Chronically ill patients are finding it hard to access essential medication. Pharmacists and patients interviewed by Al-Ahram Weekly say diabetics are facing problems buying insulin, that penicillin is increasingly hard to find and medications for hypertension, haemophilia, muscular atrophy and Parkinson's disease are in short supply. There is also a lack of infant formula on the market. “I'm diabetic and have to inject insulin. Lately I've had to trail from pharmacy to pharmacy until I find one that stocks my prescription,” Ahmed Ezzat, 53, told the Weekly. “Now I've started to try and stock up on the medicine I need out of worry that one day I will be unable to find it.” Teacher Mona Negm also had to look long and hard for penicillin, prescribed to treat an infection from which her son was suffering. “I had to go to several pharmacies in different neighbourhoods before I found it,” she says. Ahmed Kandil has been searching for subsidised infant formula but has been unable to find it. Instead, he says, he is forced to use much more expensive imported formula, though that too is in short supply. Widespread shortages of essential drugs first hit the headlines before the pound was devalued when difficulty in accessing dollars saw the import of medicines, and of the components needed to produce local alternatives, dry up. The situation improved after devaluation, when dollars became more available, and following an agreement between the Health Ministry and pharmaceutical companies in January 2017 which saw drug prices rise by up to 20 per cent. Abdel-Maguid Mamdouh, a pharmacist in downtown Cairo, says the current shortage in drug supplies is particularly problematic because it affects not just medicines in high demand but alternatives to the prescribed brands. “There has been a shortage in almost all types of insulin since July. Medication to treat Parkinson's disease, including Sinemet and its imported alternatives, has been in short supply for the best part of a year and now we are having problems obtaining drugs to lower blood pressure for pregnant women,” Mamdouh told the Weekly. Dina, a pharmacist in Alexandria, reported “a shortage in medicines for chronic diseases like hypertension and diabetes”. “We've asked the pharmaceutical companies to increase supplied but to no avail. When patients come in looking for a specific drug we let them know if there is a shortage before recommending an alternative, when that is possible. The problem is that sometimes the alternatives are not as effective as the prescribed medication,” she says. Ali Ouf, head of the Pharmaceutical Division at the Federation of Chambers of Commerce, insists supply problems are not comparable to the situation in 2016. Then, he says, more than 1,000 different medicines were affected whereas now there are supply difficulties with 150. “The problem,” says Ouf, “is developing into a crisis due to a lack of awareness among customers who are in panic buying medicines to store at home.” “The shortage of insulin was first felt in July and was a result of problems within the distribution companies. It became a crisis as alarmist and misleading reports posted on social media lead to panic buying,” said Rasha Zeyada, head of the Pharmaceutical Affairs Central Administration (PACA), during a telephone interview with MBC Egypt channel. “Demand increased from 380,000-400,000 injections in June to 580,000 in July and August.” Ouf said domestic insulin factories have been urged to increase their production and work is underway to establish a hotline linking pharmacies with the PACA so they can report shortages. Multinational drug companies like Pfizer, Novartis and GlaxoSmithKline supply 40 per cent of Egypt's drug market, with domestic private producers supplying the remaining 60 per cent. Egypt imports about $600 million of finished medicines per year and $1.8 billion of ingredients. Al-Roushetta Al-Khaireya (The Charitable Prescription), a Facebook page started in 2016 to help patients access medicines, currently has 43,519 members. Members of the group are either patients seeking medicines in short supply or volunteers helping to search for the required drugs. The #Twitter_Pharmacy allows patients to swap medicines they cannot find in pharmacies. Hospitals, too, are taking to social media to advertise their needs.
