By Neo Kolane
Concerns are gradually growing at the mushrooming of pharmacies owned and operated by unqualified people in the country, which pose a serious health risk to gullible customers.
These health facilities are growing in numbers in and around the different towns and peri-urban settlements. Most of them are run by either Asian origins or the locals with no professional knowledge in pharmaceutical practices.
Most of these establishments sell prescription medicines right over the counters at customers’ behest without following proper practices within the pharmaceutical field.
Customers are sold the medication on demand without any prescription from a medical doctor or clinician, without regard to the suitability of the medicine.
Local pharmaceutical scientist, Teboho Kalebe, told this publication this week that some pharmacies are owned by pharmacists who do not work at such establishments but are employed elsewhere.
According to Kalebe, such pharmacists employ unqualified staff at these health facilities to dispense medications, contrary to regulations. Some of the personnel employed are not trained in the practice.
He said due to the rising number in pharmacies, some of the people employed are offered on the job training and paid low wages.
“The regulations require that for a person to own a pharmacy there should be a pharmacist stationed at facility. In most cases in Lesotho the pharmacies do not demand prescriptions from the doctor or general practitioner. A doctor should diagnose a patient and write out a prescription, especially when such medication is not available at the hospital.
“In Lesotho, we have doctors who run their own private surgeries and have their own dispensaries. In that regard no one performs the duties of a pharmacist. So it may be difficult, for example, for anyone to give out any antibiotics without prescriptions.
“It may be the discretion of a pharmacist to determine whether it is necessary for a patient or sick individual to be offered an antibiotic. Some people cannot afford high fees charged by our doctors when seeking medical care. Consultation fees are exorbitant.”
Kalebe said patients seek medical care from the pharmacies in search of quick service, believing the staffers are highly skilled and knowledgeable in the medical practice.
For instance, he observed, there were a few pharmacies in Maseru, but they have significantly grown in numbers, making patients believe they offer professional medical services.
“I wish a law enforcing strict regulation of the sector would be made. I advise patients to desist from instructing the pharmacists to give them antibiotics without a prescription from an authorized person.
Some of the health risks associated with giving out wrong un-prescribed medication is that it may cause ailments to the consumer.
The National Medicines Policy of 2005 says the major problem of the country’s pharmaceutical sector is insufficient financial power and shortage of human resources to enable the sector to efficiently plan, manage and coordinate the functioning of the profession.
It observes that there is no legislation that effectively regulate the industry.
On rational medicine use, the policy notes that prescribers hardly have any objective medicine information at their disposal, except for wall posters from pharmaceutical companies.
“Medicine use indicators show that 54 percent of prescriptions contain one or more antibiotics, and on average 2.95 items are prescribed per encounter. Dispensing is haphazard: no proper labels and not enough time to explain rational use to patients.”
The deputy president of the Pharmacy Association of Lesotho (PAL), Rethabile Mothobi says there are no laws that regulate medications in Lesotho. He is adamant that that are no laws stipulating what type of medication is to be allowed into the country – their quality and quantity.
“Quality assurance is seriously lacking in the medicines supply chain. The Medicines Control Council of Lesotho which will set out the prevision of quality assurance of medicines can only be formally established after the Medicines Act has been passed.
“Whatever is imported, the National Drug Service Organisation (NDSO) is supposed to work with the ministry of health and other laboratories in South Africa to test the medication, but whatever is imported, no facility can test if its legit. There are no institutions because there are no laws; that is why anyone can make medicines claiming to cure whatever ailment. This way, there is no regulation whatsoever, and no one can be prosecuted.
“That is why when the law has been passed, it will establish a drug regulatory authority which will spell out how medicines will be regulated. We are currently working under a council which is made up of doctors, pharmacists, dentists, health workers; it also has a challenge because it was established under an obsolete law of 1970.
Mothobi lamented that at the moment, anyone can open a pharmacy any day and nobody seems to care to monitor the practice. Another difficulty is that there is only one body known as the Lesotho Medical, Dental and Pharmacy Council which oversees the activities of all health professionals.
Mothobi claimed that practitioners employed by the ministry have been operating pharmacies illegally and no one does any monitoring.
“It is mandatory for personnel working at the Queen ‘Mamohato Memorial Hospital (QMMH) and Baylor to be registered with the council. Health professionals should register with the council before practicing.
“All that it is needed is to be in possession of a pharmacy retention certificate and present it for renewal to the trade and industry ministry in order to operate, without confirming that one is qualified or not. Some fee is then paid to the council,” Mothobi emphasized.
“Some members of the council are still practicing and several letters alerting the ministry about the matter have been written to the ministry but no decisive action has been taken. They do not even pay their dues to the council,” Mothobi lamented.
On May 21, the principal secretary of the ministry of health Khothatso Tšooana wrote a letter to the director general, the director of human resources and all the heads of programmes warning that it was a requirement of the law that practicing health professionals were bound to register and update their registrations annually with the council based on the law, and the nursing and midwifery legislation.
Tšooana urged that all health professionals working under the ministry of health should adhere to the requirements of the law regarding their duties with their councils.
President of PAL, Teliso Letsatsi said police hardly raid “these pharmacies which operate illegally. When they do, they go with a health professional, but unfortunately no case has been opened against those breaking the law.”
