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New NDA boss: Ugandans shouldn’t consume medicine like its food

Dr. Medard Bitekyerezo, the new Chairman of National Drug Authority (NDA) spoke to The Independent’s Flavia Nassaka about the challenges at NDA and how he plans to tackle them.

You are joining an institution whose image is not impressive following the previous corruption scandals and intrigue which has led to some top officials losing their jobs. How do you intend to turn this around?

I am not a man of scandals and intrigue. If there is a problem, I will tell you there and then. That’s the approach I intend to use here. What brings intrigue is lack of satisfaction, hypocrisy, and lack of information. People here are not given targets and I am now telling them that they will have targets and if they don’t deliver results we will fire them.

In your view, what is NDA’s biggest challenge?

The challenge at NDA is that it’s unclear who reports to whom. There is no supervision which makes it hard for people to accomplish tasks. Even if a manager has a heart to work, it may not be easy if they don’t get the necessary support.

We started with meeting departmental heads and coming up with working committees to handle the most urgent issues affecting availability of drugs. The General Manager of National Medical Stores is a member of the board and is also on the Commission of Four that can make urgent decisions in absence of the board. Members of these committees are very knowledgeable about Uganda’s drug sector.

There is growing interest in pharmaceutical and drug shop business around the country explained by their increasing number. How do you intend to regulate them?

That has been my concern; mushrooming pharmacies in the country at a terrific rate as if Ugandans were meant to consume medicine like food.  I got to know what was actually happening when I was in parliament and interacted with both officials from NDA and Ministry of Health. I realised the pharmacy industry is full of quacks.

If you go to Nakasongola now where fake and expired drugs are supposed to be burnt, there is no business going on because even when raids are made and drugs confiscated, they are not taken there. Where do you think these go? I am suspicious there is a problem there.

The law provides for pharmacists or at least pharmacy technicians to dispense drugs and that there must be some distance from existing licensed outlets, but this doesn’t happen. Many unqualified people, including non-Ugandans, are operating these businesses. The non-Ugandans use certificates of Ugandans who they pay a small fee to use their credentials.

I am equipping my team to ensure that it’s only pharmacies with verified requirements that operate. The current system does not restrict ownership of a pharmaceutical business as long as those operating it are qualified. That has its own disadvantages that we have to live with.

Ugandan scientists have come up with new drugs; for instance the recent Dei anti-malarial but many of these stop at being registered. What’s affecting approval of new drugs?

My job is to ensure the availability at all times of essential, efficacious and cost-effective drugs to Ugandans as a means of providing satisfactory healthcare. While we would want more drugs to be manufactured here, it’s important that we ensure a particular new drug will not be hazardous and establishing this may take time. However, I am keen on innovation and will ensure the authority doesn’t sit on someone’s dossier for years even when they meet all the requirements.

You said your job is ensuring we have cost effective drugs but buying drugs remains not just expensive but also confusing;  for instance one pharmacist will ask you whether you need UK, India or Kampala made panadol. Are cheaper drugs not as effective?  

 The price of any drug is largely determined by the cost of developing it. There are those drugs that will remain expensive and we will have nothing to do about it. However, because of laxity, patients come to a pharmacy and buy drugs without a prescription. Patients now choose how much drugs they will take and not what’s required. That is breading resistance and in future the cheap available drugs will not be able to work for us because we will be treating drug resistant pathogens.

However, with the market awash wish counterfeit drugs, we want to improve the way we approve drugs used in the country and determine which drugs are important, and which ones work or not. I will meet with importers of drugs to let them know of what to expect because in future some drugs will not be allowed in the country.

Herbal medicine is one area where one would feel NDA has not done enough. What difference should we expect with you as chairman of the body?

I encourage people to go into herbal medicine but at this time you can’t differentiate a genuine practitioner from a quack. There is a law in parliament called the Complementary Medicine Bill which will provide for such issues as who is supposed to practice, how the medicine should be packaged, testing it, and how it should be sold. Without the law yet however, we have included a representative of the herbalists on the board and have decided that dealers in herbal medicines be issued with certificates of suitability and manufacturing licenses.

What would you say about the issue of food supplements being marketed as drugs?

I call it fraud. There is currently no law stopping them from importing or marketing these products the way they do but we are working on turning NDA into the National Food and Drug Authority where we will regulate drugs, food and cosmetics. The law has left cabinet and is now back at NDA and consultations with different stakeholders are on-going. When we finally have a law in place we will be able to control everything from packaged foods like biscuits, food supplements, and creams.

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