Health will bet on Unops to solve the problem of drug shortage in hospitals

The shortage of medicines and medical-surgical supplies in national hospitals is a problem that persists. According to monitoring by the Foundation for the Development of Guatemala (FUNDESA), three of those building the public network will be in critical conditions and will close in 2023 with low inventory availability, thus starting the new year.

Part of the solution that the Ministry of Health provides is to work closely with the United Nations Office for Project Services (UNOPS) to purchase these products.

Hospitals that appear to be in critical condition include the General San Juan de Dios and Totonicapán departments, which as of December 30 had executed 98% and 99%, respectively, of the allocated budget for obtaining medicines and supplies, according to a detailed Fundesa report. Has gone. , Whereas, by September Jutiapa National – the latest available report – had already spent 99% of the amount allocated for this purpose, and it would be difficult to obtain medicines to cover the next months.

In the monitoring, it was observed that about 50% of the products purchased in the first two hospitals were slow consumption, that is, they were core products for patient care and had availability for three months.

At the end of 2023, in the case of San Juan de Dios, survival was 68% for one month of supply included in the original list, and dropped to 40% to cover three months. Regarding tracer drugs – essential – the supply for one month was 68%. The percentage has decreased till this time.

To solve this crisis, Dr. Erica Pérez, executive director of the San Juan de Dios General Hospital, mentioned that an increase in the budget will be requested from Health Ministry officials to be able to get what they need.

Regarding the totonicapane department, the list of medicines for one month reached 79%, for covering three it was 57%, and in the case of tracers for one month it was 84%.

In the National of Jutiapa, by September, the existence of medicines was low, and its situation would not improve in the following months, given that there was no longer a budget for purchases.

An ideal inventory in hospitals should not have less than 85% of essential medicines, and should not be of slow grade and low turnover, as is the case.

Carmen Salguero, an analyst at the Fundasa Health Commission, said that to avoid the “bad practice” of purchasing non-essential medicines, it is necessary to update the basic list of medicines used in services, because the current one is “out of date”. “and violates patients’ rights by denying them access to new, innovative and more effective medicines.”

He said each hospital’s purchasing units should be reviewed and reclassified to determine which have high, medium or low turnover. “This is outdated since 2019 when we handed over the inventory management system to the government,” he said.

In February 2020, Fundesa provided government officials with a suggested purchasing module tool that allows “consolidated and intelligent information from isolated and hand-held, weak and scattered data to manage inventory in an efficient and transparent manner,” As published by the Foundation. those days.

In Salguero’s opinion, annual acquisition planning should be restarted, given that each hospital knows in detail which drugs they consume each year, the information provided by the inventory management system, and which Allows better planning of what is to be purchased. You need to buy products while ensuring their quality and safety.

The system provides up to two years of historical data for inventory, purchases and consumption, information Salguero noted can help improve acquisition processes.

“They cannot continue to make partial purchases and continue purchasing in a high-value manner,” he said.

in analysis

Dr Linda Valencia, recently appointed Deputy Minister of Hospitals at the Ministry of Health, pointed out that, when analyzing the supply of medicines, the percentage in the above hospitals is below the standard.

They said they are currently making the necessary coordination to minimize the impact of the shortage of these products on patient care.

While in the long term there will be changes in the way medicines and supplies are procured to guarantee their survival in warehouses.

“The acquisition of supplies and medicines is planned through UNOPS, which will allow us to buy at lower prices and guarantee continuous supply. There will be an approach with large pharmaceutical suppliers to health care centers to evaluate strategies to meet the acquired commitments,” the official explained.

UNOPS login

Regarding UNOPS’s involvement in the procurement of medicines for the public health system, the Minister of Health, Oscar Cordon, said that with international support the Guatemalan Social Security Institute managed to save approximately US$550 million in the acquisition of medicines, and they hope That experience will be replicated across the portfolio.

“They have logistics chains with over 2,000 suppliers around the world and purchasing is consolidated with multiple countries, so in the end their prices are beneficial to the countries that become part of the project,” Cordon said.

According to the minister, they have identified 80 medicines that are in greatest demand in hospitals, and which are essential to be able to provide specialized care to patients, this is compared to more than 500 medicines that hospitals currently have. Are in the list. Tertiary care centre.

In case of health centres, 30 tracer drugs are most commonly used, while in health posts the list is 15.

“We have identified establishments in each of these categories, which will be in the red between March and April, these are the ones we are going to privilege with this system (procurement through UNOPS),” he said.

The intention is that the contract with the United Nations entity will remain in place during this Government, and in parallel with the acquisition of supplies, UNOPS is expected to help the Ministry develop its capacity to procure medicines efficiently.

“We train national personnel in the management of the digital tools they use, and the systems they have already tested in other countries, so that when they retire, we can use these systems,” the official said. “Can continue autonomously.”

Regarding when UNOPS will start working with the Ministry of Health, Cordon said he expects to sign the agreement in the coming days, and after 45 days, the international entity will begin these procedures.

He concluded, “We have a policy of austerity, so this international agreement is a mechanism that will guarantee us that medicines will be available in public establishments at the price they should be.”