On arriving in country, the malaria drugs were transported to a state warehouse and stored prior to distribution to hospitals and clinics. However, some of the drugs stored at the warehouse were stolen and diverted to the country’s black market as well as other countries for sale, despite having the words ‘Not for Retail Sale’ on the packaging.
Malaria patients visiting public health clinics to obtain the free drugs they were entitled to were turned away because there were none left. These stock outs were caused by theft and diversion. Patients were told that they would have to buy the drugs from a private pharmacy or in the market. Patients who could not afford to buy the stolen drugs at the market had to go without treatment. The few that could afford to buy the drugs at a pharmacy or market, purchased the same drugs that they should have received free. They were also at risk of buying a substandard product due to the lack of quality controls regarding transport and storage conditions. In some cases the patients unwittingly purchased counterfeit drugs that had no effect. The diverted drugs bought in the market had the words ‘Not for Retail Sale’ on the packaging.
After receiving the initial report from the Secretariat, the Office of the Inspector General commissioned a market survey of pharmacies and other likely vendors of malaria drugs throughout the country to gauge the scale of the theft of the malaria drugs that had originally delivered for the public health system. A stocktake was done at the state warehouse and the distribution of drugs was checked against the receipt of drugs by public health facilities. Security measures at the warehouse were improved and internal controls including record-keeping were strengthened to prevent more thefts. Spot-checks of the warehouse were also introduced.