Despite a recommendation to revoke its licence, one of Malawi’s largest pharmaceutical suppliers that was shut down for supplying state hospitals with faulty antibiotics – linked to a number of infant deaths – has continued to supply them with expired, falsified medicines after relaunching under a new name, a Platform for Investigative Journalism (PIJ) investigation has found.
Regulators recommended revoking the company’s licence but only a warning was issued, and allegations of political interference and attempted bribery during the disciplinary process have never been investigated, write Golden Matonga and Tumpale Ng’ambi for GroundUp.
Documents show a company operating as GPSL Wholesale Ltd is the same company previously going as Galaxy Pharmaceuticals and Surgical Logistics, closed in 2013 for supplying dodgy antibiotics linked to the babies’ deaths at Mzimba District Hospital.
The company rebranded itself as GPSL Wholesale (GPSL) in 2019 and has continued selling dubious medication. It refused to respond to GroundUp’s questions.
Insulin scam
Between January and March 2022, Malawi faced a critical shortage of insulin. GPSL Wholesale took advantage of the crisis.
Documents show that expired insulin stored at Queen Elizabeth Central Hospital (QECH) in Blantyre and awaiting destruction, was stolen and redistributed to state hospitals.
Strict procedures govern the disposal of expired medicines in Malawi. In this case, those safeguards failed. The insulin, according to minutes from a Pharmacy and Medicines Regulatory Authority (PMRA) investigation, appears to have been stashed in a storeroom with a broken lock and no dedicated guard.
A pharmacy technician at the hospital, Michael Lemeka, spent weeks smuggling insulin vials out of the hospital in his laptop bag. He then contacted an illicit drug broker, Habib Goba, who was previously linked to the trade in stolen public medicines.
GPSL bought the stolen insulin at well below the market rate from licensed wholesaler Worldwide Pharmaceuticals and entered it into its books as if it had been legitimately sourced.
Under Malawian law, pharmaceutical wholesalers can only procure medicines from registered international suppliers. The brand of insulin in question had a single authorised distributor, Intermed Pharmaceutical. GPSL listed multiple local companies as suppliers.
None was authorised to do so.
Documents trace how the expired insulin was then relabelled and distributed to hospitals across the country. Ironically, nearly 1 000 vials were supplied back to QECH, the hospital from which they had been stolen.
The scheme began to unravel when clinicians noted that insulin supplied to Mzuzu Central as an emergency order was not effective.
Then an intern at another hospital noticed labels peeling off refrigerated vials. Beneath them were the original expiry dates.
Limited accountability
The discovery triggered an investigation and within days, the PMRA shut down GPSL offices and several people were arrested, including the directors – but not prosecuted.
A PMRA report identified a company manager as a “central figure” who was “fully involved” in sourcing medicines from illegal dealers.
The PMRA’s disciplinary committee recommended revoking GPSL’s licence and making the sanctions public, but the recommendation was ignored, and just a warning issued to the company’s managing director.
Allegations of political interference have also clouded the case. Sources described pressure from senior officials and claims of attempted bribery during the PMRA disciplinary process, which appears not to have included a forensic review.
The regulator’s report only notes that “it was observed in the clinical departments that the product was not effective in the management of diabetic emergencies, which prompted hospital users to scrutinise the product”.
No findings of the PMRA investigation have been published as required.
The Ministry of Health told PIJ journalists it is waiting for the courts to conclude the matter before taking further action.
The criminal case against GPSL for selling expired insulin has stalled for several reasons, including the deaths of key suspects, including Habib Goba.
Substandard and fake
A 2022 study by the Kamuzu University of Health Sciences found that more than 14% of antibiotics, antimalarials and antidiabetic drugs in Malawi were substandard or falsified.
In the 2013 infant death tragedy, doctors at Mzimba District Hospital had noticed that babies born to women treated with the chloramphenicol antibiotic supplied by GPSL were dying.
Before the regulators could fully investigate, the drugs disappeared. GPSL removed stock from the hospital and issued a recall, but sources have told the PIJ that those batches also vanished before they could be tested.
With the evidence gone and the victims buried, regulators were left without definitive proof of what had gone wrong. Still, the PMRA found the company guilty of supplying faulty medicines and revoked its licence.
The company officially closed, but is now operating as GPSL Wholesale Ltd.
During a three-month investigation, PIJ journalists filed requests under Malawi’s Access to Information Act for records related to both the insulin and antibiotic investigations. While documents on the insulin case were released, records relating to the infant deaths were denied.
The PIJ has established that the denial was because the case file was stolen from PMRA offices during the investigation.
GPSL refused to respond to questions.
This story was produced by the Platform for Investigative Journalism, edited by GroundUp, and syndicated by the IJ Hub on behalf of its member centre network in Southern Africa
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