$2.3 million of malaria medicines stolen

By Dr. Ananya Mandal, MDApr 20 2011

According to the Global Fund to Fight AIDS, Tuberculosis and Malaria, malaria medications valued at almost $2.3 million may have been stolen from government-run distribution centers in Africa and other locations.

The World Health Organization reported 247 million cases of malaria and almost 1 million deaths in 2008, most of whom were African children. The disease is spread through mosquito bites and causes fever, headache, chills and vomiting and can be fatal if not treated, according to the World Health Organization in Geneva.

The organization Global Fund that came into being in 2002, paid for the medicines and is looking into whether drug thefts are increasing worldwide as it quantifies its missing inventory, Jon Liden, a spokesman for the Geneva-based Global Fund, said. This Global Fund is an independent entity funded by national governments and private entities including the Bill and Melinda Gates Foundation in Seattle. It spent $21.7 billion in 150 countries from 2002 through 2010 to combat the three diseases. The organization is subject to the “perennial problem” of drug theft in developing countries, Liden said. “Yes, there’s drug theft in Africa,” he said. “These are not Global Fund-specific issues.”

The Fund suspects its malaria drugs may have been stolen in 13 countries and that 70 percent of the thefts were by insiders at government-distribution centers, Linden said. The countries include Tanzania, Togo, Sierra Leone, Swaziland, Nigeria, Kenya and Cambodia. The Global Fund financed the purchase of $98 million in malaria medicine in the 13 countries during the past 2 1/2 years and is looking into how much may have been stolen, the organization said in a statement today. Togo has repaid $600,000 of $850,000 in drugs the Global Fund confirmed as stolen, according to the statement.

The fund singled out a $200 million contract for malaria drugs in Tanzania in which it suspects theft took place. It listed the theft at more than $1 million but said “the potential cost of the misappropriation is not yet quantified.” In Togo, the fund reported $850,000 worth of drugs disappeared in 2008 in a case of “insider stealing.”

Liden said cutting African governments from the medicine supply chain isn't realistic and that setting up independent distribution systems would be too expensive. “We thoroughly reject the idea that we need to simply clamp down on drugs being sent to poor countries," he said. "That will cost lives.”

To prevent these thefts the Global Fund is coming up with strategies. “The Global Fund is at the forefront of the response to drug theft” and “has acted upon each instance of misuse of its resources taking strong and swift action by suspending grants, freezing cash disbursements and demanding a return of misused funds,” the organization said. It has called together other funders of medicines for people in developing countries in December to devise plans to prevent thefts of drugs in Africa and elsewhere, Liden said. “The aim is a range of measures we mean to take to minimize theft of drugs,” he said.

One of the plans include hiring new security companies to guard the medicines and setting up distribution centers on a temporary basis to operate in place of government-run systems in countries where theft is suspected, he said. After the U.S. government discovered evidence that its malaria drugs were disappearing in Angola and Malawi several years ago, it stopped using local government warehouses and set up entirely separate systems to give out U.S. medicines. The Global Fund has occasionally set up separate distribution systems on a temporary basis in Angola and Malawi.

“If drugs are sitting in a warehouse just waiting to be pilfered, we need to figure out a different way to make sure the people who really need them actually get them,” said David Sullivan, a malaria expert at the Johns Hopkins Bloomberg School of Public Health in Baltimore. “It's an unfortunate reality that when staff are poorly paid and systems under-resourced, the temptation of selling drugs for money will always be there,” said Nathan Ford, a medical coordinator for Doctors Without Borders.