Evaluating pricing and affordability of veterinary drugs among livestock farmers: A case study of Mityana district in central Uganda

Patrick Vudriko, Richard Kikomeko and Samuel Majalija*

Division of Pharmacology and Toxicology, Department of Physiological Sciences,
School of Veterinary Medicine, Makerere University, P.O Box 7062, Kampala, Uganda
vpato@vetmed.mak.ac.ug
* Department of Veterinary Parasitology and Microbiology, School of Veterinary Medicine, Makerere University,
Kampala. P.O. Box 7062 Kampala, Uganda

Abstract

The supply of veterinary drugs in Uganda is solely carried out by the private sector. This study evaluated the prices of animal drugs, availability, affordability and its impact on livestock enterprise survival in central Uganda. The cross-sectional study was carried out in Mityana district from January to March 2010. One hundred farmers reporting to four selected animal drug shops were interviewed and these included 49% small holder farmers, 36% and 15% large and medium holder farmers, respectively.

Of the 282 drug purchases, 31% (88) were antihelmintics while antimicrobials and acaricides constituted another one-third of the purchases. The majority (75%) of the farmers could not afford the prices and these mostly included essential veterinary drugs such as acaricides, antimicrobials, de-wormers and drugs for treatment of tickborne diseases. Seventy-two percent of the farmers reiterated that high drug prices reduce their livestock enterprise profitability and survival. Due to increased drug prices, 63% of the farmers devised coping methods which included change to cheaper alternatives (32%), reduced the dosage (16%), reduced the period of treatment period or abandoned the treatment regime (1%). Eighty-nine percent of the farmers wanted the government to regulate the prices of veterinary drugs. In conclusion, the high price of veterinary drugs especially to commercial farmers due to lack of price control by the government impacts negatively on livestock enterprise survival, profitability and rational use of veterinary drugs. Therefore, the government needs to consider reducing tariffs levied on importation of veterinary pharmaceuticals to reduce the priced burden on livestock farmers.

Key words: Copying strategies, enterprise survival, private sector, small holder

Introduction

Significantly, livestock are source of income, store of wealth and social security as well as ensuring food security, provision of draught power and manure for smallholders in sub-Saharan Africa (FAO 1998). In Uganda, the livestock sub-sector contributes 12.7% and 5.2% to agricultural GDP and total GDP, respectively. This sector continues to grow at a rate of over 4% per annum due to increasing demand for milk and meat (Uganda Investment Authority 2005). The majority of households engaged in livestock agriculture have shown resilience, higher incomes and faster rates of overcoming poverty than crop-based households in Uganda (FAO 2003). What African agriculture needs is a viable productive livestock industry to achieve optimum growth for her impoverished rural communities. However, the economic viability of the livestock sub-sector is continuously threatened by high prevalence of infectious, vector borne and parasitic diseases (FAO 2005). This necessitates the use of veterinary drugs and pesticides for prevention, control and treatment towards improvement of livestock productivity.

Efficient and reliable animal health services constitute an essential prerequisite to livestock development in Sub-Saharan Africa (FAO 1996). Most African countries including Uganda have privatized their veterinary services in order to enhance efficient productivity of the livestock sector for the benefit of the producer, the veterinarians, animal agriculture and national economies (Mpelumbe 1994; De Haan and Bekure 1991).  In countries with successful privatization programs such as Morocco, there is improved provision of veterinary services (Holden 1999) and supply and availability of animal drugs (Daniels and Skerman 1993; Holden 1999).  Nonetheless, in many developing countries animal drugs have variable prices, often high in relation to income levels of farmers. No pricing policies or regulation mechanism for the private-sector drugs pricing system for veterinary drugs exist in Uganda (National Drug Authority 1993). In contrast, however, the pricing by pharmaceutical companies or distributors in South Africa for instance, depends on standardized price lists, with bulk discounts and sliding scales on over the counter products (Dijk 2008). Similarly, in Australia, Canada and the United Kingdom mechanisms for setting, monitoring, regulating and reviewing of drug prices so as to keep them at reasonable levels are well established (WHO 2009).

The distribution chain of veterinary drugs in Uganda can broadly be categorized into; sole distributors (importers), regional distributors (regional pharmacies) and retail outlets (drug shops) which interface mostly with rural livestock farmers. In the rural pastoral communities, the pharmaceutical companies focus on selling dewormers, ectoparasiticides, antibiotics and vaccines with a restricted number of packed sizes available (Dijk 2008). If any, there is minimal price regulation along the supply chain, hence the drugs shops prefer the sale of lower priced generic drugs from where they generate higher profits compared to higher priced products. Although the generic drugs are a ‘hot cake’ in most rural pastoral communities because of the affordable prices, their quality is relatively lower than innovator drugs. Such products may lead to the emergence of microorganisms resistant to drugs in man and animal, residues in milk and meat, chronic disease and death (Owens 2003).

