Hargeisa — Imports of poor quality medicine, misuse of drugs and an unregulated pharmaceutical industry are endangering public health in the Somaliland region, officials say.
Self-medication is becoming major health concern in Somaliland as many people take medicine without consulting a doctor or trained pharmacist, according to Ali Sheikh Omer, public health director at Somaliland's Ministry of Health.
"If you take medicine without a prescription and without any illness that necessitates its use, it will result in the medication becoming ineffective," Omer said, urging the public to consult a doctor or pharmacist before taking even over-the-counter medications to avoid adverse side effects or building up drug-resistance.
Further exacerbating the problem are television advertisements for drugs targeting consumers, a lack of trained personnel at pharmacies and the government's inability to verify the quality of medications that make it to the Somaliland market, said Omer, who is a medical doctor by trade.
Most of the over 1,000 pharmacies throughout the Somaliland region are run by operators who do not have the necessary skills, he told Sabahi. "Hargeisa, which needs only ten pharmacies, has about 400 that we know of," he said.
According to Abdikadir Ahmed, who owns a pharmacy in Hargeisa, some pharmacies will sell medicine without a prescription.
"Most of the walk-in patients who come to us do not have a doctor's prescription," he said, adding that parents even send children, often younger than 10 years old, to buy medicine at pharmacies.
"Medicine has become something to only think about in business terms," Ahmed told Sabahi.
Another problem is the use of traditional medicine to treat patients. Some traditional practitioners give patients herbal medicine, which is expensive and dispensed without being measured in doses, Ahmed said.
The current practices are particularly risky for expecting mothers whose babies could suffer irreversible damage due to improper use of medicine, said Doctor Abdirizak Yusuf Abdullahi, head of the reproductive health department at the Somaliland Ministry of Health.
"When a pregnant mother takes the wrong medication it has a negative impact on the child such as being born with disabilities, missing limbs or illnesses," he told Sabahi, adding that a media campaign to raise awareness is needed. "A pregnant mother must learn the medicine she cannot take."
Doing the most with limited resources:
Although hampered by limited resources, the government has made ensuring the quality of medicine among its priorities, Somaliland Quality Control Agency Chairman Ali Mohamed Bikalo said.
Established in 2010 to ensure the quality of medicine, food and other goods, the agency lacks a laboratory for inspecting drugs and has yet to formulate standards for quality, he told Sabahi.
"Nonetheless, while the agency has been in existence, it has seized and burned medicine, such as those that have expired, and also other goods that were of low quality," Bikalo said.
Where medicine is concerned, the agency advises importers to bring in drugs with a minimum six-month shelf life at the time of entry in order to prevent the sale of expired medicine, Bikalo said. "We will try to purchase the necessary [laboratory] equipment as soon as we can afford to."
To ensure the quality of drugs sold to the public, all medicine entering Somaliland should be required to have World Health Organisation (WHO) certification and be inspected by Somaliland's Ministry of Health before being distributed for sale, ministry public health director Ali Sheikh Omer said. However, that would require additional funding, which is now scarce, to pay for drug quality inspectors at all points of entry.
In 2012, the ministry created a designated drug quality control unit and built a structure for housing inspection machines, fulfilling WHO requirements needed to receive laboratory equipment assistance from the organisation, Omer said.
He said the ministry hopes to receive the needed equipment and be able to carry out drug inspections by the end of 2014.