OPINION: Crackdown on drugs needs a coordinated approach

Recently the government ordered for the fresh round of verification of licenses for pharmacies and agrovets by the Veterinary Medicine Directorate (VMD) and Pharmacy and Poisons Board.

The government, through the CS Interior, Prof Kithure Kindiki says the crackdown is necessitated by a marked increase in the abuse of drugs and other illicit substances.

The campaign, initiated by DP Rigathi Cachagua’s war against alcoholism, has now spread to cover the regulation of medicines for both human and veterinary use. For the veterinary profession, concern has been raised about the misuse of anesthetics such ketamine and xylazine for recreational purposes, as supported by the new report from the National Authority for the Campaign Against Alcohol and Drug Abuse (NACADA).

It is important to note that this exercise goes well beyond general law enforcement as it has implications for the regulation of the practice of veterinary medicine. 

There’s need to acknowledge that some controlled veterinary medicines are used for recreational purposes posing a significant threat to public health and safety. The report by NACADA notes that drugs intended for animal use end up finding their way into hands of individuals who seek to abuse them contributing to the proliferation of substance abuse.

This is not just an issue affecting Kenya but other jurisdictions too including the US and the UK where different formulations of anesthetics are regularly abused by being mixed with other substances such as heroine. The misuse of veterinary medicines not only has consequences on public health but also on animal welfare and food safety.

The practice where medicines are used and obtained without proper veterinary oversight, contributes to antimicrobial resistance, an urgent public health crisis. This practice also jeopardizes the public trust bestowed upon veterinarians as per their oath to protect both human and animal life. 

However, for this crackdown to succeed, it requires a multifaceted approach that addresses both the supply and demand of the drugs as well as access to healthcare. The wanton use of Prescription Only Medicines (POM) does not happen in a vacuum-it reflects our societal norms and values. We are a society that loves shortcuts and quick riches, and this just a reflection of that culture.

There’s however another bigger factor at play- inadequate access to healthcare services. The government must address access to both human and veterinary healthcare as primary healthcare in Kenya seems to be a preserve of the wealthy and those in urban areas.

Large areas of Kenya lack even basic healthcare facilities such as dispensaries and veterinary offices. In such localities, agrovet and chemist assistants play the role of medical and veterinary doctors filling a void the government ought to have filled. The dilemma for these assistants is how to turn away an ailing patient for lack of a prescription when the nearest medical centre is 70km away.

Furthermore, relevant regulatory bodies including the Kenya Veterinary Board and the Veterinary Medicines Directorate should enforce the government directive humanely. Giving professionals and businesses a reasonably extended period to regularize will lead to better compliance.

The long lines witnessed at the two agencies as vets rushed to beat the deadline are a sign that our members are willing to comply. Extending this period is necessary to ensure order compliance that focuses on compliance instead of harassment.

On a related topic, senators must maintain the progressive arc of Kenya’s legislative shifts by rejecting the Kenya Drug Authority (KDA) Bill’s provisions that seek to revert the regulation of veterinary medicines to the Pharmacy and Poisons Board. Before the creation of the Veterinary Medicines Directorate, the practice of veterinary medicines was beset with problems as all the board PPB was interested in was collection of license fees.

The board either lacked capacity or interest in the key facets of regulation including pharmacovigilance. The Veterinary Medicines Directorate has worked to streamline control and regulation of veterinary medicines and those efforts should not be watered down by reverting to the old order.

Caution should always be exercised when rushing to adopt practices in the US, and instead follow precedence in the commonwealth or the European Union. This is because the US has some of the most conservative regulatory laws and hence, we shouldn’t use the Food and Drugs Authority (FDA) as a template. In fact, most other jurisdictions including the UK and Canada have ensured control of veterinary medicines rests with veterinary professionals.

Rather than pushing for a reversion of roles, stakeholders should push the government to build the capacity of both the Pharmacy and Poisons Board and the Veterinary Medicines Directorate to ensure better regulation.

Veterinarians believe that the senate will do the logical thing, ensuring that Kenya remains compliant with international practices and the World Organization for Animal Health (WOAH) recommendations. The ill-informed move to water down the work of the Veterinary Medicines Directorate has the potential to hinder our international trade in animal products. 

Another issue facing the veterinary profession is a ‘failure of the systems’ that has seen veterinary interns go months without pay. The emotional and financial strain that the young interns are going through would have been avoided if the internship programme was well thought of and better implemented.

The Veterinary Internship Programme was introduced after the enactment of the Veterinary Surgeons and Veterinary Paraprofessionals Act in 2011. The aim was to ensure the country complied with the World Organization for Animal Health (WOAH) requirements.

Spending 5 years in veterinary school only to go several months without pay as an intern is unjustifiable. Doing so while being paid peanuts compared to their peers in other professional courses and other countries is unconscionable.

Much of the blame for these woes facing the interns and veterinary surgeons lies with the outdated veterinary scheme of service. It is high time the government takes care of its veterinary professionals as is done in other countries.

This starts with paying veterinary interns stipends that mirror those by other comparable professionals and reviewing the scheme of service to ensure vets earn non-practice allowances and justifiable risk allowances.

It is hypocritical for a government that proclaims its recognition of healthcare and agriculture as mainstays of the economy to treat professionals with important roles in both sectors with such disdain. 

The Kenya Veterinary Association elections will take place on April 26th at Elboran Resort in Isiolo with a hotly contested Chairman’s race the highlight of the polls.

By Dr Kelvin Osore, a Veterinary Surgeon and a candidate for the position of National Chairman in the upcoming Kenya Veterinary Association Elections