amid limited supply of essential medicines
By Amadou Manjang
On the evening of November 15, 2024, Isatou walked into Serekunda General Hospital seeking medical attention for malaria. After consulting the doctor, she was prescribed a list of essential medicines, including Combiart, normal saline, paracetamol, and vitamin B. However, to her dismay, neither paracetamol nor vitamin B was available at the hospital.
“I have no choice but to buy the medicines from a pharmacy,” Isatou said, expressing her frustration.
Isatou’s experience reflects a growing issue faced by patients across the country. Lamin Njie, whose daughter suffers from sickle cell anemia, frequently visits hospitals and clinics, including Banjulunding Clinic. Yet, he too often encounters the same problem: the lack of prescribed medicines.
“This time, we bought the tickets and completed all the medical checkups, but we couldn’t get any medicines,” Lamin lamented.
The persistent shortage of essential drugs in public hospitals has become a source of distress for patients who rely on affordable healthcare services. While consultations and diagnostic services are provided, the unavailability of medications means patients must bear additional financial burdens to purchase the prescribed drugs from private pharmacies.
For families like Lamin’s, who depend on regular access to medications for chronic conditions, this shortfall undermines the effectiveness of public healthcare. As more patients speak out, it is clear that urgent action is needed to address the systemic challenges facing The Gambia’s healthcare system.
Scenarios like this are common in public hospitals. People like Isatou hardly get prescribed drugs at the hospital; despite, the Ministry of Health stating that all Gambians have the right to health, and the right to access essential medicines is a fundamental element of the right to health.
It is the responsibility of the Gambia Government to facilitate equal access to adequate health and medical services as stated in section 216, subsection 4 of the Constitution. But the lack of drugs causes a rise in out-of-pocket spending of patients. In fact, this is driving them to private pharmacies.
In this report, Foroyaa revealed the names of hospitals and some of the essential medicines they are lacking. The inquiry was conducted between November 12 and January 5, 2025.
Hospitals and the essential medicines they lack
Foroyaa was able to gather information from close sources from the major hospitals, who disclosed the essential medicines that are lacking.
As of November 12, 2024, Serekunda General Hospital in Kanifing lacks paracetamol tabs, amoxicillin caps both 250mg/500mg, septrin tabs, augmentin tabs, ciprofloxacin tabs, doxycycline caps, ampiclox caps, normal saline, folic acid, Hb12, vitamin c tabs /syrup.
As of November 13, 2024, it was revealed that the Edward Francis Small Teaching Hospital in Banjul, the country’s main hospital lacks augmentin tabs, ciprofloxacin tabs, doxycycline caps, ampiclox caps, hb12, vitamin c and omeprazole iv.
Furthermore, in the North Bank Region, as of November 22, Essau District Hospital lacks amoxicillin cap both 250mg/500mg, augmentin tabs, ciprofloxacin tabs, ampiclox caps, fefa, folic acid, Hb12 and vitamin c tabs /syrup.
Foroyaa was informed that as of November 25, Kuwonku Health Centre, Sandu, Upper River Region, lack over 30 drugs including paracetamol, amoxicillin, septrin, ciprofloxicillin, ampiclox, doxycillin, Omeprazole, Fefa, Hb12, Vitamin C, Folic acid, Normal saline and Ampicillin IV. The hospital also lacks salbutamol, ringers lactate, 5% dextrose, sanduhposital, Hydrocortisone cream, clotrimazole cream, Neomycin cream, Diclofenac cream, Intramuscular inj Diclofenac, Tetracycline eye ointment, Gentamycin eye drops, multivitamin, Flagyl , Bisacody, erythromycin , ibuprofen, piriton, paracetamol syrup, cough syrup, Gurze badage and Gv paint.
As of November 28, Bwiam General Hospital in Foni also lacks augmentin tabs, ciprofloxicillin, doxycillin caps, Omeprazole iv, Fefa and Vitamin C.
