The quality and stability of essential drugs in rural Zimbabwe: controlled longitudinal study

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Abstract
During a two year period (January 1991 to December 1992), samples of drugs arriving at central medical stores in Harare and Bulawayo were retained as controls, and samples of the same batches were later retrieved from hospitals and health centres in five remote, hot, rural districts. We studied 789 samples of 26 brands of 13 essential drugs (selected for relevance to public health and suspected stability problems); 176 samples were taken from central stores and 613 from rural facilities. Of the latter, 261 samples were matched with central samples of the same batch to make longitudinal pairs. Drug quality was measured by level of active ingredient as percentage of stated content and by compliance (pass/fail) with assay standards of the British Pharmacopoeia. Drug stability was measured by comparing mean assay values at central and rural level and by paired analysis of central and rural samples of the same batch.

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