‘Madam Minister, please, what about the medicines’, cry of serious patients

Thyroid cancer has spread in your body, it has metastasized. “It is spread throughout the body due to the lack of medication,” says Paola Valencia, a 51-year-old from Quito, mother of two adolescents and a patient of the Ministry of Health since 2012.

Paola is treated at the Eugenio Espejo hospital in Quito, where she frequently holds sit-ins with dozens of patients to complain about the shortage of medicines. He does not want to die as happened to David Reinoso, a 41-year-old man who collapsed, because he did not receive the treatment to fight liver cancer that consumed him daily. “I testify that he died due to lack of medicine, if he had continued with the treatment, he would still be alive,” says this woman who together with David and a couple of friends, also with catastrophic illnesses, helped each other due to the lack of drugs at the hospital.

In 2016, Paola started taking expensive medication. The most expensive is called Sorafenib, a pill that stops an abnormal protein from sending signals for cancer cells to multiply, in other words, stops the spread of cancer. Each box of Sorafenib costs $ 3,100. Paola needs two boxes a month.

I have received with great irregularity, the lack of medicines is repeated every year. I have had to get rid of goods, I sold a car, I no longer have to sell

Paola Valencia, 51 years old.

Paola questions the indolence of the authorities to allocate resources and supply the hospitals. In 2021, he did not receive Sorafenib for five months. “Delivering at the wrong time is just as terrible, the patient gets worse, as has been my case, and surgery is already needed, they can’t even operate on me, I’m already too sick,” he lamented through tears.

Paola speaks with pauses, holding the tracheal tube to her neck, and at times she suffers from shortness of breath and a cough. Nothing matters when it comes to getting your medicine. “It’s like having gold, with that I buy my life,” considers this Quito woman who, together with other patients, doctors and foundations, managed to have Sorafenib included in the Basic Table of Medicines of the Ministry of Health.

A contingency plan is applied to prevent COVID-19 from complicating hospital care in Quito

Every Monday, during the change of command, and since the government of Rafael Correa, Paola was stationed in front of the Carondelet Palace to demand medicine. He also followed the president when he had an agenda outside the presidential headquarters. “I was morning, noon and night trying to have an appointment with the minister, they took me out so that I did not speak to the press, the tumor was approaching the marrow.” Since 2019, Sorafenib is part of the Basic Table of Medicines, although its delivery has been irregular.

After sit-ins and protests, Paola received the medicine for a month in December. Her fight will continue, she says disappointed, every month. “For this to change, they must change the people who are at the forefront, who have another heart, who feel sorry for the patients. We are people who have loved ones who care about us and who matter to us ”. (I)

The supply of drugs in hospitals is at a critical level of 49%

The deficit of medicines in the medical centers of the Ministry of Public Health reaches critical levels, according to an analysis of the institution itself, which, as of December 2021, placed the supply in the 135 hospitals at 49% – less than half – in 1995 health units of the country.

There, 62.7% of the national population is served, the same population that in the streets or on social networks complains daily about the lack of drugs to treat catastrophic or not so serious diseases, including essential supplies such as gauze, syringes or medical gloves.

The shortage of 51% of medicines upsets all the goals of the ministry set out in its National Medicines Policy 2017-2021, in which it was contemplated that in 2017 coverage of 70% should be achieved and the following year it was expected to reach the 80%. In 2019 the goal was 85%, in 2020 90% and in 2021 more than 90%.

In protest, agility is demanded in the purchase of high-cost drugs and timely attention

In the report Situation Analysis of the Supply of Medicines in the health establishments of the MSP-December 2021 the critical hospital situation is detailed, the one “that prevents the adequate provision of the health service …, affecting the continuity of treatment and essential procedures.”

The report warns of the risk of death for patients, since the shortage of drugs –admits the Ministry of Health– “generates a negative impact on the conditions, way of life and style of life, compromising their evolution and recovery and, consequently, increasing the possibility of developing sequelae or dying ”.

Given the serious situation, and although only for a period of five months, The Ministry of Health began in December the purchase of 293 medicines for $ 19.8 million, a value that was awarded on December 27 to the Public Company Technical University of Ambato UTA EP. Three days later, on the 30th, the contractor made the first delivery of 149 drugs, including antibiotics, pediatric medicines, and other medications for patients with chronic and catastrophic illnesses.

On January 10, the MSP expects to receive a second batch of medicines from this contract, which has a term of 90 days. Drugs purchased included, for example, acetazolamide (glaucoma), acetylcysteine ​​(cystic fibrosis), amikacin (severe infections), amiodarone (severe arrhythmias), bendamustine (leukemia), calcitriol (hyperparathyroidism), sorafenib (metastatic cancer), and others.

Oncological diseases were prioritized in emergent purchase of medicines, according to the Ministry of Health

The quantity of drugs is contemplated for a supply of five months, depending on the purchase process.

Thus, for example, 13 million paracetamol and 14 ibuprofen tablets will be purchased, both drugs frequently used in the ministry’s health centers.

In the purchase, as detailed by the MSP, “the main drugs aimed at treating those pathologies with high risk of severe morbidity and mortality were prioritized., and within these, those with the highest consumption at the national level, as well as those concentrations and pharmaceutical presentations most consumed at the national level were prioritized ”.

However, the drugs of the programs acquired through strategic funds, such as the National Blood Program, Neonatal Screening, judicialized drugs and others that are difficult to access, were left out of the purchase.. On August 12, the Ministry of Health declared a state of emergency due to the shortage of medicines and indicated 123 priority drugs, of which only 43 were purchased, it was reported. (I)

Planning failure affects the lack of medicines in the country

The lack of planning in the purchase of medicines to supply public hospitals directly affects people, especially those who suffer catastrophic diseases, said Gustavo Dávila, national coordinator of the Alliance for Health, an organization that groups together 30 other associations that claim health and drugs.

“We have to make stoppages, sit-ins. Patients are not taken into account, they are not informed about the drugs they are going to buy ”, claimed the representative of the organization.

Dávila pointed out that they will be pending the president’s commitment to allocate $ 50 million for the supply of medicines for rare diseases, both for public hospitals and for those of Social Security, IESS. (I)