Tunisia’s financial crisis leaves patients struggling to find medicine

TUNIS, June 1 (Reuters) – Sick Tunisians face a frantic struggle to find some medicines as the cash-strapped state has cut back on imports, leaving doctors unable to control debilitating health problems and patients turning to informal markets for their medications.

Hundreds of medicines have been missing for months, pharmacies say, including important treatments for heart disease, cancer and diabetes, as well as more basic products such as medicated eye drops whose absence makes chronic conditions worse.

“The issue of missing medicine has become very difficult for patients. We have a real problem with some medicines for which there are no generics available,” said Douha Maaoui Faourati, a Tunis-based doctor who specializes in kidney and blood pressure diseases.

Faourati has had to ask patients to try to obtain drugs from Europe, including those used to control dangerously irregular heartbeats, swelling and clotting, and for which he says no good alternatives are available in Tunisia.

Its woes show how Tunisia’s worsening fiscal woes are affecting ordinary people and fueling public anger at a state barely able to maintain even basic services.

Since last year Tunisia has struggled to pay for other goods sold at subsidized rates, causing periodic shortages of bread, dairy products and cooking oil as foreign exchange reserves fell from 130 days of imports to 93 days.

Tunisia wants a $1.9 billion International Monetary Fund bailout, without which ratings agencies have warned it could default on sovereign debt, but President Kais Saied has rejected key terms of the deal and donors say talks have stalled.

Tunisia imports all medicines through the state central pharmacy, which supplies medicines to hospitals and pharmacies across the country who offer them to patients at a subsidized rate.

The head of the Tunisian pharmacies union, Naoufel Amira, said hundreds of medicines were no longer available, including those for diabetes, anesthesia and cancer treatment.

Amira and two Central Pharmacy officials, who spoke anonymously because they were not authorized to speak to the media, said the body owed large sums to foreign suppliers, who in response limited their sales to Tunisia.

“The problem is mainly financial,” Amira said.

Amira said the central pharmacy owed about 1 billion dinars ($325 million) to suppliers. Officials said he owed around 800 million dinars, adding that public insurance companies and hospitals were delaying bill payments by up to a year.

The Tunisian Ministry of Health and Central Pharmacy did not respond to requests for comment.

EXCHANGE OF MEDICINE

From the roof of his home in Tunis, retired soldier Nabil Boukhili has opened an unofficial medicine exchange for his neighborhood in coordination with local doctors. “We have dozens of people who come here every day to get medicine,” he said.

It procures medicines from people traveling abroad as well as leftover pills from people who have finished their treatment, dispensing them free of charge to people who can show a prescription.

While Reuters was interviewing Boukhili, a woman arrived who needed medicine for a thyroid problem. “I have been without this medicine for more than a week,” said Najia Guadri, adding that she felt unable to function without it.

Sitting at his parents’ home in Tunis, Abdessalem Maraouni described how a lack of medicated eye drops left him at risk of blindness and unable to go out, forcing him to drop out of law studies at university.

“This country can no longer supply even a box of medicine,” he lamented, sitting in the family’s modest home decorated with posters of his favorite football team but unable to see objects more than a few feet away.

The 25-year-old has been unable to find medicine, or an alternative, for six months and has had to seek supplies from people traveling abroad, paying much more than he would have done in Tunisian pharmacies and rationing their use.

Maraouni’s father Kamal wept as he described how the state’s inability to import medicines had affected his son’s prospects.

“We’re not asking the state for money or big places to live. We’re just asking for medicine. Is that too much?” he said.

Reporting by Tarek Amara and Jihed Abidellaoui, Writing by Angus McDowall, Editing by Ros Russell

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