Customs control is a serious business, and there is congestion when officials check medicine and other commodities after they are imported.

When it was first reported in Wuhan, China, on December 31, 2019, the last day of last year, no one gave any attention to Novel Coronavirus (COVID-19). Since then, the virus has spread rapidly and been declared a worldwide pandemic by the World Health Organization (WHO).

Many countries' health systems are being overwhelmed as governments run out of medical supplies and money to contain the spread of the virus. It causes a risk to lives, businesses, jobs and livelihoods.

The spread of the virus and not knowing when the world will turn right-side up again only adds to the burden on patients who suffer from other illnesses. Many of the drugs that have to be imported to Ethiopia are not available anymore, adding to the pressure caused by the pandemic.

Aelaf Habte, 32, has been searching for medicine for her father, who has struggled with cancer for years, and her mother, who suffers from hypertension. She used to obtain the medicines directly from individuals who carry the supplies into the country.

Now, Ethiopian Airlines has suspended flights to over 90 countries, and other airline companies have stopped operations to Ethiopia altogether.

Up until the outbreak of the virus, Aelaf was able to get enough drugs through individual travellers, but recently it has become a major challenge to get Docetaxel, an anti-cancer drug, for her father and Metoprolol succinate, Rousuvstatine, Vitamin D, and Tegretol CR for her mother.

"Now, I can’t find them anywhere,” said Aelaf, a professional psychologist.

For the past three months, her father has been using chemotherapy, an aggressive form of the chemical therapy that is meant to destroy rapidly growing cells in the body. This kind of medicine is not usually available in Ethiopia, and it is expensive even if it does reach the country.

“The drug must be taken every 21 days,” said Aelaf, who is still hopeful after inquiring at several hospitals and pharmacies, including Tikur Anbessa. "It shouldn't be neglected," she says.

As the government responds to the virus, many companies and individuals are not shipping the medicines to the country, which causes additional strain on the patients.

After receiving imported medicine and other commodities, an employee of A to Z Express arranges to deliver it to customers.

It has been a steep hill for many cancer patients with lower incomes. The effect of the epidemic is being felt especially by these patients.

“My mother uses six to seven medicines, and I recently purchased the drugs for twice the price,” said Aelaf. “We've really been in a difficult situation since the arrival of the virus.”

Aelaf tried on social media to get an individual, a supplier or a traveller who will be coming to Ethiopia to bring her the medicine, but to no avail.

She is not the only person who finds it hard to find medicine. Nebyu Negash, 46, is one of many patients who is looking for Beracizumal 400mg and SIG 10mg.

Nebyu wishes the government would allocate at least one cargo plane for transporting medications that are not available in the country as part of fighting the pandemic.

Ethiopia guides the pharmaceutical industry through the National Drug Policy, which is designed to ensure a regular and adequate supply of drugs and medical supplies is achieved through import, donation or local production, according to the Ministry of Health.

Currently, there are 54 factories engaged in the local production of drugs and medical supplies. There are also 622 factories manufacturing health care products, including soap and hand sanitizer.

The Health Ministry, through the Pharmaceutical Supply Agency, also imports drugs that are not available in the local market. Governmental organisations, private importers, NGOs and international agencies, including UNICEF and WHO, participate in the import and distribution.

But there are still many medicines that are not locally available.

Poor medicine management practices in the country diminish the supply of essential medicines, which are subject to high prices, poor quality, theft and expiration, according to a research article conducted on Pharmaceutical Care & Health Systems at Ambo University. It also results in irrational prescriptions and incorrect use of medicines, according to the research.

“Since no one knows when it will be controlled, and it’s difficult waiting for the medicine out of hope,” said Nebyu, ”I have been hunting for the medicine everywhere and even planned to import it, but I still couldn’t find anyone.”

In addition to the lack of availability, the price plays an essential role in access to medicine. There are some pharmacies that are selling drugs over the price they cost.

Last year, Aelaf used to buy the hypertension medicine for 60 Br to 100 Br, but now she is buying it for 400 Br. Similarly, the 5,000 Br she used to pay for chemotherapy jumped to 10,000 Br in the past month.

The government is subsidising drugs that are expensive. If the medicines are out of the government's hands, they are hard to control, and all the responsibility lies with hospitals and their pharmacies, according to Seharela Abdullah, state minister for Health.

“If private clinics are overpricing the drugs," Seharela said, "they will be subjected to legal action."

Beyond the inflated price, what concerns patients and their families is the lack of availability. Thus, Nebyu's and Aelaf's hope is to get the drugs through passengers coming into the country and from a pharmacy that manages to get a shipment. They are trying to find a courier company that ships medicine from abroad.

After the outbreak of COVID-19, the demand for medicine, hand sanitizer and different types of medical equipment shot up, according to Yonathan Beyene, a managing director at A to Z Express, a company that was established in 2013 and provides international air and ocean cargo shipping services.

A to Z Express, which offers shipping and warehousing services across the world, used to ship one day a week from Europe, Africa and the Middle East but is now shipping three times a week since the outbreak of the virus.

“The demand has increased by 40pc, and we're carrying vitamins, flu suspensions and various sanitizers,” said Yonathan. "Customs control of commodities and goods has become tight, and there is congestion that needs to be addressed.”

The company, which charges a minimum of 35 dollars a kilogram is ready to help and bring the medicine for the patients if they cover the cost and provide doctor’s prescriptions.

In addition to A to Z Express, a private company that provides logistics and shipping services worldwide has witnessed the increasing demand for goods and commodities, especially medicine.

“The entire logistics and shipping industry has been affected by the virus, and after Ethiopian Airlines halted a lot of flights, we have not been able to provide shipping services, despite the fact that the demand has increased,” said one of the businessmen at a shipping company who did not want his name mentioned.

These companies are shipping drugs and medical equipment approved by the Foods & Drugs Authority. which lists gastrointestinal, cardiovascular, respiratory, central nervous system, anaesthesia medicines and several other types as "essential."

While letting these medicines enter the country, the Authority's inspectors look at the doctor's prescription if the medicines are imported by individuals. The technical documentation must be provided if the drugs are being delivered to a company, production site or laboratory, according to Ayalsew Melese, Central Ethiopia Branch Office director at the Authority.

There may be an input problem associated with the Coronavirus, but 50 types of cancer drugs have been identified and distributed by the Pharmaceutical Supply Agency (PSA) along with other medications since last year, according to Seharela.

The Ministry is working with the Pharmaceutical Supply Agency (PSA) to expand facilities among 100 governmental hospitals. Between private organisations and the government, 20 billion Br has been spent on the drugs over the last fiscal year. In the first half of this year, the government spent 11 billion Br to import medicine.

Gebrie Dinkayhu, a medical director at Debre Tabor Hospital, believes that at this time patients with diabetes, lung cancer and HIV/AIDS are more susceptible to the pandemic.

Currently, there is a stock of drugs in the market, but if the epidemic continues like this, medicine will become unavailable, so the government should take precautionary steps to help patients, according to Gebrie.

"If patients stop taking the medicine, they might get into trouble," he said, "so the regulatory body should control pharmacies and hospitals who sell drugs above the market price."

PUBLISHED ON Apr 17,2020 [ VOL 21 , NO 1042]

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