Pharmacists working in West Africa have spoken about the overwhelming scale of the challenges they have faced in Liberia in the battle against the Ebola virus.
They paint a picture of a system unable to cope and a problem that is beyond the “capacity and responsibility of any single government”.
They speak of pharmacists ill-equipped to manage the disease and of pharmacy technicians dying because they lack the necessary protective clothing.
The frank disclosures come from Lloyd Matowe, program director for Pharmaceutical Systems Africa — an organisation devoted to developing sustainable supply chains in developing countries — and John H Harris, from the Liberian government’s health and social welfare department, where he is responsible for supply chain management.
A successful medicines supply chain, they say, is “pivotal” to the treatment of the potentially killer virus and to prevent its spread. But lack of medicines and poor road links have presented insurmountable barriers.
“In addition to limited resources, pharmacists who serve as logisticians in the public health system had to battle with transport and geographical accessibility problems in a country that does not have the best of road infrastructure even by developing country standards.”
The unpredictable nature of the virus and the speed with which it spreads has made it almost impossible for pharmacists to predict their workforce and medicines requirements. Even when pharmacists were able to estimate supply needs there was not enough stock to meet demand.
“And, because of the sporadic nature of the outbreaks, with regard to locations, it was not easy to concentrate deliveries to any particular site. In other words, the system became overwhelmed and needed the support of the international community,” they say.
Pharmacist technicians and other healthcare workers are being put at risk from exposure to the virus because of a lack of protective clothing — the government’s procurement regulations prevent it from buying the necessary urgent supplies on the open private market, they explain.
“As a result, a number of healthcare workers have died of the disease, including pharmacy technicians who worked in major hospitals,” they reveal.
The deaths led to the closure of four major hospitals between 27 July and 2 August 2014. With nowhere else to go, the public turned to community pharmacists who had to step into the breach.
“Pharmacists and other pharmacy personnel found themselves as the fulcrum for managing the epidemic, including giving advice that they have not been previously trained on,” they explain.
The comments from Matowe and Harris coincide with latest figures from the World Health Organization which reveal that Liberia had the highest number of new Ebola cases and the highest number of deaths from the virus in West Africa between 7 August and 9 August.