Expired ARVs recovered at Ha Thetsane

The Ministry of Health has recovered 160 bottles of expired antiretroviral medicines (ARVs) from a small dam near the Mabolou River at Ha Thetsane.

The medicines, identified as Tenofovir/Lamivudine/Dolutegravir (TLD 300/300/50 mg), were recovered on Monday this week following an alert regarding medicines reportedly dumped in the river.

In a report issued on Wednesday, Maseru District Health Management Team (DHMT) Pharmacy Manager ‘Mamapolesa Qoliso Makepe said a team comprising the pharmacy manager and the district logistics coordinator, accompanied by a police officer from Thetsane Police Station and community members, searched the reported site.

The medicines were found alongside bottles and plastic waste, Makepe said.

The recovered medicines had expired in May 2023 and were from batch number 318818. Makepe said the packaging was intact when the medicines were recovered.

“The medicines were removed, documented and transferred to the DHMT pharmacy store,” she noted, adding they were quarantined and securely stored pending authorised disposal by the Ministry of Health Headquarters Pharmacy Department.

The Maseru District Medical Officer and Health Inspector were also notified of the recovery.

Makepe said improper disposal of medicines poses risks to the public and the environment, including the possibility of misuse or accidental ingestion, particularly by children.

She also warned that people could use expired or inappropriate medicines for self-medication if they are improperly discarded.

Unsafe disposal of medicines may contribute to antimicrobial resistance (AMR), where germs become resistant to medicines, making infections harder to treat or causing medicines to stop working effectively.

Makepe further identified contamination of soil and water sources through dumping in rivers, dams and open areas as another risk, alongside exposure of the public, waste handlers and animals to pharmaceutical products.

She called on hospitals and clinics, including government, Christian Health Association of Lesotho (CHAL), Red Cross, private clinics and retail pharmacies to counsel patients on the safe storage and return of unused and expired medicines.

Health facilities should also prevent medicine expiry through proper stock management, including First-Expiry-First-Out principles, appropriate quantification and ordering, stock management and redistribution of medicines where appropriated.

Makepe said expired and unserviceable medicines should be removed from usable stock, recorded and securely stored in a designated pharmaceutical-waste area.

She further advised facilities to obtain the required authorisation from the Pharmacy Department at the Ministry of Health headquarters before disposal and to ensure secure transportation to approved disposal sites.

Makepe called on DHMTs and pharmacy personnel to supervise and monitor government, CHAL, Red Cross and private health facilities on pharmaceutical-waste prevention, segregation, storage and disposal.

She also urged patients, caregivers and communities to return unused and expired medicines to hospitals and clinics, as well as medicines remaining after a patient’s death or medicines no longer required following treatment changes or non-compliance.

She said certain medicine-administration devices such as used insulin syringes should be returned through the recommended channels.

“Do not throw medicines into rivers, dams, toilets or open spaces and in household garbage,” Makepe noted in the report.

She advised the public not to use or give expired or unused medicines to another person, but to return them to the nearest hospital or clinic pharmacy or dispensary at the earliest convenience for safe disposal.

Until they are returned, medicines should be kept safely away from children and animals, the report stated.

Makepe urged community leaders, schools, health workers, pharmacies, village health workers and the media to help spread the message on safe medicine disposal.