…implies that ANSA McAL’s donations to GPHC put them over the top

Public Health Minister Volda Lawrence has finally broken her silence and confirmed that she gave her blessings for $605 million worth of pharmaceuticals to be sole sourced by a Trinidadian firm over local manufacturers.

Since the awarding of the contract, local pharmaceutical companies have come forward, pointing to the fact that they can deliver the required drugs for half the cost Government is set to pay the foreign company.

Local manufacturer, NEW GPC INC, in a statement on Wednesday pointed out that it could have supplied many of the items instantaneously, since there is usually inventory on hand. In a worst-case scenario, the company said, the delay would have been less than a few days to get the products manufactured right here in Guyana.

Management of the Georgetown Public Hospital have been accused of deliberating creating an emergency situation in order to sole source drugs from its preferred supplier.

It had cancelled and delayed four out of its five public tenders within the last four months, thereby creating a situation wherein there was a massive shortage of pharmaceuticals.

In a letter dated February 28, 2017, Chief Executive Officer (CEO) of Georgetown Hospital, Allan Johnson, thanked Lawrence for authorising the procurement of medical supplies from ANSA McAL to the tune of $605,962,200,

The deal had local manufactures fielding questions as to why local firms which could have supplied the pharmaceuticals at cheaper prices had been sidelined.

The Health Minister in a statement recused herself from the scandal and instead laid blame squarely at the feet of the suppliers, the procurement body and staff of her Ministry and GPHC among others she deemed as “moles.”

However, she outlined in a statement that her impetus for giving the contract to the Trinidadian company ANSA McAL, was because procurement for the “engineered shortage” of pharmaceuticals needed to be expedited and “ANSA McAL not only airfreighted the drugs (this helped spike the cost to import the items) for the public health sector, but also donated four refrigerators to GPHC to store the emergency supplies at the internationally acceptable temperature of 20 to 80 C.”

In justifying her decision that the donation was the precipitating factor that led to her choosing ANSA McAL, Lawrence in her statement outlined that “No other company in the history of the institution has provided cold storage facilities at the hospital even though, at least one of them was the sole supplier of pharmaceuticals to the institution for over 20 years.”

Head of State David Granger had stated that disciplinary actions will be taken against anyone found to be at fault as it relates to the recent sole scouring of pharmaceuticals for the GPHC.

“If there is some procedural irregularity that can be rectified and if it is found that somebody is at fault, well there can be disciplinary actions,” he told reporters on the televised programme – The Public Interest, which aired on Friday.

See Lawrence’s full statement below:

PUBLIC Health Minister Volda Lawrence blamed a conspiracy among drug suppliers and ministry staff for the crisis in the sector at the time she was appointed.

When she moved from Social Protection to Public Health, Lawrence said she was “greeted with the news of a shortage of drugs in the system” and immediately held talks with Material Management Unit (MMU) staff of the Ministry of Public health. She also visited several regional hospitals and the Georgetown Public Hospital Corporation (GPHC) executives to correct the problem.

To deepen her anxieties, Lawrence said three months after she is still uncovering a combination of skulduggery, collusion, delinquency, deliberate breaching of established sector protocol by Public Health staff, manipulation of the of system by importers with the support of employees and fabrication of records including evidence of bogus receipts.

So pervasive is the practice that “we have had to call in the police to deal with staff who are selling drugs to private pharmacies,” Lawrence disclosed.

The current drug shortage was a ploy manufactured by some unprincipled importers and crooked Public Health staff to enrich themselves Lawrence said.

She pointed to the widespread practice among some suppliers who wait until close to the contractual delivery date and then indicate their inability to supply the items for which they have had been paid. Others, she said supplied a few of the items then refuse to supply the remainder, blaming unexpected changes in the global market prices.

“This has created the supply gaps creating acute shortage especially in the outlying Regions,” Lawrence said.

While they are short-changing the public health sector the very items are available on the local market at very steep prices from the same suppliers and their pharmaceutical clients.

This has forced private health institutions nationwide to buy the now high-priced items in limited quantities to help meet the needs of their patients.

Critical drugs, in short supply at Guyana’s only tertiary referral hospital and available from suppliers whose products were of an inferior quality, often compromised during both production, transportation and delivery to the Public Health sector and sold at high prices. These poor quality pharmaceuticals have often-times negatively impacted the lives of patients and resulted in increased health care cost to the nation.