In Uganda, veterinary drug pricing, availability and affordability by livestock farmers have not been studied. Hence this study aimed at evaluating the pricing on the availability and affordability of veterinary drugs and its impact on the survival of livestock enterprises in central Uganda.

Methods

Study area

The study was carried out in the central Uganda district of Mityana, which lies within the cattle corridor. Veterinary services are provided by both government veterinary staff, private veterinarians and other professionals working with non-governmental organizations.

Study design and population

This was a cross- sectional descriptive study involving the participation of farmers in Mityana district from January to March 2010. Four retail veterinary drug shops which sold a variety of animal drugs and mostly frequented by livestock farmers in Mityana town were selected as study sites for the collection of data. The target population was livestock farmers purchasing veterinary drugs from any of the four drug shops between January and March 2010. During these periods, questionnaires were filled for all farmers reporting between 9.00am-2.00pm on three consecutive days of each week.  

Study population

The target population was livestock farmers from Mityana district that purchased animal drugs from any of the four drug shops between January and March 2010.  In total 100 farmers, 25 from each of the four veterinary drug shops were targeted in this study.

Inclusion and exclusion criteria

All livestock farmers who visited the selected drugs shops and bought animal drug during the time of the interview were included. All farmers who visited the drug shop for other reasons, other than buying animal drugs were excluded from this study. 

Ethical considerations, data collection and analysis          

A written consent was obtained from each of the farmers explaining the rationale of the study. For each farmer, a coded questionnaire was completed including information on the demographic characteristics, veterinary drug pricing, affordability, availability and use. The information obtained was confidentially kept. The data obtained were categorized and analysed descriptively using SPSS (Version 17).   

Results

Demographic information and categories of farmers

A total of 100 livestock farmers participated in this study. Forty-one percent of farmers had primary education, 27% had Uganda certificate of education, 10% had Uganda advanced certificate of education and 22% had attained a diploma or above. The farmers were categorized into smallholder, medium and large-scale holder farmers depending on the number of animals as shown in Table 1. Forty nine (49%) of the farmers were smallholder farmers, while 36% and 15% were large and medium holders, respectively (Table 1).  

 The small holder farmers kept their animals in the backyard of the homestead. The cattle and goats were tethered around home, while pigs were tied with ropes around trees. The birds were local scavenging chickens which were often prone to predation. The medium and large holder livestock farmers grazed their cattle in paddocks or rangeland. The pigs were housed and provided with feeds mainly composed of leftovers and crop residues, while chickens were reared both under free range system and confinement. 

Individual drug purchases by farmers in Mityana district

Out of 282 drug purchases by farmers, 31% (88) were anthelminthics and one-third of the drug purchases were either antimicrobials (17.4%) or acaricides (16.3%).  The remaining 6 categories of animal drugs (multivitamins, mineral supplements, anticoccidials, poultry vaccines, anti-tickborne fevers and trypanocidals) constituted slightly above one-third (35.1%) of all drug purchases (Table 2). 

Veterinary drug pricing

Antitheilerial drugs were the most expensive per unit pack. A bottle of Buparvaquone (40 mls Butalex^TM) and Parvaquone (100 mls Parvexon^®) costs 90,000 and 70,000 Uganda shillings (Ug.Shs) respectively. A 100 mls bottle of antibacterials costs a minimum of 6,000 Ug.Shs while a litre of acaricide would cost atleast 60,000 Ug.Shs.  The above drugs are also dispensed in small quantities such as 1 ml to those who can not afford a whole vial or bottle. Such clients are mainly small holder farmers who pay between 100 and 500 Ug.Sh for 1 ml of the various categories of drugs that are sold (Table 3). 

Affordability of animal drugs

Out of the 100 farmers, only 25% could afford the prices of the drugs, while the majority (75%) could not afford (Table 4). Only 41% of the smallholder farmers could afford the prices of animal drugs compared to 51% who could not afford the prices. Only 7% and 11%  of the medium and large scale farmers could afford the the prices of drugs (Table 4).  

About 80% of the smallholder farmers could afford the prices of the drugs compared to the medium and large holder farmers (P = 0.002) because they purchased drugs in smaller quantities. The most affordable drugs were wormicid^® (levamizole) and small quantities of acaridies and antibiotics (Table 5). 

 Categories of unaffordable drugs reported by farmers

Of the 75 farmers that could not afford the high prices of drugs, the majority 64/75 (85%) could not afford acaricides (25%), antimicrobials (24%), de-wormers (20%) and drugs for treatment of tickborne diseases (16%) as shown in Figure 1. The remaining 15% could not afford trypanocidals (10%) or anticoccidial drugs (5%). There was no significant difference between type of drug and unaffordability (p>0.05).

