Smuggled and Counterfeit Medicines Endanger Civilians' Health in Yemen (Video)

   Since the outbreak of war nine years ago, millions of Yemenis have been living under challenging conditions, especially having access to health and medical services, due to the collapse of state institutions and the exposure of many health facilities to damage and destruction.

Currently, Yemenis have mainly relied on the aid of donor countries and international organizations to obtain medicines, but this aid is delayed due to several factors, some of which are related to the conditions of war or are linked to local mismanagement.

Obstructing the delivery to those in need affects the safety of the quantities of medicines. Moreover,  other medicines are smuggled into Yemen unofficially and may not conform to specifications.

Instead of contributing to alleviating the suffering of patients, it doubles their misery and may lead to death, as happened late last year when 11 children died in a hospital in the capital, Sanaa, after they were injected with an expired dose of medicine. Last week, a First Instance court in Sanaa convicted three individuals involved in this issue, and the court ruling punished them with imprisonment for one year with a suspended sentence, obligating them to pay blood money for the wrongful killing of 11 children.

Activists in Aden raised the issue of medicines vulnerable to storage damage. Journalist Fathi Bin Lazraq, editor-in-chief of "Aden Al-Ghad" newspaper, wrote on his Facebook page that Aden Airport receives at least three UN flights loaded with various medicines monthly. Quantities of drugs allocated to Aden go to the stores of government hospitals and health centers. However, most of them remain locked in the stores until they expire and then be burned in a landfill, according to Bin Lazraq.

However, Dr. Abdul Qadir Al-BakIri, Director General of the Supreme Authority for Medicines and Medical Supplies, a government institution under the Ministry of Health, said, "Such an allegation is not true," indicating in his speech to  Sheba Intelligence that Yemeni health institutions depend on the medicines provided by international donors. The medications are distributed to all health sectors, especially the primary healthcare institutions.

However, he pointed out that there are problems in the process of transporting medicines, as it takes a very long time due to the supervision and inspection carried out on all ships entering Yemen, and thus, shipments are delayed. He added that the power outage for long hours significantly affects medicines' appropriate storage and distribution.

An official in the Yemeni Ministry of Health spoke about the damage to medicines is attributed to "the existence of complex routine procedures, which are being implemented slowly, whether by the external donor organizations or concerned Yemeni authorities."

Speaking to Sheba Intelligence, he said that the donor organizations often rely on a complex mechanism that takes a long time, which may reach several weeks or perhaps several months.

He indicated that once the medicines are shipped, they pass through several steps, each taking time. He added, "Procedures of transportation and distribution of medicines to stores, hospitals, and health centers in Aden and the rest of the Yemeni governorates are also time-consuming."

According to the source, some concerned authorities adhere to the rules of traditional administrative work in dealing with the required documents and papers, which happens at the expense of the validity time of the medicines.

He said that the matter gets worse the longer these procedures take, as medicines are vulnerable to damage due to poor storage and the end of their validity time.

From time to time, the Supreme Authority for Medicines destroys a quantity of medicines.Despite that, the Director General of the Medicines Authority said the amount of disposed expired medicines is little.

 He told Sheba Intelligence, "Based on our monitoring of this matter, 45 items were withdrawn last year due to non-compliance with specifications." According to Al-Bakiri, unsafe medicines are withdrawn in all countries, including the developed ones.

He said 9,750 items were imported last year, and only 45 items were withdrawn in the same, and that was a small number, especially in the conditions Yemen is experiencing as a result of frequent power outages, which last for long hours.

Al-Bakiri explained that many areas are hot with high humidity, which affects the quality of medicines, revealing that nearly twenty thousand types of different medicines were imported during the past two years, 2021 and 2022, covering all aspects of health needs.

Aden-based citizen Jamila Nasser said her friend is a nurse in a government hospital in Aden. The nurse told Nasser that the hospital administration stores medicines until they are about to expire and then distributes them to the hospital employees so that they can give the medication to their sick relatives who need it.

Mohamed Khaled, accompanying one of his relatives in one of Aden's hospitals, told Sheba Intelligence that many medicines offered by aid organizations to Yemen are sold to pharmacies, whereas poor patients are deprived.

Medicine landfill

Bin Lazraq said, "A large portion of the medicines entering Yemen are smuggled, and counterfeit, and some of them are remanufactured, and the date of production and expiration of the medicine is changed, which means that Yemen has become a dumping ground for medicines imported from all over the world."

He said this matter happens due to the absence of control given the conditions of war and the diversity of importing companies. This has opened the door wide and made Yemen an open arena for various medicines. These medicines are put on the market without supervision and cause significant complications for patients, according to Bin Lazraq.

He added, "We favor destroying medicines that violate specifications, expired and harmful medicines, or medicines that have an unknown country of origin. Unfortunately, some medicines are destroyed due to the delay in their arrival in Yemen due to complex import procedures due to the war, and ships going to neighboring countries for inspection and delaying them at the docks."

He called for raising awareness about the issue so that "importing unchecked medicines is stopped and controlled, companies flouting rules are seized, and the legal and regulated import process is facilitated for the entry of authorized medicines."

Imported medicines control

Regarding the control of medicines entering Yemen, Al-Bakiri said that the Medicines Authority is responsible for the officially imported medications and takes measures to control them.

According to Al-Bakiri, the procedures include registering medicines and factories to ensure that the factories meet the conditions of good practice for manufacturing quality medicines, and there are accompanying control procedures, which involve taking samples from ports upon their arrival, examining them, and ensuring their quality.

As for subsequent control it comes through control and inspection teams that continuously visit drug stores, wholesale offices, pharmaceutical factories, and companies and post-consumption follow-up through documenting the side effects of medications.

Despite the series of procedures, Al-Bakiri said these official procedures and control, the quality of some medications may change. He said the quality of smuggled medicines is worse affected, and fighting medicines smuggling is not the responsibility of the Supreme Authority for Medicines. It is the responsibility of those guarding borders.

He called on these authorities to implement legal penalties for seizing smuggled medicines and not only confiscating smuggled items. The smugglers should be punished with imprisonment, as the law stipulates, which requires the activation of the competent judicial authorities to deter those who smuggle medicines, Al-Bakiri said.