After meeting with public health officials around the country and at GPHC, the Honourable Minister was compelled in the interest of the health of the people of Guyana, to ensure that an adequate supply of drugs were immediately available in the country to meet the current crisis.

To this end, she sought to fast track the procurement of these pharmaceuticals to minimise the negative effects on patients due to the shortage of some critical drugs. This influenced the decision to seek the green light from the National Procurement and Tender Administration Board (NPTAB) for ANSA McAL to supply drugs and pharmaceuticals to the tune of some G$605M.

The Trinidad-based firm was among four companies, including New GPC, Health 2000 and Chirosyn Discovery from which these emergency supplies were procured.

Other companies were not a part of this process due to ongoing investigations into their late/or non-delivery of critical drugs during 2016, which they were contracted to procure for GPHC.

Some of these pharmaceuticals were overdue by as much as six (6) months, which exacerbated the drugs shortage at the hospital. These are the same suppliers who before May 2015, when all the pharmaceuticals for the nation was sole sourced from New GPC for billions of dollars were given the opportunity under the Granger Administration to become suppliers of pharmaceuticals to the Public Healthcare sector.

The Trinidad companies is one of only two companies in Guyana that is able to provide the cold chain storage necessary to maintain the integrity of a wide range of pharmaceuticals, that are critical in the health care sector, in Guyana.

ANSA McAL not only airfreighted the drugs (this helped spike the cost to import the items) for the public health sector, but also donated four refrigerators to GPHC to store the emergency supplies at the internationally acceptable temperature of 20 to 80 C.

No other company in the history of the institution has provided cold storage facilities at the hospital even though, at least one of them was the sole supplier of pharmaceuticals to the institution for over 20 years.

All pharmaceuticals for the entire nation was sole-sourced from that company for billions of tax-payers’ dollars. During that period, GPHC used icepacks to store these sensitive drugs at the facility, because the main refrigerator was in poor condition and unable to maintain the correct temperature for these drugs endangering their efficacy, potency and integrity.

Lawrence was unwilling to jeopardise the sector and patients’ lives and took what may appear to be the now-controversial route.

Moles at the GPHC procurement system have constantly being leaking information to the media with the aim of discrediting officials of the institution and often-times it is misinformation. The tender process was never breached and the route to procure the emergency supplies was fast tracked.

The National Procurement and Tender Board Act makes provision for such, and the same suppliers would have emerged.

“My priority is to ensure the nation’s health is given top priority. The health system will not be held hostage by unprincipled persons and therefore I made the decision to shortlist the critical but unavailable items and the suppliers with the ability to provide them on time to avert deepening the drug demand difficulties,” Lawrence explained.

The Public Health system needs urgent and massive overhaul with Lawrence finding that several procurement officials are not only unqualified for the job, but also unwilling to follow protocols and processes thus helping to “create a sand storm” within the health sector.

Consequently “slippages are many and gaps are very wide” Lawrence said.

The slippages and gaps are Lawrence said are maintained because health is a lucrative sector and a magnet for corrupt individuals and venal firms. Hence, many have fallen victim to the allure of dishonest gain.

“Without a shadow of doubt this shortage is manmade and created to cheat the country of medical supplies and cash…but I am not for sale,” Lawrence said.

The engineered shortage meant that drugs that should have been in the public health system since 2016 to cater for demands in the first quarter of this year are not there and this has far reaching implications for the tender process for drugs, Minister Lawrence said.

She is bracing for a fierce fight from suppliers and stiff staff opposition because they now feel threatened by the new course being chartered for the public health system.

The fresh wind of change has brought open tender, a proper procurement policy which includes computerisation of information, storage of critical drugs under internationally acceptable conditions and the placement of pharmacists in wards of the GPHC.

In addition, the Pan American Health Organisation and World Health Organisation (PAHO/WHO) are throwing their support behind local efforts to help develop a proper and accountable public health system.

PAHO/WHO is helping to shape policy directions in the areas of procurement, distribution, storage and managing consumption levels of pharmaceuticals at the GPHC.

The current difficulties in the public health system are compounded by its inability to forecast future needs accurately by its reliance on a manual system which is rarely updated.

Lawrence wants these ended immediately and has promised a raft of new measures to accomplish this. The first step was taken Friday when she met with several delinquent suppliers at her Brickdam, Georgetown office.

“The policy and standards will be rigorously applied to guarantee the safety of the Guyanese people who are my first interest,” Lawrence said giving a hint about what is to come.