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Logo of Phnom Penh Post newspaper Phnom Penh Post - Nation's hospitals headed for drugs shortage

Nation's hospitals headed for drugs shortage

The country's hospital system is set to experience shortages of blood, serum and

drugs, including antibiotics, following lengthy delays in the awarding of procurement

contracts.

The lucrative contract to supply the country's drugs had been held by the well-connected

Sokimex group, but was put out to tender following donor pressure on the Ministry

of Health (MoH).

But the lag in approval within the MoH and the Ministry of Economy and Finance (MEF)

has meant delays in supplying drugs are likely in the first quarter of 2003. Health

experts warned the country could face significant problems if there was an outbreak

of dengue fever or cholera.

The MEF has moved to cut some of the expected shortfall by authorizing on December

31 the release of a further half million dollars for emergency procurement of drugs.

Dr Te Kuy Seang, director-general of administration and finance at the MoH, said

the extra funds would be drawn from the health ministry's 'Priority Action Plan'.

Richard Veerman, country head of health NGO Médicins Sans Frontières-Holland

Belgium (MSF), said that supplies of around 30 to 40 drugs, including penicillin

and paracetamol, were set to run out in the first quarter of the year in Sot Nikum

in Siem Reap district. The NGO works there with the referral hospital and 17 health

centers.

"Normally we receive our first quarter supply around this time, but we understand

that the central medical store is quite low," he said of the MoH body that distributes

drugs around the country.

Veerman added that MSF would likely buy in drugs from Europe, but was hopeful the

MoH would solve the problem without the need for external assistance.

Dr Te said the depleted stores would have particularly adverse effects if there was

an outbreak of dengue fever or cholera in the next four to five months.

"The infusions are very important," he said. "If there is an outbreak

of dengue or cholera, then we [will] have a real problem."

The 'infusion sets', which are used to rehydrate patients and deliver intravenous

drugs, are to be supplied from Thailand by Cambodian importer Suoy Chheng Company.

The Cambodian-based importer is one of two companies that won the right to supply

around $8 million worth of drugs and other equipment to the health ministry for 2003.

The award of the contract to the two companies marked the first time competitive

tendering was used, and followed pressure on the MoH from donors to end Sokimex's

monopoly.

"Many donors had been keen to see a change as a principle because open bidding

is supposed to be a better system," said Maurice Hours of UNICEF, which supports

the MoH's Essential Drugs Bureau, the body that determines the country's drugs requirements.

Dr Te said the previous system did have some benefits.

"Under the monopoly system the price was very high, but there were advantages

- they could meet supply very quickly," he said.

Tenders were advertised in May 2002 with bids opened and evaluated by the MoH in

September. Approval by the MEF took another six weeks, and final contracts were signed

on December 5. The contractors have been given up to ten months to deliver the supplies.

Dr Te blamed a lack of experience on the part of both ministries for the delays but

said he was confident the companies could bring forward their deliveries to alleviate

the problems.

"Most of the shortage can be filled by CPE," said Dr Te referring to a

local manufacturer Cambodia Pharmaceutical Enterprise, which is a joint venture between

the MoH and a Chinese company.

"For reagents [essential for testing blood] I have written to the company three

weeks ago and asked them to bring forward their delivery," he said. "If

the supplier has goodwill, then they will provide the supplies".

The MoH had also called on donors, NGOs and international organizations to help.

UNICEF had said it would supply some low dose vitamin A capsules.

UNICEF's Hours said policy at the country's 75 "Operational Districts"

meant they were expected to maintain sufficient supplies.

"Many ODs have three months stock, so where the system is working well they

should be able to mitigate the effects of the shortage," he said.

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