Customs clearance of leishmaniasis injections facing delay

PESHAWAR: Delay in the customs clearance of the glucantime injections has caused problems for the people infected by cutaneous leishmaniasis in Khyber Pakhtunkhwa.

“The Medecins Sans Frontieres and World Health Organisation are importing drug for free treatment of leishmaniasis patients but they will take around two months for clearance. The government should accelerate the process in view of the outbreaks of the skin ailment,” an official told Dawn.

KP health secretary Dr Syed Farooq Jameel told a news conference on Friday that around 21,000 leishmaniasis cases had been recorded in the province for which the WHO had pledged to provide 11,500 vials of injection to begin treatment.

Officials insist vials promised by WHO will take a month for delivery

“These vials will be available within few days,” he said, adding that patients are currently treated with local medicines and injections.

Officials, however, claimed that it was highly unlikely that the vials would be delivered within a month due to delay in clearance by customs authorities adding to the misery of patients.

The consignment imported by charity and humanitarian aid groups required exemption of duties, which takes a long time to reach patients in a timely manner.

Glucantime is the only drug of choice for the treatment of cutaneous leishmaniasis but it isn’t registered in Pakistan.

The WHO had ordered 50,000 doses last year but they have yet to be delivered. It is taking the drug from the MSF on a ‘loan basis’ before sending it to patients after getting a request from the health department to deal with outbreaks, sources said.

Sources, however, said that wasn’t a solution as 11,500 vials pledged by the WHO would treat 1,000 patients only.

“Pakistan isn’t ready to purchase the drug from the manufacturing firm over pricing issue. Nevertheless, the firm has agreed to sell it to Pakistan on the price paid by the WHO,” an official said.

He said the company argued that it was a researched product and couldn’t be provided at low rate.

Pakistan requires at least 27,000 vials to cope with the situation.

MSF Pakistan chief Thomas Balivet told Dawn the organisation received regular supply of drugs for its project run in collaboration with the health department.

“We have resources for the inclusion of 150 new patients every month. For the time being, we have stopped new admissions as we have around 380 patients on the waiting list,” he said.

“We are concerned about outbreaks but are in no position to increase our activities due to limited budget and shortage of human resources,” he said.

He said drug continued to arrive for the treatment of patients already on the waiting list but there was a need for other organisations to mobile resources besides taking measures vector control to ensure its prevention.

The MSF is treating patients at its centre at Peshawar’s Naseerullah Khan Babar Memorial Hospital, where around 150 patients were received.

“The MSF advocates the treatment of cutaneous leishmaniasis to be available, affordable and adapted to the needs of the patients. A global shortage of the meglumine antimoniate due to an outbreak in Africa has also affected MSF’s supplies to Pakistan,” Mr Thomas said.

He said the situation had improved.

“We are hopeful that the MSF’s next shipment of drug will arrive in Pakistan in some days, which will allow us to start treatment of new patients,” he said.

Mr Thomas said since the launch of the centre in May 2018, the MSF had treated nearly 1,400 patients, while around 188 were currently under treatment.

“We have over 350 patients on the waiting list,” he said.

He said the MSF was concerned by the latest reports of cutaneous leishmaniasis outbreak in KP but was committed to continuing with its activities.

“The MSF is the only medical aid organisation having cutaneous leishmaniasis programmes in Balochistan’s Quetta and Kuchlak areas where diagnostic, treatment and counselling to patients are given to cope with their psychological problems,” he said.

Mr Thomas said in 2018, the MSF treated over 5,000 patients of cutaneous leishmaniasis in Pakistan.

He said besides diagnosing and treatment, the MSF was also conducting research to investigate other effective and safe treatment modalities.

The officials said the WHO wanted registration and purchase of drug alongside vector control measures to put brakes on the infection on a permanent basis.