Liquidity crunch forces suspension of organ transplant

ISLAMABAD: Serious health crisis has unfolded in the wake of the acute liquidity crunch confronting the country forcing several leading transplant centres across the country to stop performing kidney, bone marrow and liver transplants due to the unavailability of a critical and imported medicine used to prevent the body from rejecting any transplanted organ, leading transplant surgeons and officials said on Tuesday.

The essential medicine known as Anti Thymocyte Globulin (ATG) is not being imported due to a ‘dollar liquidity crunch’ in the country, they said and claimed that due to the absence of the essential medicine, not only kidney transplants but several other transplants including liver and bone marrow transplants were not being performed across the country.

“For the last two to three weeks, we are unable to perform kidney transplants at Pakistan Kidney and Liver Institute & Research Center (PKLI&RC) due to the unavailability of an essential medicine called ATG (Anti Thymocyte Globulin). This medicine is imported but suppliers are not distributing it citing dollar liquidity crunch”, Prof. Faisal Saud Dar, Chief of PKLI&RC told The News.

The officials at Shifa International Islamabad, one of the leading transplant facilities have also confirmed that due to the unavailability of ATG injections and kits for bone marrow transplant, they were forced to put on hold several transplant procedures in the last several weeks.

Pakistan is facing a shortage of essential medicines and medical equipment as local banks are not opening Letters of Credit (LCs) for the import of Active Pharmaceutical Ingredients (API) for locally produced medicines, several vaccines, immunoglobulins and biological products for the treatment of cancer and other diseases.

Same is the situation of medical equipment which is not being imported due to the dollar liquidity crunch and healthcare professionals fear that if the issue of LCs is not resolved, heart surgeries requiring valves replacement, angioplasties and several other essential surgical procedures and interventions can also be stopped soon.

Dr. Faisal Saud Dar maintained that kidney transplants were not being held at PKLI&RC and at several other transplant centres in Islamabad, Lahore and Karachi due to extreme shortage of ATG injections and nobody would be willing to take the risk of performing kidney transplants without it. “There is an urgent need to ensure the availability and provision of ATG injections and some other essential medicines to save lives. We can live without several other imported items but not without importing essential medicines, raw materials and medical equipment”, Prof. Dar added.

Officials at another transplant institute, Gambat Institute of Medical Sciences (GIMS), Khairpur Sindh also confirmed that they were only performing ‘emergency’ kidney transplants as the essential medicine ATG was not being supplied. They warned if the supplies were not resumed within the next few days, the situation could become extremely critical for the patients requiring transplants. “This is an essential medicine whose stocks have almost been exhausted and the companies supplying ATG are unable to import it. We are also facing problems in performing bone marrow and liver transplants”, Dr. Rahim Bux Bhatti, Director GIMS told The News.

The GIMS Director said they were the largest transplant centre in the country where kidney, bone marrow and liver transplants were being performed free of charge and people from the entire Pakistan approach them for live-saving procedures but due to unavailability of essential medicines and supplies, they were only performing procedures, which were extremely necessary. “The government must address the issue urgently and seriously as we need an uninterrupted supply of essential medicines to save the lives of hundreds of patients, Prof. Bhatti added.

Officials of the Allmed Laboratories which imports the ATG injections from Germany said around 2000 injections of the essential medicines were stuck at Karachi Airport as local banks were not approving Electronic Information Form (EIF), a financial requirement, without which customs authorities were not releasing any shipment imported into the country.

“ATG injections used for kidney, liver and bone marrow transplants are not being imported due to financial crisis and dollar liquidity crunch. Two consignments of 2000 injections are lying at Karachi airport but customs are not releasing them due to verbal instructions from the State Bank of Pakistan”, an official of the Allmed Laboratories said.

The Drug Regulatory Authority of Pakistan (DRAP) officials when approached said on their recommendations, the Ministry Of National Health Services had written to the Ministry Of Finance for facilitating the pharmaceutical sector to help patients.