SIX years ago, one of my family members was diagnosed with late-stage cancer. As part of her treatment, she was prescribed morphine for pain management. The only brand of morphine that was available on the Zimbabwean market at the time, was what pharmacists commonly refer to as ‘a Section 75 brand’.
That just means it was a brand that required extra paperwork to be completed before it could be dispensed. I, being the pharmacist in the family, was tasked with finding the morphine for her. Before the ink on her morphine prescription was dry, I had downloaded and printed the necessary paperwork. I got it signed by her doctor and a fellow pharmacist.
There was absolutely no delay. The morphine was ordered overnight from the authorised local distributor and delivered to the pharmacy that had co-signed our paperwork. Twenty-four hours later, we had our morphine. This experience, however, got me wondering. If it took 24 hours for a pharmacist’s beloved relative to access medication, how long would it take the average Zimbabwean with zero connections in the pharmaceutical sector? How many people are busy pounding the pavement in town, hopping in and out of different pharmacies, paper prescription in hand, looking for a medicine that is proving hard to find? Many I imagined.
So why is this bizarrely unsystematic and distressing method of finding critical medicines the norm?
Well, the short answer is, in Zimbabwe and indeed in many countries in the world, pharmacies are prohibited by law from advertising medicines in the way other retail businesses advertise their merchandise. So, a pharmacy cannot broadcast an advert that says, “Hey, we have got morphine here! It costs US$20! Hurry while stocks last!”
This restriction on medical advertising is necessary. It is meant to protect the members of the public from misleading medical information. It shields people from exaggerated and predatory medical claims that they aren’t qualified to assess.
However, paradoxically, in Zimbabwe, this well-intentioned restriction on medical advertising potentially harms people or compromises health because it blocks citizens from access to information about where to quickly find affordable medicines. In Zimbabwe, we frequently have widespread medicine shortages. We are also subjected to medicine price variations — different pharmacies can (and often do), charge different prices for the same medicine.
The advertising restrictions therefore mean that the pharmacies that have cheaper medicines, or pharmacies that have medicines that are in short supply everywhere else, are unable to announce it to the public. As a consequence, when the average Zimbabwean gets a prescription from their doctor, he or she starts walking or driving from pharmacy to pharmacy looking for the pharmacy that can supply the medicine he or she needs, looking for the pharmacy that accepts his or her medical aid and looking for the pharmacy that can supply the medicine at a price he or she can afford.
This wastes valuable time and vehicle fuel, exposes people to the COVID-19 virus and (at the risk of sounding melodramatic), during emergencies, people die while their family members are frantically making door-to-door enquiries in pharmacies.
Thankfully, because of digital crowd sourcing technology and a tool as unsophisticated and as pervasive as WhatsApp, the unsystematic search for affordable medicines is a problem that is about to become avoidable for many residents of Zimbabwe.
My beloved family member who needed ‘Section 75’ morphine passed away eventually. The cancer felled her. Her death, though, was not for a lack of access to medicines. I always found out, timeously, which pharmacies had the medicines she needed in stock, even the medicines that were especially hard to find. I think everyone deserves to be able to say the same, whether they know a pharmacist or not. So, the idea of a Medical Information Service was born, and I have been working at it ever since. If one is looking around for a medicine in Zimbabwe, sending an enquiry message to the MIS WhatsApp contact centre, one gets information about which pharmacies that have the particular medicines — and the prices too — all in the time it routinely takes to order a pizza.
I believe this service is essential and will not only save lives. But time and money as well.
- Dr Dudzai Mureyi is a pharmacist and researcher who holds advanced degrees in Health Policy and Global Health from the University of Edinburgh, United Kingdom. Her research on the use of digital health tools to improve access to medicines was commended for the Alexander Fleming Prize – a prize administered by the United Kingdom department for Research & Innovation (UKRI). The MIS, a digital health start-up driven by this research, was awarded 3rd prize by the Postal and Telecommunications Regulatory Authority of Zimbabwe (POTRAZ) in the 2021 edition of Hackathon. Its successful setup followed legal battles in the High Court and the Supreme Court of Zimbabwe, which both ruled in favour of MIS.The service launches today.