Dr. Nader Kowiri, the Deputy Minister of Health in the Provisional Government for the city of Benghazi spoke to Correspondents about the chronic shortage of medicine in hospitals in Eastern Libya. Dr. Kowiri acknowledges that key medical facilities have not received key supplies and explained why his agency finds itself between a rock and a hard place.

Dr. Nader Kowiri, the Deputy Minister of Health in the Provisional Government for the city of Benghazi spoke to Correspondents about the chronic shortage of medicine in hospitals in Eastern Libya. Dr. Kowiri acknowledges that key medical facilities have not received key supplies and explained why his agency finds itself between a rock and a hard place.

Why is the Medical Supplies Department in Benghazi still not able to cover hospitals’ key medicine needs?

There are many reasons for this failure. The country in general is suffering a political and economic crisis. The government in Tripoli did not fund the department to cover the needs of the hospitals in Benghazi which, in turn, affected the medicine supply in the eastern part of Libya. The political and security situation also creates logistic difficulties for transporting medical supplies.

Since citizens in their day to day life frequent the facilities of the health department, it is normal to find them complain about the health department whenever there is a failure. However, what citizens do not know is that the Medical Supplies Department is an independent institution that receives its budget independently from the Ministry of Health.

Do you mean that the Ministry of Health is exempted from the responsibility to supply the hospitals and health care points with medicines?

No, I do not mean that the ministry is completely exempted, but I want to say that our role in this process is mostly technical. The medicines must be paid for from a budget given to the Department of Medical Supplies, and since that budget was not given to the department, there is nothing we can do. The government in Tripoli stopped supplying the east since the Ministry of Health in the east government in Al-Baida formed a Medical Supplies Department. However, this department has not yet received its budget and we are left here waiting for the supplies and trying to make the best of the little medicine we already have.

What are the steps that the ministry took to deal with the shortage?

Honestly, the financial and administrative situation of the ministry is not very good, yet we tried to ease the suffering by giving ten million Dinars (7 million USD) in funds to the hospitals of Benghazi to buy what they need. And five months ago we gave two and a half million Dinars (1.73 million USD) to the Benghazi Medical Center.

The Benghazi Medical Center services a large number of people in Benghazi and beyond. Is the above amount enough to cover their needs?

This amount is not enough to run the center for more than a month. There are treatments like heart surgery, stenting, tumor and maternity treatments that are very costly – especially with the drop in the Libyan currency. We now have a problem to deal even in the local market, because the prices follow the rules of the international market.

The ministry also gave special payments to the hospitals that have tumor departments, including a pediatric hospital that received a grant of one million Dinars (700,000 USD) last January directly from the ministry. This payment was granted under the condition of committing to the list of materials considered necessary by the World Health Organization for tumor treatment. 

The head of the media office in the pediatric hospitals told Correspondents that the medical supplies have not arrived at the hospitals, even after the million Dinar grant was awarded by the minister. Can you tell us why?

When the decision was given by the ministry, only two companies applied for the contracts because the big companies usually take bigger contracts from the state and they usually have what is ordered or they can supply quickly and according to the standard. In this case, the contract stated that the material must be made in Europe, but when the shipment arrived we found eight sorts of drugs made in India. Therefore, we stopped the shipment before it passed to the tumor section. Nevertheless, the hospital store did receive the shipment.

Why is the shipment in storage yet not being used?

Eighty per cent of the medicine arrived at the hospitals and the other 20 per cent did not arrive for logistic reasons. We did not try to re-send it after we found out that it was made in India and not in Europe as stated in the contract. However, the scientific committee convened and decided to refuse the shipment entirely without discussing the reasons.

But there are serious cases of children who may lose their lives, is there a life saving alternative for them?

I said to the committee that we are in an exceptional situation, and that we would prefer to have medicines made in Europe, but we have to find a solution. The company violated the contract and there must be legal consequences. We should either turn the supplies back or take penal action against the company.

However, if the medicines we have received are approved by the world health organization, by the FDA, and by our experts, then we should use the medicines and at the same time take legal action against the company. Because even if we found a new importer who does supply European medicines, time is not on the side of the suffering children.

There are rumours about hospital staff members selling drugs to private pharmacies, even highly specialized drugs. How true do you consider these to be?

No one can deny that corruption exists, it is a universal phenomenon and the whole world is trying to prevent it. Let me first make clear that the drug purchasing mechanism makes it very difficult to smuggle drugs to private pharmacies, especially the specialized medicines. For example, narcotic drugs are given to the patients in air-tight tubes and no one can buy the drug without prescription signed by a doctor. Moreover, the drugs are kept in special stores that run an official annual inventory; every hospital has its own hierarchical inventory committee and the Ministry of Health also supervises the work of these committees.

Does this mean that you deny any rumors of drugs being smuggled from hospitals?

I do not deny such news and I do not think they are far fetched. I am only saying that if there is a smuggling incident proved by evidence, then we are ready to open a transparent investigation beyond the hospitals’ administrative authority. Even within the hospitals, the inspection departments is independent from the hospitals‘ administrations. If in fact there are such incidents, the amounts would not exceed one or two boxes.

Lately, some private pharmacies provided tumor treatment medicines, but they are privately imported from outside of the country. The municipal authorities must be vigilant in inspecting the quality of these drugs and must mandate that they enter the country through the official channels.