By Pilar Montes
HAVANA TIMES — In June 2018, the list of available essential medicines in Cuba was short by 45 drugs, according to Public Health authorities.
Official sources say that shortages today aren’t as serious as they were last year, when missing medicines reached a peak number of 150 in August, 18 of which were essential basic drugs.
Three years ago, Juventud Rebelde newspaper published an article in their June 2nd 2015 edition which collected statements from doctor Jose L.Fernandez Yero, first vice-president of the BioCubaFarma Business Group, who responded to readers who were complaining about medicine shortages.
Fernandez Yero explained that “Cuba’s biotechnology and pharmaceutical industry is regulated by international laws.”
“The country has an essential medicines list with 857 products, and the stock of this industry (including chemical, biological, biotechnological medicines, diagnostic devices and medical equipment) reaches 1,099.”
Yero added that every product requires multiple components which come from different places and suppliers always have to be assessed, approved and registered, with no exception. If they are lacking in quality, receive negative assessments or any other reason, then they need to find and assess another supplier which is a long and expensive process.
He further noted that a large number of suppliers “are from very far-away markets, like India and China”, while he said that the industry had only been a part of the BioCubaFarma group for 30 months, and was undercapitalized and labs and pharmaceutical manufacturing plants were being modernized.
The industry never met demand in the past and it still doesn’t today, especially of medicines which are very popular and cheap, like Duralgina or Dipyrone, when consumption stands at 70 million tablets every month and about 870-900 million of these are imported every year. Instead, within their productive capacity, they prioritize more strategic medicines such as Enalapril and Captopril, which are prescribed to people with high blood pressure, heart disease, as well as other medicines such as Glibenclamide, Metformin and Insulin for diabetics.
According to Doctor Emilio Delgado Iznaga, director of MINSAP’s Medicines and Medical Technologies, this “lack of coverage” is due to the fact that even though the industry meets its production targets, it still doesn’t produce enough so that medicines don’t run out at pharmacies.
Another very important factor is that sometimes suppliers aren’t paid on time, which can slow down replenishing stocks.
Medicines on the black market
Taking advantage of medicine shortages, the “black market” for medicines is booming.
Sellers’ lack of scruples is combined with the sale of expired medicines or medicines that aren’t handled appropriately. There is a skit on Cuban TV which shows a man who buys a baguette and he takes out the middle of the bread to then fill it with pills.
Then, this person goes out to sell them to people in need, including a mother who has a sick son and as a result of the medicine she gave him, had to urgently take him to the hospital.
Because Cubans ridicule their problems, in the comedy program “Vivir del Cuento” (Living by your wits), its main character Panfilo, the typical elderly pensioner with a low income, learns about a woman on the block who is called “the pharmacy”.
Whatever drug Panfilo asked for, Epifanio (the name of this character) took it out of her big bag. In the end, Panfilo was happy with his medicine purchases but was shocked when the woman told him that it would be a total of “one-eighty”, to which Panfilo jubilantly replied, “How cheap!”. Seeing that he hadn’t understood, the seller corrected him, “Panfilo, that’s 180 pesos” (about 20 pesos less than his monthly pension).
Stricter controls on prescriptions and sales at pharmacies are some of the measures that have been adopted recently. The reality is that until people see that there is a steady and sufficient supply of medicines they need at the State pharmacies the black market will continue to flourish and the health of Cubans aged 60 and over is greatly affected.