Bayamo, Granma - Responding to the demands of the population and achieving a stable supply of drugs marketed in Cuba’s network of pharmacies is today one of the greatest productive challenges faced by the nation’s pharmaceutical industry, which faces many financial obstacles as a result of the U.S. blockade.
The Pharmaceutical Oral Liquids Enterprise, Medilip, has not spared from this tense situation. The company located in the province of Granma and the only one of its kind in the country, is devoted to the industrial production of pharmaceuticals in the form of liquids (suspensions, solutions and emulsions) and has suffered a significant decline over the last few years.
Suffice it to point out that the plant, affiliated with the BioCubaFarma state enterprise group, after reaching the annual record of 33.5 million units produced in 2013, has not been able to come close to that level of production, which was distinguished by both the efficiency with which it was accomplished and the quality of the drugs.
"Over the last five years, through the end of 2018, the factory produced between 25 and 28 million units annually, but with the tightening of the restrictive measures imposed by the U.S. government on Cuba, as of 2019 we have not been able to exceed 20 million units," Efren Rodriguez Lora, Medilip's general director, explained to Granma.
Thus far in 2021, these indicators have shown no sign of recovery. Of the more than 50 generic products that the factory can manufacture, he monthly production of some 25 has been affected.
Included among these are several medicines in high demand by the population, such as multivitamins, products administered as drops and the company’s line of natural products, like Ambroxol, Oregano and Caña Santa for the common cold, among others.
In addition, drugs for hospital use have been affected, which, Rodriguez said, “does not mean that they are not being produced, but rather that their production has been at a low level and intermittent, due to the low stock of raw materials and imported inputs, such as caps, containers and bottles of 15, 30, 60, 120 and 240 milliliters," he added.
Likewise, it has been necessary to postpone production cycles of some drugs to be administered orally that have substitutes in other pharmaceutical formats, tablets and injections for example, in line with the country's strategy of prioritizing the production of medicines to treat the principal health problems faced by the Cuban population and confront the COVID-19 pandemic.
The complex dynamics Medilip has faced over the last two years, as a direct consequence of the hostile policy maintained by the United States government toward our country, has not only limited its productive capacities, but also had an impact on the financial stability of the factory, where some 430 workers, including operators, technicians, specialists, researchers and developers, are employed.
To this must be added the progressive deterioration of some equipment and precarious working conditions that prevent a better performance, as well as interruptions in research projects due to the shortage of reagents and imported reference materials, which are critical to studies’ analytical results.
Although these conditions have not eroded the rigor or quality with which all of Medilip’s industrial processes are conducted, they have generated concerns among those who put their hearts into the production of medicines on a daily basis.
“The prevailing attitude in the factory has always been to move forward; if we are obliged to remove a component from one machine so another one can function, we do it; if we have to work a holiday, we are here; if we need to stay after normal working hours, we stay, but for those of us who are directly involved in production on 12-hour work shifts, the distribution of earnings has not been as good as we would like," commented operator Edilberto Agüero Rubiet.
Liliana Céspedes Tamayo, Medilip's economic director, acknowledged that earnings are down, since Medilip is operating far below its productive potential.
"Even when we have complied with the distribution to the workers, the individual dividends do not exceed two salaries, since the sales levels have not allowed us to pay our debts, because as a result of the implementation of the reordering task, production cost of a number of drugs went up, while the price at which they are sold to the population did not change.
"There are cases in which the Ministry of Public Health provides a subsidy and allows us to vary the retail price, but not always, as is the case with diphenhydramine in suspension for children, which is sold to the population for 50 cents, although it costs around eight pesos to produce.
“To address this issue, we are already in the process of reviewing, with the Ministry of Finance and Prices, the inputs that affect retail prices and, consequently, the factory's financial results," Céspedes added.
As part of the national program promoting economic growth, socialist state enterprises have been afforded more authority to advance their development. In this context, Medilip has been able to free itself from some of its foreign dependence to undertake new productions, through technology transfer and productive chains with other companies and research centers, which have allowed it to manufacture products with domestic raw materials.
Among its first accomplishments are disinfectants used to combat COVID-19 (chlorinated detergent, sodium hypochlorite solutions for water, hand washing and surface cleaning), as well as medicinal syrups, all well received by the population.
"We started at the local level by linking up with entities like the Pharmacies and Opticians enterprise and Labiofam, but these products, as is the case for bulk disinfectant alcohol, have had tremendous acceptance not only in Granma, but also in Las Tunas and Villa Clara, and we already have requests from other parts of the country," Rodríguez reported.
We are also producing liquid vitamin C and propolis, which were made locally, in small quantities, by the production centers of Pharmacies and Opticians, and given the national call to industrialize natural medicine, to support the basic drug supply, we took on this line with a volume of over 20,000 bottles," he added.
Similarly, Medilip formalized a contract with Apicuba in order to guarantee a supply of honey derivatives for the production of several products including propolis, the syrup line and, soon, eucalyptus extract.
Despite the limitations they face with generic products, according to Niurka Benítez Guerra, the factory's Development Director, one of this year's novelties is the approval, by the Center for State Control of Medicines, Equipment and Medical Devices (Cecmed), of the drug potassium citrate for the treatment of renal lithiasis (kidney stones), with its first industrial-scale production scheduled for the end of the year.
Thus, the plant is now consolidating three lines of production: generic, natural and alternative products, with which it intends to gradually return to its previous level of production.
Making a reality of this aspiration will depend, to a large extent, on more stable deliveries of imported raw materials and supplies, but also on the willpower, commitment and creative ingenuity that distinguish the plant’s workforce; the people betting on the quality and proven safety of products bearing the Medilip label.
