The Federal Government through the Ministry of Health must come up with a clear policy to address the current shortage of medicines on top of a longer-term “national medicine security strategy” to be devised to prevent future drug shortages in Malaysia, given the country’s current vulnerable position as a net importer of pharmaceutical products.
On the ground different medical bodies including the Malaysian Association of Pharmaceutical Suppliers (MAPS), The Association of Private Hospitals Malaysia (APHM), Medical Practitioners Coalition Association of Malaysia (MPCAM), and Malaysian Medical Association(MMA) has sound the alarm on shortage of medications like antibiotics and over-the-counter(OTC) drugs for fever, flu, and cough and cold, including cough and flu syrups for children.
While the Ministry of Health including the Deputy Health Minister Datuk Dr Noor Azmi Ghazali has come out to downplay the seriousness of the issue and the shortage of medicines is under control, but this issue cannot be taken lightly as these shortages are unlike previous shortages, as this will hit the entire health care system, both public and private, since it’s a global supply issue.
The two-month hardcore lockdown in Shanghai, China, and Russia’s war in Ukraine have sparked major shortages of various prescription and over-the-counter (OTC) medications in Malaysia.
This is because Malaysia’s entire supply of finished pharmaceutical products are either directly imported, or indirectly imported through the import of active pharmaceutical ingredients (APIs) and pharmaceutical intermediates for local manufacture – both of which have been disrupted due to these external events and a surge in both local and global demand for medicines.
Even locally manufactured pharmaceutical products in Malaysia are heavily dependent on imported APIs and pharmaceutical intermediates. China is the world’s number one supplier of APIs and pharmaceutical intermediates.
This issue is slowly rippling through the system now, and it’s only a matter of time before the public really feels it, especially once the stockpiles are gone, including generic drugs, then it may be too late to do anything.
That is why i believe MOH must spell out a clear short-term, mjd-term and long term policy to address the current issue to minimise its effect on the healthcare system in Malaysia.
In the short-term, the National Pharmaceutical Regulatory Agency (NPRA) must do a extensive audit and stock count of all pharmaceutical stocks both public and private health facilities to understand the full extent of the country’s medicine shortage. It is also important they determine manufacturing capacities of manufacturers, turn over rate and stock holding.
The Malaysian Organisation of Pharmaceutical Industries (MOPI) and Pharmaceutical Association of Malaysia (PhAMA) needs to be committed in ensuring that manufacturers of both innovator and generic drugs have enough manufacturing capacity for enough stockpile of medicines.
Then, I believe MOH should compel concessions companies such as Pharmaniaga and other central contracts company to priorities their stocks and supplies to MOH facilities where more than 70% of the general population goes to. Such supplies should then be properly distributed based on a “ring strategy” to ensure areas of highest needs get them first.
On top of that an advisory can be issued for health care providers to start rationing some supplies now to buffer against the possible high likelihood that stockpiles may not be enough. Wastages of medicines should also be reduced by reconsidering prescription quantities and duration upon patients being reassessed.
NPRA then can explore new markets in other countries and look to reconsider some alternative suppliers and brands of OTC drugs including those manufactured from neighbouring countries such as Indonesia and even Egypt. Such arrangements can be done through import permits to ensure adequate supply in our country for time being.
On a longer term, the “national medicine security strategy” must include plans for local production of active pharmaceutical ingredients (API) – the active components of a drug – and increased stockholding by local pharmaceutical manufacturers and importers.
While this likely is a temporary issue, but how temporary it will be is still unknown and when it comes to essential items such as medication, it must not be taken lightly.
Many experts predicts that due to China’s lockdowns and the Ukraine war impact on global trade, it may take months or even the entire calendar year to properly recover because the whole global supply chain is complex. Some experts even predicts that global supply chains “won’t get back to normal this calendar year,” because the port and shipping bottlenecks are complicated to resolve.