In a bid to ensure the availability of essential drugs throughout the year in state-run health facilities, the Ministry of Health and Population is said to have been working to produce medicines for low prices within the country.

For that the ministry has proposed financial as well as other necessary support to the Nepal Drugs Limited for the production of essential medicines.

“We have been working to prepare a proposal for support to produce at least 25 essential drugs at Nepal Drugs Limited first,” said Dr Roshan Pokhrel, secretary at the Health and Population Ministry.

“We can increase the production of other medicines continuously, which means from the low budget, we can ensure availability of essential drugs in the state-run health facilities throughout the year.”

The government provides more than 70 types of medicines for communicable and non-communicable diseases from all district hospitals. Patients get more than 60 types of essential medicines from primary health care centres and 35 types from health posts.

For the purchase of the essential drugs distributed free of cost, the Health Ministry provides a conditional grant to all 753 local governments. Some local units allocate budgets from their own resources to procure additional medicines and distribute them for free.

However, availability of essential drugs has always been an issue.

“Despite spending huge amounts of money by the three tiers of government—local, provincial and federal, people do not get the essential drugs around the year,” said Pokhrel. “We hope that if we can produce essential medicines at low cost, problems of unavailability of the medicines will be addressed to some extent.”

Earlier, the erstwhile district public health offices and the Department of Health Services procured essential medicines and distributed them free of cost through state-run health facilities. There was a separate mechanism to check if the said medicines were supplied or not.

But after the implementation of federalism, no agency is monitoring the supply of the medicines and their quality.

“Budget for the essential drugs has been increased several fold but most of the health facilities throughout the country don’t have all essential drugs,” said Dr Guna Raj Awasthi, former chief of the provincial health directorate of Sudurpaschim Province. “No one is monitoring the quality of the essential medicines being distributed from the health facilities across the country.”

As the local governments are free to procure essential medicines of any brand and company on their own, it is impossible to regulate the quality of medicines. Prices of the essential medicines could vary from one local federal unit to another, Awasthi said.

Health Ministry officials said that assisting the Nepal Drugs Limited in the production of essential drugs is also in the national interest, especially in view of health crises and to control the prices.

“Production of essential drugs by the government agency will help control the market price of medicines,” said Pokhrel, the health secretary. “The government can purchase more medicines from the limited budget allocated for the programme. Problems of drug shortages will be addressed if we could buy more medicines from the same amount of funds.”

Nepal Drugs Limited produces cetamol and Jeevan Jal (oral rehydration solution), which helped health authorities ensure their supply during the coronavirus pandemic.

Currently, Nepal Drugs Limited has been producing only six essential drugs including paracetamol and oral rehydration solutions.

Meanwhile, the Health Ministry said it has been working to set up seven provincial departments of drug administration next year. For that, organisation and management survey is being carried out, according to the Department of Drug Administration, the national regulator of the drug market.

“We will furnish the organisation and management survey report to the ministry,” said Santosh KC, spokesperson for the department. “If approved by the Ministry of Finance and budget allocated, the process of setting up provincial drug regulatory bodies will be started.”

Currently, there are three branches of the department in Birgunj, Biratnagar and Nepalgunj.

According to KC, regulation of the drug market and quality control will be more effective with the provincial drug regulator.

Along with the monitoring of dispensaries, the department is responsible for ensuring the quality of medicines and regulating the drug companies to ensure that they follow good manufacturing practices.