As thousands die from opioid addiction in rich countries, millions in the poorest nations have no access to opioids. Rwanda has an answer.
In this photo taken Tuesday, Nov. 5, 2019, palliative care nurse Madeleine Mukantagara, 56, left, prays with Vestine Uwizeyimana, 22, right, who has spinal degenerative disease and is taking oral liquid morphine for her pain, as she visits to check on her health at her home in the village of Bushekeli, near Kibogora, in western Rwanda.
Companies don’t make money selling cheap, generic morphine to the poor and dying, and most people in sub-Saharan Africa cannot afford the expensive formulations like oxycodone and fentanyl, prescribed so abundantly in richer nations that thousands became addicted to them. As her visitors left Uwizeyimana blessed them, wishing for them what she might never have herself. May you get married, if you are not, she said. May you have children.
But medical advances meant more people were living into old age and facing diseases such as cancer. Some thought their pain was punishment from God for past sins, recalled Dr. Christian Ntizimira, one of Rwanda’s most outspoken advocates for palliative care. At the same time, health workers treating Rwandans in the late stages of AIDS pleaded for a way to ease their pain.
Administration of morphine for hospice patients is undisputed -- in 2016, when the U.S. Centers for Disease Control called on doctors to cut back on the flood of opioid prescriptions that fed the addiction crisis, it specifically exempted end-of-life patients. The study estimates it would cost only $145 million a year to provide enough morphine to ease end-of-life suffering around the globe, yet millions still suffer without pain medication in the poorest places.
In 2013, Stephen Connor, executive director of the Worldwide Hospice Palliative Care Alliance, made a list of all the companies that make opioids and invited them to attend a conference. It was a chance, he said, to discuss how they could help address the crushing need for end-of-life pain treatment by producing morphine as a social good.
By putting morphine production and distribution under strict government control and covering the costs for patients, Rwanda has quietly become the new model for Africa. The liquid is produced from imported powder three times a week, about 200 bottles at a time, in a single room where a handful of workers in protective scrubs are checked before leaving to prevent the drug being smuggled out, said Richard Niwenshuti Gatera, a pharmacist and director of the production facility.
Mukantagara arrived at the bedside of 89-year-old Athanasie Nyirangirababyeyi. She lives on a mattress in her son’s home, sleeping under a poster of Jesus and the words of Psalm 23 — “The Lord is my shepherd; I shall not want” — though she never learned to read. She has been sick for five years and has taken liquid morphine for three.
“I miss school. I miss my friends,” she said. If the chemotherapy helps, she is expected to return to class. “What makes me mad is the confusion this causes,” he said. “If you would have asked me two years ago, I would say we’re steadily improving. But now I’m really afraid that the crisis in the U.S. is triggering a backlash which leads to rapid deterioration of the global situation.”
Purdue wrote in a statement that the report is “riddled with inaccuracies,” and the company denies influencing the documents. The statement maintained that the marketing of OxyContin was in line with the U.S. Food and Drug Administration’s approved labeling and that Purdue always complied with the agency’s orders to update labels or enhance warnings “to maximize patient safety.” Decisions about when to prescribe opioids, the company said, should be up to doctors and their patients.
United States Latest News, United States Headlines
Similar News:You can also read news stories similar to this one that we have collected from other news sources.
Rwanda avoids US-style opioids crisis by making own morphineRwanda doesn't have access to costly opioids from big pharmaceutical companies, so the African country has come up with a solution.
Read more »
Without access to costly opioids, Rwanda makes own morphineBUSHEKELI, Rwanda (AP) — It was something, the silence. Nothing but the puff of her breath and the scuff of her slip-on shoes as Madeleine Mukantagara walked through the fields to her first...
Read more »
U.S. diabetes patients turn to 'black market' for medications, supplies(Reuters Health) - Diabetes medications and blood-test supplies are sold, traded...
Read more »
USDA Receives Twitter Backlash For Joke About Issuing Santa Permit To Enter U.S.Many said the joke was tone-deaf, given the migrant children detained at the U.S. southern border.
Read more »
Trump's stock market rally is far outpacing past US presidentsThe S&P 500 has returned more than 50% since Trump was elected, more than double the average market return of presidents three years into their term, according to Bespoke Investment Group.
Read more »