The Ongoing Crisis in Liberia's Pharmaceutical Sector
The pharmaceutical sector in Liberia has been under intense scrutiny following the continued presence of Bupivacaine (Marcaine, Spinal Heavy 0.5%) on the market despite being linked to a tragic death. This situation has raised serious concerns about regulatory oversight and the integrity of drug imports into the country.
Regulatory Failures and Continued Imports
G2 Pharmacy, a major pharmaceutical importer, has faced criticism for continuing to import the drug despite a recommendation from the Board of Directors of the Liberia Medicines and Health Products Regulatory Authority (LMHRA) to halt all imports. The company has not only ignored this directive but also continues to bring the medication into the country, raising questions about its compliance with national regulations.
In January 2025, a 16-year-old boy died at St. Joseph’s Catholic Hospital after being administered Bupivacaine. An LMHRA investigation revealed that the drug lacked a batch number, expiry date, and English labeling, which are essential requirements for pharmaceutical products. Additionally, it was imported under a special permit, bypassing standard safety checks.
A Tragic Incident and Obstructed Investigation
The patient experienced severe adverse reactions shortly after receiving the medication, leading to his death during emergency interventions. Hospital staff were unable to save the boy, and the facility refused entry to LMHRA inspectors, hindering the investigation. The drug was found to be labeled in Dutch, with no English instructions or necessary information such as manufacturing and expiry dates.
An investigation conducted by the PV Team identified the cause of the adverse drug reaction (ADR), which included symptoms like itching, rash, respiratory distress, and penile discharge. The findings led the LMHRA Board to recommend the suspension of G2 Pharmacy's import license and the recall of all its fake drugs. The company was also ordered to pay a fine of US$118,000.
Unaddressed Recommendations and Alleged Corruption
Despite these recommendations, the suspension has yet to be implemented by Dr. Luke L. Bawo, the LMHRA Managing Director. Moreover, G2 Pharmacy has only paid a small portion of the fine, with just US$1,000 of the total amount paid so far.
Sources have indicated that there may be higher-ups within the sector shielding G2 Pharmacy, emboldening the company to continue importing harmful drugs. Dr. Bawo is accused of having vested interests in the company, further complicating the situation.
Calls for Immediate Action
A top LMHRA source expressed frustration over the lack of action, stating that the importation of fake medicine is not just a medical error but a regulatory failure that cost a young life. The source emphasized the need for urgent intervention and urged President Joseph Nyuma Boakai to take immediate steps to close G2 Pharmacy and launch a broader crackdown on illegal drug imports.
Public Health Concerns and Systemic Issues
Medical experts have highlighted the broader issue of substandard products in Liberia, including expired goods, counterfeit drugs, spoiled food, and unhealthy beverages. These products pose significant health risks, contributing to rising cases of kidney and liver problems among Liberians. The prevalence of such products underscores the dangers of regulatory negligence and the need for stronger oversight.
G2 Pharmacy's Response
Facing mounting pressure, G2 Pharmacy has denied selling counterfeit drugs and claimed that its products are genuine. The company acknowledged a labelling issue with a batch of Bupivacaine imported from India in 2023. While the product was cleared by LMHRA upon entry, it lacked an English-language leaflet, violating local labelling requirements. G2 Pharmacy stated that it was initially fined US$118,000, but the fine was reduced to US$1,500, which has been fully paid.
The company has announced initiatives to improve internal controls, including the establishment of a compliance task force, enhanced import documentation processes, internal quality audits, and proposed joint inspections to increase transparency.
Leadership Challenges at LMHRA
Dr. Bawo faces increasing challenges as the LMHRA Board raises concerns about his performance. Since the appointment of the current Board chaired by Dr. David Sumo in April 2024, issues have emerged regarding Dr. Bawo's ability to execute his duties effectively. A performance report cited various challenges, including a lack of technical capacity and disregard for the supervisory role of the Board as outlined in the LMHRA Act.
Concerns have also been raised about the recruitment of close associates to senior positions, high salaries without proper oversight, and the procurement of vehicles for personal acquaintances while essential activities like inspection remain under-resourced.
The Need for Accountability and Transparency
The influx of substandard and counterfeit medicines in the local pharmaceutical market has been attributed to poor performance within the LMHRA leadership. Board members have emphasized the need for accountability, transparency, and adherence to regulatory frameworks to uphold public safety and maintain the integrity of the pharmaceutical sector in Liberia.
Dr. Bawo has yet to respond to these allegations, and efforts to contact him have been unsuccessful. However, an alternative source revealed that the LMHRA management has prepared its response and will release it this week.
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