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Kenya – 90% of Nairobi’s poor get wrong medication

Poor residents of Nairobi have turned to self-medication, with 90 per cent of them getting inappropriate drugs and wrong dosages.

A new report by the Kenya Medical Research Institute (Kemri) blames the Pharmacy and Poisons Board for the alarming trend, accusing it of laxity in enforcing rules.

“Because of the high cost of health services, the urban poor have turned to the neighbourhood retail pharmacy for self- medication which is aggravating drug resistance and fuelling infections,” says the study, published in the September issue of the East African Medical Journal that was distributed last month.

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The team, led by Kemri researcher Zachary Kwena, did an in-depth study in Nairobi’s Kibera slums and found that only 10 out of 100 people are getting the recommended drugs for gonorrhoea and genital ulcer disease.

“In fact only nine out of fifty pharmacy attendants offered the recommended treatment for gonorrhoea and only one individual offered the right treatment for genital ulcer disease,” says the study.

The researchers said they investigated gonorrhoea and genital ulcer disease to get a picture of medicine use among the poor in Nairobi. In this scenario, say the researchers, the pharmacies are putting Kenyans at a greater risk of aggravating an existing disease and an increased opportunity for infecting others.

“Most of the pharmacy staff offered drugs that were not recommended for present conditions and unfortunately even those who offered the correct medicine did not give the right dosage, frequency or duration,” says the study.

This, it concludes, points to a serious problem that could lead to resistance and treatment failures. They are also concerned that the habit is contributing to the high rates of HIV prevalence found in most slum settlements. “This is fuelling the HIV pandemic since the management of sexually transmitted infections as an HIV prevention tool is well documented.”

In a medical commentary over the study, Dr Bill Lore of the International Network for the Rational Use of Drugs, says there is total anarchy in the country’s health care system and blames the Pharmacy and Poisons Board for laxity and the Medical Practitioners and Dentists Board for not punishing errant members.

He says the decay spreads across the whole city and cited an earlier study which surveyed 34 pharmacies in the city centre and 90 in peri-urban centres. The study found 64 per cent of the pharmacies selling antibiotics without prescriptions and most of the drugs were under-dosed.

Profit margins

In December, the World Health Organisation said the majority of Kenyans cannot afford essential medicines mainly because of unreasonably high profit margins being enjoyed by manufacturers.

In a study involving 36 developing and middle-income countries, including Kenya, WHO says manufacturers are making mark-ups of more than 380 per cent and those made by retailers were more than 550 per cent.

It urged governments to intervene. A government survey done in 2007 said more than 60 per cent of Kenyans can hardly afford essential drugs and have to stay without treatment.

The Pharmaceutical Society of Kenya chairman, Dr Dominic Karanja, blames the free market economy. “There are no controls since it is a free market, therefore, everyone sets their own mark-ups according to demand,” he said.

Source – Daily Nation

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