Dear Editor,
In reference to the recent National Review story in The Nassau Guardian, "Sounding the alarm. Public Hospital Authority audit should shock us all", I would like to address only the statements made regarding suppliers of pharmaceuticals.
The article stated: "The report concludes that the PHA operates a 'defective system of procurement' that allows for the continued control of the market by a cartel of pharmaceutical supplies and suppliers of medical and surgical supplies, using a theory called selective tendering."
It went on to say: "The process of selective tendering effectively excludes new entrants into the marketplace and introduces extreme risk of bid rigging, collusion, kickbacks and corruption."
If the Public Hospital Authority does indeed have a "selective tendering" process for the procurement of drugs, it would be in the best interest of the Bahamian public. It is extremely important that the general public be educated about the importance of being "selective" when supplying medication to the Bahamian public. This is serious business.
Substandard and counterfeit drugs are on the rise worldwide, and in order to protect the welfare of the general public, it is very important that medication is purchased though "secure" sources, especially in a country where there is no registration of drugs and no strict controls on the importation of pharmaceuticals - i.e. no FDA equivalent and no testing facilities.
Sourcing medication is not the same as sourcing shoes and hats and bags. World police agency Interpol says more than 1 million people die each year from counterfeit drugs, highlighting one of the fastest-growing and most lucrative income sources for global organized crime networks. Not only must the quality of the drug be uncompromised when supplied, but the drug must also be shipped and stored properly, with stringent temperature controls. There must be liability, and someone must be made to answer in the event that the drug produces any adverse effects.
Medicine can be a matter of life and death. It is supposed to heal and not kill. In a country like ours where standards are often set aside for the sake of the almighty dollar, someone responsible has to take action, and that is what is expected of the PHA when it sources a drug.
What is not only corrupt but extremely dangerous, is someone who would be allowed to bid and supply a drug to the hospital through a non-secure source, or a source not authorized by the manufacturer, without proper temperature controls in their warehouse, without a proper warehouse, without a back-up generator in its warehouse (can't depend on BEC) and no liability.
This is not an ordinary business, so while it should never be controlled by any group of persons, it should not be left open to unscrupulous people.
Anyone who qualifies should be allowed to bid to supply drugs, but the PHA must ensure that it can prove authenticity of the product, proper sourcing, proper storage and quality of any drug it provides. This is always best done though a manufacturer-authorized distributor.
Now if the government can demand that a system of procurement only through secure source (i.e. manufacturer-authorized distributors) be used to import pharmaceuticals in both the private sector as well as the government procurement agencies, we would all be able to breathe easier.
If the PHA is in fact using a deficient procurement system that allows for little accountability and which promotes abuse, waste and corruption, I totally agree that the PHA should be answerable. However, the last thing I would like to see happen as a result of the audit report is that ethical and responsible suppliers get unwarranted blame.
- B. Wilson
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