A long-time diabetes patient, Almaz Teshome has been battling the effects of what she suspects to be substandard insulin bought from one of the pharmacies in public hospitals. Her condition worsened after using the medication, which she noted was visibly different from what she had used for 20 years. Her experience is part of a growing chorus of complaints from patients at Tikur Anbessa Specialized Hospital, who have reported that essential medicines, including insulin and chemotherapy drugs, have not been working effectively over the past year. Despite her reliance on community-based health insurance, Almaz is now considering buying medicine from private pharmacies, although the cost is prohibitively high.

The Ethiopian Diabetics Association (EDA) has acknowledged receiving complaints from patients about potential product defects but downplays the issue, suggesting that the problems might be due to improper administration rather than the medicine itself. However, recent research conducted by universities in Bahir Dar and Gonder reveals a troubling trend: nearly 22pc of medicine samples tested across sub-Saharan Africa failed quality tests. These medicines were found to be substandard, falsified, or unregistered, presenting serious risks to public health. The study uncovers the vulnerability of the pharmaceutical supply chain, which relies heavily on imports, with over 85pc of the market being met by foreign suppliers. India, the Netherlands, and Belgium are the largest sources, but the intricate and fragmented supply chains create opportunities for illicit products to enter the market. The Ethiopian Pharmaceuticals Supply Service (EPSS), the largest buyer of pharmaceutical products, has been urged to enhance its monitoring systems to ensure the safety and effectiveness of the medicines distributed to public health institutions.