Thursday, September 6, 2018

Blogpost: on the challenges of finding medicine in Sudan

Najla Norrin has owned and operated a pharmacy in a working-class neighborhood in Khartoum for over ten years, but 2017 was her worst year in business.

The pharmacist and business owner has struggled to stock her pharmacy due to price hikes and has been unable to find medicine needed for chronic diseases such as diabetes, hypertension and mental illness.

“I can only buy medicine in small stock because pharmaceutical companies are only accepting cash from us and even with this, I am struggling to sell what I have as the prices have increased between 100% to 300%,” said Norrin.

Sudan’s currency has steadily plummeted since South Sudan’s secession in 2011 as the country was dependent on oil revenues from its Southern region. On the eve of secession, Sudan lost 75% of its revenues from oil.

For the next few years, the country tried to stabilize its economic situation through selling and leasing agricultural land to investors as well as taking generous grants and loans from China and Arab countries. The money that flowed into the country was not enough to save its economy and the Sudanese pound (the SDG) lost an annual 10% to 20% of its value each between 2011 and 2016.

In November 2016, the medical field was hit by a storm. At that time, pharmaceutical companies, the only entities permitted to import medicine into the country, were able to purchase hard currency from the Central Bank of Sudan at $1 equals 8 SDG. At the time, the price of the SDG to a dollar was double that in the black market.

“The new price we received from the bank in late 2016 was 14 SDG to $1 which meant that medicine prices went up by 100%, but just a few months later, they wanted to hike up the price to 21 SDG to $1 which led to an outcry from our side” said a senior staff member at one of the largest pharmaceutical companies in the country who wished to remain anonymous.

Things quickly went downhill and the pharmaceutical council had to intervene and hold talks with the pharmaceutical companies and the government. As a result, 100 medicines were recognized as critical and they would be purchased using the old price and all other medicines would be purchased using 21 SDG per $1.

By the end of 2017, the dollar reached 40 SDG in the black market and the industry faced a even larger blow.

“We import medicine from abroad on instalments, we used to sell it also on installments and then pay our debt, but when the SDG plummeted in the end of 2017, companies and pharmacies stopped selling medicine as they could not set a price,” said the source.

The source’s company and all major pharmaceutical companies in Sudan slid into debt and some companies were over $5 million in debt. They could not pay the bills for the medicine they imported as the SDG lost its value with each passing week.

In February 2018, the Central Bank weakened the SDG value to the dollar to 31.5 only months after it was devalued from 6.7 SDG to 18 SDG per dollar.

All companies including pharmaceutical companies were required to buy hard currency from the official channels and not the black market.

“There is not enough hard currency in the country and we are unable to pay the companies abroad our past bills, we had to stop importing medicine since the beginning of the year, we are now selling old stocks , I don’t know what will happen when it runs out,” said the source.

Individual solutions are on the rise

Direct me is a Sudanese Facebook group with nearly 400,000 users. The group aims to help users find what they are looking for from handymen to an address they are trying to get to.

In recent months, many users have posted about a specific kind of medicine and asking the users if they know where to find it in Sudan. 

Some pharmacists intervene and give directions to pharmacies where this medicine is available and sometimes, users who are the diaspora volunteer to send it with someone traveling to Sudan.

Essra Al-Mahi, an electronics engineer was trying to find products in a cosmetics line only found in pharmacies and when she failed, she started the Facebook group, ask a pharmacist.

“Ask a pharmacist is a group bringing together ordinary citizens and pharmacists and it is a space for people to ask about medical products because availability is a big issue,” said Al-Mahi in an interview.

Pharmacists in the group are consulted on availability of a specific medicine and sometimes, people offer free medicine they don’t need for those in need. 

“The group is still growing, but it proved that pharmacists are a tight-knit community and they know who has what at all times,” said Al-Mahi.

Pharmacists and doctors are often taking matters into their own hands when medicine is scarce.

Nada Haleem, a medical doctor, knows first-hand how her patients suffer when they can not find their medicine.

“I group my patients together in groups and order their medicine from Cairo every few weeks and I find someone coming to the country and willing to carry this medicine,” said Haleem.

The risks are real as the customs are very strict when it comes to bringing medicine into the country without the official channels, and for this reason, people often carry a small supply of medicine.

Some pharmacies order small shipments for their clients from Egypt as well.

“They are very careful because it is illegal so they only sell this kind of medicine which is usually rare in Sudan to their regular and trusted clients, the prices are usually higher because they charge a transport fee,” said the source at the pharmaceutical company.

Norrin believes that there is a growing black market that can not easily be brought under control.

“It is becoming chaotic day by day, recently someone came to my pharmacy and said that he has 100 boxes of a specific medicine and asked if I am willing to buy, he had no relation to any company or even our field,” said Norrin who believes that black market dealers are paying their way out of the checkpoint at the border with Egypt and are smuggling medicine into the country in large amounts.

Norrin added that the only medicine she brings from Egypt on her own is for her parents whose medication is scarce or totally unavailable in Sudan.


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