication, there is always an alternative.

"They (patients) are not going to die. We offer them alternative medication. They can use them and revert to their normal medication once it is back in stock, unless it's not good for a patient; maybe if they are allergic to it," Rwehumbiza stressed.

The health ministry's executive director, Ben Nangombe, on Monday said some supply delays and shipping issues resulted in the amlodipine's delivery delay.

"The stock arrived at the Walvis Bay port, and should be delivered to the CMS by Tuesday next week," he told The Namibian. Nangombe added that due to the current stock-out, the new stock would quickly be allocated to facilities on a national level.

"There is already a procurement process underway to secure more hypertension medicine," he explained.

The executive director noted that the ministry has made sure that alternative treatment is offered, which include peridopril, amiloride and indapamide.

He said the ministry has a web-based stock system that not only shares the stock situation at the CMS with all facilities on a weekly basis, but also provides information on the stock at the facility level monthly.

"Should an item be received at CMS that was out of stock for some time, the stock system would be updated immediately so that facilities know they may proceed to order this item," he noted.

However, Nangombe said given the current economic climate, a global shortage of the active pharmaceutical ingredient and the fact that no annual pharmaceutical and clinical long-term contracts were awarded led to shortages occuring when maintaining huge amounts of items.

He said the ministry is trying to improve the situation by pooled procurement, and the re-submission of the two-year tender for pharmaceutical and clinical products.

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