An acute shortage of anti-rabies vaccine has hit government hospitals in Khyber Pakhtunkhwa, especially medical teaching institutions, to the misery of dog bite victims, who can’t afford to buy expensive injection from the market.
Officials in the health department told Dawn that anti-rabies vaccine was procured from the National Institute of Health (NIH) under the government policy but it didn’t cater to the needs of hospitals. They said last week, a boy with minor dog bite injury was administered initial dose of the vaccine at the Hayatabad Medical Complex, Peshawar, and was told to get the remaining four doses from other hospitals. When contacted, HMC director Dr Faisal Shehzad confirmed the shortage of anti-rabies vaccine and blamed it on poor supply.“ Money is not the issue. We have ordered ample quantity of vaccine but the NIH has yet to deliver it.The real problem is that the vaccine supply is not consistent,”
The director said last year, the Lady Reading Hospital, Peshawar, ran out of vaccine stocks, so the HMC ‘loaned’ 200 injections to it for dog bite victims. “There is also a seasonal surge in anti-rabies cases, so the vaccine consumption increases with a rise in the incidents of biting by street dogs,” he said.
Dr Faisal said the hospital had to ensure strict controls to keep stocks from running out, especially for the poor people, who couldn’t afford to buy them from the market. He said the policy of administering one dose of the vaccine to every dog bite victim was made a few years ago over anomalies. “Whenever poor patients need injection, we give them its multiple doses,”
The HMC director said as the vaccine supply hadn’t been very consistent, the hospital’s accident and emergency department adopted that strategy sometimes ago to prevent stocks from running out and make the people living in the city manage the other doses from other hospitals or even private sector in the worst scenario.
He said the first vaccine dose mattered a lot for the safety of patients. Dr Faisal said in the past three years, the hospital had provided all anti-rabies vaccine doses to patients whenever the stocks were sufficient. He said everyone knew that inconsistent medicine supplies were caused when the demand was high. The director also said monopoly regarding drug manufacturing or supply also caused shortages. He said the hospital was still short of around 1,000 vaccine doses.
“The main area we need to work on is the handling of street dogs and the vaccination of pets on time. We pursue the health department’s Medicines Coordination Cell for procurements. If the MCC doesn’t have medicines, we purchase them from manufacturers and authorised distributors through competitive bidding in line with the rules of the Khyber Pakhtunkhwa Public Procurement Authority,” he said.
Dr Faisal said recently, the HMC had to buy small quantity of an extremely essential medicine of anesthesia from the market as no bidder responded to repeated advertisements. He complained that the hospital faced audit issues on the matter. “No one realises that had we not procured the medicine from the market, our operations, including emergency, would have come to a halt. At times, we have to walk a tightrope,” he said. Officials at the directorate-general (health services) told Dawn that the vaccine stocks were available in district hospitals but majority of the people went to MTIs, so the latter ran out of those medicines.
They said the MCC, which approved drug prices, had fixed Rs1,195 for a vial of anti-rabies vaccine that was sold for over Rs5,000 on the market and therefore, the hospitals avoided its purchase from the market to prevent audit objections. The officials said several companies manufactured those vaccines from imported raw material for which they made payments in dollars, so the vaccines cost very high locally. They said they had to wait for long periods to receive vaccine from the NIH despite advance payments as the latter made supplies to the entire country.
Source: This news is originally published by dawn