Potential paucity and price increases for medicines and protection equipment for
COVID-19 across developing countries with a particular focus on Africa and the implications
Brian Godman1, 2, 3, 4*, Israel A. Sefah5, 6, Olayinka O. Ogunleye7, Darius O. Essah5, Sylvia
Opanga8, Nadia Rizvi9, Annie Wamaitha9, Anastasia N. Guantai8, Ibrahim Chikowe10, Felix
Khuluza10, Dan Kibuule11, Lahya Nambahu11, Abdullahi R. Abubakar12, Ibrahim H. Sani13, Zikria
Saleem14, Aubrey C. Kalungia15, Thuy Puong16, MAINUL HAQUE17, Nenad Miljković18, Amanj
Kurdi19, 20, Antony Martin21, Salequl Islam22, Santosh Kumar23, Joshua Wamboga24, Janney
Wale25, Jacqueline Sneddon26
1Laboratory Medicine Clinical Pharmacology, Karolinska Institutet (KI), Sweden, 2Strathclyde Institute of
Pharmacy and Biomedical Sciences, Faculty of Science, University of Strathclyde, United Kingdom,
3Universiti Sains Malaysia (USM), Malaysia, 4Sefako Makgatho Health Sciences University, South Africa,
5Keta Municipal Hospital, Ghana, 6University of Health and Allied Sciences, Ghana, 7College of Medicine,
Lagos State University, Nigeria, 8University of Nairobi, Kenya, 9Kenya Medical Training College, Kenya,
10College of Medicine, University of Malawi, Malawi, 11University of Namibia, Namibia, 12Bayero
University Kano, Nigeria, 13Northwest University Kano, Nigeria, 14University of Lahore, Pakistan,
15University of Zambia, Zambia, 16Hanoi University of Pharmacy, Vietnam, 17National Defence
University of Malaysia, Malaysia, 18University of Belgrade, Serbia, 19Strathclye Institute of Pharmacy and Biomedicial Sciences, United Kingdom, 20Hawler Medical University, Iraq, 21University of Liverpool,
United Kingdom, 22Jahangirnagar University, Bangladesh, 23Karnavati University, India, 24Uganda
Alliance of Patient’s Organizations (UAPO), Uganda, 25Independent consumer advocate, Australia,
26Healthcare Improvement Scotland, United Kingdom
Abstract
Background: Countries across Africa and Asia have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE). However, there has been considerable controversy surrounding some treatments including hydroxychloroquine where the initial hype and misinformation lead to shortages, price rises and suicides. Price rises and shortages were also seen for PPE. Such activities can have catastrophic consequences especially in countries with high co-payment levels. Consequently, there is a need to investigate this further.
Objective: Assess changes in utilisation, prices, and shortages of pertinent medicines and PPE among African and Asian countries since the pandemic.
Our approach: Data gathering among community pharmacists to assess changes in patterns from the beginning of March until end of May 2020. In addition, suggestions on ways to reduce misinformation.
Results: 131 pharmacists took part building on the earlier study in Bangladesh. There were increases in the utilisation of antimicrobials especially in Nigeria and Ghana, which was mainly antimalarials. There were limited changes in Namibia and Vietnam reflecting current initiatives to reduce inappropriate prescribing and dispensing of antimicrobials. Encouragingly, there was increased use of vitamins/ immune boosters across the studied countries as well PPE where documented. In addition, generally limited change in the utilisation of herbal medicines. However, shortages have resulted in appreciable price increases in some countries although moderated in Pakistan through government initiatives. Suggestions in Namibia going forward included better planning and educating patients.
Conclusion: Encouraging to see increases in utilisation of vitamins/ immune boosters and PPE. However, concerns with increased utilisation of antimicrobials needs addressing alongside misinformation, unintended consequences from the pandemic and any appreciable price rise. Community pharmacists and patient organisations can play key role in providing evidence-based advice, helping moderate prices through improved stock management, and helping address unintended consequences of the pandemic.
