There is lit­tle doubt that the Chron­ic Dis­ease As­sis­tance Pro­gramme (CDAP) is one of the most im­por­tant and con­se­quen­tial so­cial pro­grammes im­ple­ment­ed in post-In­de­pen­dence Trinidad and To­ba­go.

Launched in Feb­ru­ary 2003, when Colm Im­bert, the for­mer min­is­ter of fi­nance, served as the min­is­ter of health, CDAP start­ed off pro­vid­ing 20 free phar­ma­ceu­ti­cals that tar­get­ed four chron­ic, non-com­mu­ni­ca­ble med­ical con­di­tions—di­a­betes, high blood pres­sure, glau­co­ma and heart dis­ease.

In its roll-out stage, the pro­gramme was on­ly avail­able to cit­i­zens of T&T who were aged 65 years and over and who had been for­mal­ly di­ag­nosed with one of the four ini­tial chron­ic con­di­tions.

CDAP be­came uni­ver­sal­ly avail­able to all cit­i­zens of T&T in No­vem­ber 2004, and in the pe­ri­od since then, the pro­gramme has ex­pand­ed to ad­dress 11 ma­jor chron­ic med­ical con­di­tions—in­clud­ing epilep­sy, men­tal health is­sues and Parkin­son’s dis­ease—sup­ply­ing about 50 es­sen­tial med­ica­tions across the net­work.

As it stands now, CDAP is a uni­ver­sal, gov­ern­ment-fund­ed ser­vice, pro­vid­ing free pre­scrip­tion drugs to all cit­i­zens with chron­ic dis­eases. T&T is one of the few coun­tries in the world to of­fer such a pro­gramme and, as a re­sult, cit­i­zens of this coun­try should be grate­ful that it con­tin­ues to re­ceive over­whelm­ing bi­par­ti­san sup­port.

CDAP, there­fore, is an in­valu­able ser­vice that pro­vides as­sis­tance to a wide range of chron­i­cal­ly ill T&T cit­i­zens and is one of the con­crete ways in which this coun­try’s wealth con­tin­ues to serve the pop­u­la­tion.

In Oc­to­ber last year, Min­is­ter of Health Dr Lack­ram Bo­doe un­veiled an ex­pan­sion of the list of phar­ma­ceu­ti­cals avail­able to all cit­i­zens. In an­nounc­ing the lat­est re­vi­sion of the CDAP drugs list, Dr Bo­doe said the ex­pand­ed list is ex­pect­ed to ben­e­fit more than 300,000 cit­i­zens, which is about 20 per cent of this coun­try’s pop­u­la­tion.

On Wednes­day, Dr Bo­doe seemed to con­firm re­ports re­ceived by Guardian Me­dia that some cus­tomers of the pro­gramme were be­ing told that their med­ica­tions were un­avail­able at the clin­ics or phar­ma­cies they were ac­cus­tomed to re­ceiv­ing them.

Dr Bo­doe told Guardian Me­dia he be­lieved sup­ply chain and dis­tri­b­u­tion is­sues have con­tributed to short­ages of crit­i­cal med­ica­tions.

How­ev­er, the sug­ges­tion by Min­is­ter of Health that phar­ma­cists in the pub­lic or pri­vate health­care sys­tem should call around to es­tab­lish avail­abil­i­ty of med­ica­tions is not prac­ti­cal. It means pa­tients with chron­ic dis­eases, some of whom are quite el­der­ly, may have to wait or make ad­di­tion­al trips to se­cure their phar­ma­ceu­ti­cals.

The oth­er crit­i­cal is­sue is that many of the pa­tients who ac­cess CDAP sim­ply can­not af­ford to pur­chase drugs they need from pri­vate phar­ma­cies, where there are few­er is­sues of avail­abil­i­ty. The CDAP short­ages, there­fore, re­sult in dis­tress for those at the low­er end of T&T’s in­come pyra­mid.

In an in­ter­view on the CDAP short­ages this week, Pri­vate Phar­ma­cy Re­tail Busi­ness As­so­ci­a­tion pres­i­dent Glen­wayne Su­chit said the larg­er is­sue was the sup­ply of med­ica­tion from phar­ma­ceu­ti­cal dis­trib­u­tors and the de­lays in pay­ment by the Gov­ern­ment to them.

The com­plaints about the length of time the Gov­ern­ment, or state agen­cies, take to pay sup­pli­ers of goods or ser­vices is, of course, not unique to CDAP. But the pro­gramme is too im­por­tant for pa­tients to be greet­ed with signs in­di­cat­ing no CDAP drugs are avail­able at their phar­ma­cy of choice.

Dr Bo­doe and this team of tech­nocrats at the min­istry, there­fore, must re­dou­ble their ef­forts to en­sure all the items on the ex­pand­ed list of phar­ma­ceu­ti­cals are avail­able at all of the CDAP phar­ma­cies.