What does COVID-19 Pandemic Mean for the Medicine Supply Chain in Uganda?

Uganda on Wednesday confirmed 5 new cases of COVID-19 bringing the total number of cases to 14. The first emergence of the virus in Wuhan, China towards the end of December last year and its rapid spread caused a lot of businesses across the world to worry about the disruption in the supply chain since China is the ‘factory’ of the world. Although the spread of the virus appears to be under control in China, the rest of the world is facing an unprecedented rapid increase in the number of new infections with Europe now as the epicentre of the pandemic.

Pharmaceuticals Export Promotion Council of India on 3rd of March 2020 announced restriction of export of 26 finished pharmaceutical products and active pharmaceutical ingredients. Commentators attributed the move to the fear of shortage of those medicines for domestic use in India. Some of the medicines restricted for export include acyclovir (antiviral), chloramphenicol (antibiotic) and progesterone (oral contraceptive) among others. 

Analysis of the March 2020 drug register from the National Drug Authority shows that up to 57% of the 4,142 medicines registered in Uganda are manufactured in India. Less than 4% are locally manufactured. With Uganda’s high dependence on imports to meet its medicines needs, shortages or disruptions in the supply chain cannot be excluded.

John Hopkins University which is tracking the number of confirmed cases of COVID-19 shows that as of 26th March 2020 at 12:14:15 PM GMT, India had 681 cases. Furthermore, CNN on 23rd March 2020 millions of people across India have been placed under lockdown until the end of the month as efforts to halt the spread of the novel coronavirus in the country intensified. Such a lockdown means productions in industries are halted and manufacturers without buffer stock might not be able to meet the demand of their customer. Importers of medicines from India, therefore, have to be closely monitoring the developments in India.

How can the risk of medicine shortage in Uganda be mitigated?

The government should do a rapid assessment on the risk of medicine shortage that could arise because of the COVID-19 pandemic. Current stock levels of manufacturers, wholesalers and retail pharmacies would indicate for how long they can supply hospitals and patients in the event that they are not able to replenish their stock.

The Ministry of Health should consider forming a special committee tasked to provide strategic leadership for urgent and coordinated action in the country.  The committee would engage key players in the medicine supply chain in the country, continuously monitor the risk of shortage and keep patients and healthcare professionals informed of remedial actions being taken.

Alternative sourcing would reduce the risk of importing most of the medicines from India. As the situation in China improves and factories get back to normal production, suppliers can look to China as a source of essential medicines.

The National Drug Authority shall need to look into expediting regulatory processes in the event that the risk of major medicine shortage becomes imminent. This shall allow for special imports of unregistered medicines and faster issuing of import verification certificates.

The COVID-19 pandemic has put the globe in uncharted territory with a lot of uncertainty of what the upcoming months shall be. Medicines are essential supplies and as a country, we should put all the remedial actions in place to prevent shortage and reduce preventable deaths and sufferings.