Voices from Eurasia
Time to say goodbye to the drug crisis in Moldova
22 Sep 2017 by Dorin Rotaru, Project Manager, Procurement, UNDP in Moldova
I have seen many healthy people become a candle in the wind at the blink of an eye. Such is the story of many people living with HIV in Moldova – any opportunistic infection can be fatal to them.
According to official statistics, more than 11,000 cases of HIV are registered in the Republic of Moldova. Approximately 300 people die annually from HIV-related causes. Fortunately, we now have effective treatments that allow patients to live long, healthy lives – as long as they receive timely care. Last year alone, 4,500 people received antiretroviral therapy across the country.
One major threat to the health of people living with HIV is discontinuation of treatment. If patients stop taking their meds, there is a major risk that their medications will stop being effective when they start taking them again. So treatment adherence is for people living with HIV a matter of life and death.
Imagine the kind of crisis that would unfold if the market suddenly faced a shortage of vital medications.
In 2015, that’s exactly what happened. The health system of the Republic of Moldova faced a severe crisis when the sudden devaluation of the national currency, austerity measures and inadequate medical stock management led to widespread shortages.
The Ministry of Health soon requested our assistance to help manage procurement of essential medicines. During 2017, we procured medicines and other health products for the treatment and diagnosis of diseases included in nine national and special health programs, in accordance with its corporate standards, using modern tools and transparent procurement procedures.
Purchase mechanisms based on international channels are a common practice in many countries. Procuring medications this way makes a lot of sense, because:
- National programmes fighting epidemics often lack sufficient funds in the state budget. Any attempt to save time and resources can be vitally important for the well-being whose lives depend on it.
- Such mechanisms ensure that the quality of medications is in line with international standards.
- Taking the international route also helps curb corruption, a major problem in countries like Moldova.
Take a look at some examples. In the treatment of diabetes, procurement helped save 57 percent in cost from 2016 to 2017. This helped the Ministry to double the quantities of the medicines procured for diabetes, helping a higher number of people to benefit from treatment.
Similarly, thanks to the UNDP project, we saved 37 percent in the procurement of HIV-related medications – amounting to around US$300,000. Taking this route has been a solid investment to save many lives.
As a project manager of this UNDP initiative, I’m happy to share that we are also taking crucial steps towards transparency. We engage in open communication with all stakeholders at all times and provide full and real-time access to available information. Our next step would be to implement e-Procurement tools for better transparency, accountability and efficiency of health procurement processes. Such a platform, that runs on an ‘everyone can see everything’ principle, would help nurture the trust of the business sector in state purchases, creating a healthy competition, and consequently creating savings for the state budget.
Naturally, we want our initiative to be more than a temporary measure – we hope that it will become a model that serves people of Moldova in the long-term. Only if we can manage to fully reform the public procurement system can we have a lasting impact on the health system of the Republic of Moldova and its people.