Figure 1. Categories of unaffordable drugs reported by farmers

Coping strategies for high drug prices

In case of increased drug prices, only 37% of the farmers continued using the same drugs, while the majority of farmers (63%) sought for another alternative. Of those who sought for alternatives, slightly more than half (32, 51%) changed to cheaper drugs, 20 (32%) opted to reduce the dosage (quantities) of the administered drugs, 10 (16%) decreased the period of treatment period, while 1(1%) withdrew and abandoned the treatment (Figure 2). The coping mechanisms in response to high drug prices are practiced mainly by large holder farmers (47%) and medium holder farmers (35%) than small holder farmers (18%).

Figure 2. Coping strategies by farmers in response towards increased prices

Drug pricing and the survival of the livestock enterprise

Seventy two percent of the farmers noted that high drug pricing affected their livestock enterprises and survival. Of these 36 (50%) were large holder farmers, 27 (37.5%) medium holder and small holder 9 (12.5%). The effect of high drug prices was affecting the survival of medium and largeholders than small holder enterprises since the cost of production is increased. 

Perceived role of government in regulation of veterinary drug pricing

The majority of farmers (64 of 72, 89%) who could not afford the drug prices, said they wanted the government to regulate prices of veterinary drugs, whereas 8 (11%) did not expect government to regulate drug prices. Of the 64 farmers, 31 (48%) were large scale holders, 23 (36%) medium holder and 16% (10) small holders.  

Discussion

The majority of respondents (41%) had primary education. This was not surprising because most rural farmers in Uganda are not educated, thus they concentrate on livestock and crop farming as a source of income. Many farmers (47%) had spent above four years in livestock production, this could be attributed to various benefits they derive from livestock enterprise for their livelihood. This finding is in agreement with a previous report (Plan for Modernization of Agriculture 2004) which showed that 80% of the Uganda’s population depends on agriculture production.

The animal drugs sold in Mityana District were mainly over the counter/class C drugs and few class B drugs such as antibiotics, anti-trypanosomes and drugs for treatment of tick-borne fevers. This is due to the high demand for such drugs by farmers for treatment and prevention of the common livestock diseases such as helminthes, tick borne diseases, bacterial diseases, and trypanasomiasis, which are the major livestock diseases of economic importance in Uganda. There is minimal if any restriction on the distribution and sale of prescription drugs. As such antimicrobials can be accessed by farmers without any prescription. Such a practice could predispose to irrational use of drugs with both animal health and public health implications. The high purchase of dewormers could probably be attributed to the high prevalence of helminthes in the district. Dewormers are used for both prophylactic and curative treatment of livestock helminthes. This finding is in agreement with previous studies which reported huge amount of money spent annually on deworming livestock (Tisdell et al 1999).

Seventy-five percent of the farmers suggested that drugs were expensive. This is expected because the private sector aims at making exorbitant profits disregarding the income levels of the farmers. This finding is in contrast with the veterinary drug policy in Uganda which aims to support and promote the availability and accessible of cost-effective veterinary drugs (National Veterinary Drug Policy 2002). This is partly because the policy has not been implemented. Thus, in Uganda, the private sector sets prices that a market can sustain depending on the demand and supply of the drugs. The high prices in Uganda are similar to high prices reported in other developing nations (OIE 2004), where animal drugs have variable prices. The categories of expensive drugs included acaricides, dewormers, antibiotics, antithelerials and anticoccidials. These drugs are important in the treatment and prevention of the prevailing livestock diseases in Uganda; hence they are highly demanded by both small holder and commercial farmers. High cost of drugs may lead to ineffective treatment regimen and prevention of livestock diseases, predisposing animals to high mortalities, and loss of farm profits and eventual collapse of the livestock enterprise.

Interestingly, of 25% of the farmers who could afford the prices of drugs were able to buy drugs in form of tablets, sachets and and measurable quantities of acaricides and antibiotics. The reason as to why the smaller holder farmers were able to afford the prices of drugs as compared to the medium and large scale farmers is because they purchased repackaged drugs in smaller quantities at lower cost. The high demand for smaller quantities of the drugs due to their affordability has compelled drug shop owners to repackage drugs to meet the clients’ preferences.  Such unacceptable practices predispose to adulteration of drugs and of compromise the efficacy and safety. The large and medium holder farmers could not afford the drug prices because they require large quantities of drugs for routine control and prevention of livestock diseases. Our study seems to suggest that drug availability and use per animal is lower in Mityana district. This contrasts with previous studies in several countries where privatization of veterinary services and drug supplies has led to increase in drug supply and use (Daniels and Skerman 1993; Holden 1999).

