The number of pharmacies in Yemen is increasing, creating a new challenge for the Ministry of Health as it works to stem the growing problem of pharmacists providing medication to patients without a valid prescription.

“Medical prescriptions are not that important for some Yemenis despite the hazardous consequences caused by such action,” Dr.  Mohamed Al-Hairibi, an owner of a private internal medicine clinic in Sana’a, said.

Taking prescription medications without first consulting a specialized doctor might cause long-term and short-term dangers, according to a Yemeni doctor. Moreover, the wrong prescription could hide the original symptoms of a particular disease. According to doctors, many illnesses show similar symptoms, though the nature and the reasons differ.

Adel Sinan, deputy manager of the Pharmacies Monitoring Unit at the Ministry of Health, stressed that the ministry is doing its best to monitor  pharmacies. The increasing number of pharmacies has driven the ministry to begin a study that includes tracking pharmacies nationwide.  The study is funded by the World Health Organization (WHO).


Responsibility of local councils and health offices

Sinan said monitoring pharmacies has become the responsibility of the local councils and of each district’s health office.

“The ministry finds it difficult to implement periodical visits to all pharmacies due to their huge number,” he said.

“The ministry’s job is to supervise the local authorities. The latter is tasked with submitting reports to the ministry. Thus, the local council is absolutely responsible for this matter.”


Punishments for uncertified pharmacists

Sinan said the medical punitive laws in Yemen are clear. Anyone who poses as a pharmacist while lacking certification is subject to up to three years in prison and a fine estimated at YR 800,000 ($3,720 USD). Numerous cases have been tried, and the punishment has helped decrease unlawful acts, he said.

Sinan said 95 percent of working pharmacists have a university degree.

“This negates the claim that some pharmacists only gain experience without holding an academic qualification,” Sinan said.


Chronic ailments do not necessitate renewed medical prescriptions

Sinan said that according to doctor reports, using prescription medication without the advice of a doctor or a specialized pharmacist is not uncommon in Yemen. Pharmacists may give some patients medication, particularly if the patient suffers from chronic ailments such as diabetes, which doesn’t require the renewal of a doctor’s prescription once medicine is used. Patients present test results to the pharmacist, and the prescription is filled.

Regarding those with diabetes, Sinan said that the health ministry distributes approximately 300,000 insulin tablets per month to patients receiving treatment at the state-run Al-Jamhouri Hospital in Sana’a.

According to one physician, medicine prescribed by a pharmacist can pose hazards, so the ministry should do its job to stem this act.

Al-Hraibi said, “The weak presence of the health ministry and the absence of medical unions   contribute to misusing medicines which threaten people’s lives.”


Poverty a factor for those who go directly to pharmacies

Amani Al-Khiwani, who lives in Sana’a, said some people prefer going directly to pharmacies rather than to doctors because many doctors are unethical.

“Their [doctors] objective is only gaining money,” she said. “Therefore, people usually do not trust doctors due to wrong examinations and high charges of medical tests. Also, the hard living standards force people to go to pharmacies directly with no medical tests since they can’t afford examinations and consultancy.”

Al-Huraibi said pharmacists are not trained to accurately diagnose a disease. Sometimes pharmacists guess, he said, prescribing medicine on the basis of external symptoms and without medical tests. The pharmacist gives medication that only works as a painkiller, as a vitamin, as an antibiotic or as a fever reducer, regardless of medical conditions.  

Abdullghani Ghanaim, a pharmacist in Sana’a, said at times pharmacists solely prescribe medications that help alleviate the severity of an illness, a headache or soreness.

In his opinion, pharmacists must advise patients requesting medicine without a prescription to first seek the advice of a doctor.