Better stock management to stop taking expired drugs in Africa

According to experts gathered on Friday, July 29 for a webinar organized by SciDev.Net on the issue of the consumption of expired drugs, only one plausible reason can explain the use of expired drugs by patients: c is the unavailability of the drugs sought.

Therefore, efforts are needed regarding the management of drug stocks on the continent. Prosper Hiag, President of theAfrican pharmaceutical forum (APF) says his organization has tried to solve this problem by creating purchasing centers in 14 French-speaking African countries.

An approach that has made it possible to have treatments in hospitals, to establish a list of essential drugs and to promote generics.

According to the pharmacist, this strategy obtained good results until the " governance problems get involved". “Today, central purchasing bodies are on the edge of a precipice,” laments Prosper Hiag.

Beyond stock management, Aissatou Sougou, technical administrator for essential drugs and health products at WHO Africa, points out that the epidemic of COVID-19 laid bare the vulnerability countries that produce few drugs.

As a result, she says, there is an urgent need to have African pharmaceutical production made by Africans for African consumption.

Indeed, Adanvo Isaac Hougnigbe, doctor of health public to Benin, estimates that the share of drugs produced in Africa in the drugs consumed on the continent is only 1%.

Which means that 99% of these products come from elsewhere and are manufactured far from African realities such as the climate and theenvironment.

Storage conditions

However, in the opinion of the panelists, it is not only the expiry date of a product that can affect its effectiveness; but there are also the conditions of its storage and its preservation.

This is the case for example of theAspirin which degrades rapidly in humid air. “In a 200 milligram tablet, there are only 2,28 milligrams of active ingredient left one year after the expiry date. In addition, aspirin undergoes a hydrolysis reaction and is transformed into salicylic acid which can cause stomach aches”, explains Adanvo Isaac Hougnigbe.

This is also the case with oxytocin, which is prescribed to the patient to prevent postpartum hemorrhage. “In principle, one tablet is sufficient; but in some countries, it has been noticed that even an overdose of 5 tablets had no effect,” says Aïssatou Sougou.

Over time, she continues, “we realized that this medicine, which can be stored between 2 and 8 degrees Celsius, had deteriorated due to its poor storage,” she continues.

However, on this point, Aissatou Sougou reassures by emphasizing that the WHO has set up a requalification program in order to verify the stability of a drug according to the areas. In addition, SciDev.Net learns that in addition, the organization advises, in the event that countries are not sure of having the adequate conditions to preserve or store drugs, to order generics of which they can preserve the stability.

Finally, it encourages African States to strengthen their skills to be able to read the files of providers in order to choose for themselves the treatments that are best suited.

But whatever the packaging, storage or conservation, the experts present at this webinar formally advise against the consumption of expired medicines.

The Beninese pharmacist Alix Ahlonsou, who took part in the exchanges, insists that “we must stick to the supplier's stability study which sets the expiry date. Because, after this period, no one, neither the doctor nor the manufacturer can answer for the effects of the products "...

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This article was published on the French version of SciDev.net and is reproduced with their permission.