Because of high price of animal drugs, most farmers have been compelled to devise strategies for survival of their livestock enterprises. Such measures include buying cheaper drugs, reducing treatment interval or reducing the dosage of drug administered to animals. The sources of cheaper animal drugs in rural communities include vendors, cattle markets and road side shops along cattle routes. Such drugs are often expired and of doubtable efficacy. Reducing the treatment interval or the dosage of drugs constitute irrational use of drugs and may lead to emergence of microbial agents with drug resistance to antibacterial and antiparasitic drugs. The public health consequences of such acts should not also be ignored. The residual effects of drugs in food of animal origin stemming from irrational use of drugs can compromise quality of animal products thus affecting international trade of livestock products.

In this study, 89% of the farmers said that the government could play a role in the regulation of drug prices. This was not surprising because privatization of veterinary services has received mixed reactions among the farming communities in Africa (de Haan and Bekure 1991). However, the farmers’ perceptions were contrary to the government’s mandate, since under a privatized drug system the role of the government is relegated to ensuring efficacious and safety of drugs in the market (National Veterinary Drug Policy 2002). Noteworthy, there is need for Uganda government to ensure that prices of animal drugs are regulated and in tandem with the market values as has been practiced elsewhere (Dijk 2008; WHO 2009). This is recognition of the important role the livestock sector plays in alleviating poverty for many rural households (FAO 2003).

In conclusion, all livestock drugs used in Uganda are imported and therefore any form of subsidy which could reduce the prices of drugs would reduce the cost of farm inputs, promote rational use of drugs, survival and profitability of livestock enterprises leading to improved livelihoods. 

Acknowledgement

The authors would like to acknowledge Veterinary drug shop owners and livestock farmers in Mityana town in Mityana district.  The role of Dr. Charles Lagu in reviewing this paper is highly appreciated

References

Daniels P and Skerman D 1993 Funding research and development - a producer pays approach. In: L Daniels, S Holden, E Lewin and S Dadi (eds), Livestock services for small-holders. Proceedings of a seminar, 10-15 November, 1992, Jakarta, Indonesia.

De Haan C and Bekure S 1991 Animal health services in sub-Saharan Africa: Initial experience with alternative approaches. World Bank Technical Paper 134, Washington DC, The World Bank.

FAO (Food and Agriculture Organization) 1998 Livestock and the Environment. International Conference 1998   ISBN: 9070785145 X6130/E.  Retrieved November 5, 2010 from http://www.fao.org/documents/pub_dett.asp?pub_id=60760&lang=en.

FAO (Food and Agriculture Organization) 2003 Impact of Changing Market Forces and Policies on Structural Change in the Livestock Industries of Selected Fast-Growing Developing Countries: Final Research Report of Phase I - Project on Livestock Industrialization, Trade and Social-Health-Environment Impacts in Developing Countries. Food and Agricultural Organization of the United Nations, Rome Italy.

FAO (Food and Agriculture Organization) 2005 Trypanotolerant livestock in the context of trypanosomiasis  intervention  strategies. Food and Agriculture of the United Nations, Rome Italy.

Holden S 1999 The economy of delivery of veterinary services. Revue Scientifique (International Office of Epizootics), Volume 18:425-439.

Tisdell C A, Harrison S R and Ramsay G C 1999 The economic impacts of endemic diseases and disease control programmes. Revue Scientifique (International Office of Epizootics),., 18: 380-398. Abstract available on: http://www.ncbi.nlm.nih.gov/pubmed/10472675

Mpelumbe I S 1994 Perspectives on the privatization of the veterinary practice in the livestock production in Africa. Repports de synthes surles themes techniques presentes all comite international aui aux commissions regionales, 1993: pp 73-87.

National Drug Authority 1993 National Drug Policy and Act. Ministry of Health, Kampala Uganda.

National Veterinary Drug Policy 2002 The national veterinary drug policy. Ministry of Agricultural, AnimalIndustry and Fisheries. Entebbe Uganda.

OIE (Office international des épizooties), 2004. HANDISTATUS II. Office International des Epizooties, Paris. France. Retrieved June 20, 2010 from http:// www.oie.int/hs2.

Owens, 2003. Animal health products distributions- a study of Kenya, Uganda and South Africa. AU-IBAR, PACE program, Nairobi, Kenya.

Plan for Modernization of Agriculture 2004 Plan for modernization of agriculture; eradicating poverty in Uganda, Government of the Republic of Uganda. Kampala.

Uganda Investment Authority 2005 Investment opportunities in Uganda livestock industry. Retrieved June 17, 2010 from http://www.ugandainvest.com/livestock.

Dijk V 2008 Current practices for the sale and distribution veterinary drugs in Africa. Retrieved October 10, 2010 from www.oie.int/eng/VETMED08/pdf_manuscrits/pdf_anglais/

WHO (World Health Organization) 2009 WHO member states and medicines price information. http://www.who.int/medicines/areas/access/ecofin_who_memberstates/en/index.html  Accessed on 20th April 2010

Received 21 November 2010; Accepted 24 April 2011; Published 1 July 2011

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