As of November 28, Ndemban Clinic, an annex of Edward Francis Small Teaching Hospital in Bakau, lacks augmentin tabs, ciprofloxicillin tabs, doxycillin caps, Septrin tabs, Hb12 and vitamin C.
As of December 2, Bundung Maternal and Child Health Centre lacks Augmentin tabs, ciprofloxicillin tabs, doxycillin caps, ampiclox caps, Omeprazole iv, folic acid, Hb12 and Vitamin c tabs /syrup.
The essential medicines that are commonly not available in these hospitals and are captured by this investigation include augmentin tabs, ciprofloxacin tabs, Hb12, vitamin c , ampiclox capss, doxycycline caps, and folic acid.
Some of the medicines lacking at the said hospitals such as paracetamol, augmentin, amoxillin, ampicillin, ciprofloxacin, doxycycline, ibuprofen, erythromycin, salbutamol and folic acid are among WHO Model List for Essential Medicines 23rd which ‘presents a list of minimum medicine needs for a basic health-care system’ and a ‘priority diseases.’
They ‘satisfy the priority health care needs of population’; therefore, they should be available in all ‘functioning health systems at all times’, WHO declared.
These essential medicines are to treat or prevent common sicknesses such as fever, infection, or pain. Their uses can speak for themselves for the importance of having them at health centres at all times.
Paracetamol, which was not available in Serekunda General Hospital, is used to treat ‘mild-to-moderate pain and fever.’ It is an analgesic and antipyretic drug. Ciprofloxacin, which was not available in five of the hospitals is used to treat bacterial infections, anthrax, or certain types of plague.
Doxycycline, which was not available in four of the hospitals, is used to treat bacterial infections such as acne, rosacea, urinary and respiratory tract infections, gonorrhea, chlamydia, and syphilis. Hb12 and Vitamin C, which were not available in six of the hospitals are used to treat and prevent low vitamin B12 levels and vitamin C deficiency in the body respectively.
Ministry of Health has acknowledged the persistent lack of essential medicines in hospitals in the country. Moreover, the health sector is also experiencing ‘a shortage of medical specialists including midwives, laboratory professionals, medical doctors, and physicians.
The Ministry developed a National Medicines Policy 2022 – 2025 to strengthen public health through an uninterrupted supply of essential drugs. The policy is developed to ensure continuous availability and accessibility of essential medicines in health centres.
However, two years later, the persistent lack of essential medicines in health facilities continues to exist. According to the policy, the ‘periodic shortages of medicines and other medical supplies,’ are caused by insufficient budgetary allocation of the government.
The Gambia government’s spending on health is donor-derived. The system deficiencies and low availability of pharmaceutical products at health facilities drive consumers to private pharmacies.
Drug Shortages in Hospitals: Health Services Director Blames Local Suppliers
The Director of Health Services, Dr. Nyassi, has attributed the persistent shortage of essential medicines in health facilities to delays caused by Gambian suppliers contracted to provide pharmaceutical products.
“As we speak, the 2024 supplies, which should have all been delivered by the end of March this year, are still trickling in,” Dr. Nyassi told Foroyaa. He explained that the contracted Gambian suppliers often fail to deliver the necessary medicines on schedule, exacerbating shortages across the healthcare system.
To combat this issue, Dr. Nyassi revealed that the government has now turned to the United Nations Office for Project Services (UNOPS) for procurement. This shift aims to ensure timely and reliable delivery of essential medicines to hospitals and clinics.
In the interim, he noted that hospital managements are attempting to complement national drug supplies by using their internally generated funds and the health insurance startup funds.
Despite these efforts, an inquiry found that many hospitals are unable to adequately address the shortages. The funds generated internally or through the health insurance scheme are insufficient to fill the gaps, leaving patients to bear the brunt of the crisis.
The recurring drug shortages in public health facilities underscore the need for urgent and sustainable solutions to ensure patients can access the essential medicines they need without unnecessary financial strain.
