In Rwanda, drugs are sold only in pharmacies and other qualified institutions under the supervision of a healthcare professional. Pharmacists are trusted mainly as they are intensively trained for 4 to 5 years in Rwanda, in which they gain an extensive knowledge of prescription medicines and their effects on patients.
However, as any lucrative business, some pharmacists are more focused on earning profit.
The law stipulates that most medicines can only be sold or supplied against a prescription at a pharmacy under the supervision of a pharmacist. However, pharmacists across the country continue to sell over-the-counter drugs despite prohibition.
Over-the-counter (OTC) drugs are medicines sold directly to a consumer without a prescription from a healthcare professional.
Even though some medicines do not require medical prescription, several reports condemn pharmacists in Rwanda who sell drugs to patients with no prescription whatsoever and that calls for stricter legal controls to address the issue.
Prof Kayumba Pierre Claver, a pharmacy expert from the EAC Center of Excellence for Vaccines, Immunization and Health Supply Chain Management told IGIHE that selling over-the-counter drugs is an alarming issue that must be dealt with through stricter regulations.
“Medicines should never be sold anyhow and patients should know drugs components have different side effects depending on the patient and hence should never be consumed without the advice of a health professional. As for pharmacists, dispensing medicines without the written prescription of a medical practitioner should be considered a criminal act and a violation of pharmacy regulations.”
The root of the problem
The illegal sale of prescription drugs has surged recently and is identified as one of the major causes of over-the-counter drugs. Normally, licensed health care professionals, such as doctors or pharmacists should be the only ones to sell medicines.
Some pharmacy owners reportedly instruct pharmacists on the counter to make money in every possible way rather than practicing as professionals.
The issue is exacerbated by the overcrowding of pharmacies in one area which leads to competition and a relentless race to earn profit hence increasing deceitful practices.
In addition, a shortage of qualified practitioners adds to the workload of physicians and pharmacists who are unable to exercise their functions as should be. Also, some pharmacies sell medicines that are close or past their expiry dates just to get rid of stockpiles of expired pharmaceuticals.
The international drug prohibition law states that any drug that has exceeded ½ of its duration should not be sold or allowed to pass the borders of any country.
The Ministry of Health and the Food and Drugs Authority (FDA) are required to impose stricter sanctions on the sale of unlicensed controlled substances including prescription drugs as the current regulations are seen to be too lenient.
Practitioners are also recommended to observe the legal framework for drug trafficking to address the sale of over-the-counter drugs.
Currently, one pharmacist in Rwanda cares for up to 14,000 patients per year. The objective is to reduce the number to one practitioner for 1 patient by 2025.
There are no definite statistics that show the effects of prescription drug abuse but the misuse of medication such as painkillers can have dangerous consequences.
For example, opioids can cause choking, changes in mood, decreased cognitive function, interruptions in the menstrual cycle, infertility and slowed breathing. The misuse of anti-depressants, sedatives or tranquilizers can cause severe addiction problems, lead to coma or death.