Outlines of LMHRA Managing Director Pharm. Keturah C. Smith Administration October 2019- December 2020

Based on our responsibility as Communications Unit of the Liberia Medicines & Health Products Regulatory Authority (LMHRA) to project the positive image and workings of the authority; the Unit has deemed it prudent to outline the leadership and tremendous achievements of the administration of its Managing Director, Pharmacist Keturah C. Smith from October 2019 – Dec 2020.

In this light, we present a catalogue of achievements of this administration during the year under review: Regardless of the limited resources, Managing Director Smith has made significant progress in a short period of time.

Though Managing Director Smith inherited a broken system due to some political crisis, she was however innovative with the assistance of the technical team, strengthened by additional administrative staff to hit the ground running with the statutory mandate of the entity by ensuring that the country have safe, effective and quality medicines reaching the Liberian people.  

To this end, here are some of the challenges and achievements of MD Smith:

Challenges inherited:

  1. Rent for Head Office and Regional Office in Gbarnga;
  2. Financial liabilities for staff salaries
  3. Ensure health and NASSCORP insurance for employees;
  4. Indebtedness Local vendors;
  5. Lack of logistics for operations, Post Marketing Surveillance and Inspection – only 2 vehicles
  6. Inadequate staffing (both technical & support)
  7. Depleted bank accounts
  8. To build the status of QC lab to ISO 17025/ WHO standard

Currently, all previous financial liabilities incurred by past administration as a result of the internal wrangling has been fully liquidated during the period under review by Managing Director Smith administration.

The new LMHRA administration inherited a financially broken institution. Especially with the employment of new staff members, thus, meeting the needs of staff salaries and other benefits were the greatest challenge, considering that fees were not being collected as under normal administrative circumstances.

In the same vain, there was a need for total restructuring of the entity’s revenue collection structures, including reassigning of key staff.

Upon Pharmacist Smith’s ascendancy, like all other public institutions, COVID-19 also had a serious toll on the LMHRA’s resource mobilization efforts. Hence, registration of medicines and health products, and other revenue generation areas were at the lowest pace. Accordingly, a very meticulous spending and administrative regime were immediately put into place for operations of the Authority under the ongoing global pandemic.

However, these challenges did not come without significant achievements:

Achievements

  1. Since the establishment of the LMHRA by an Act of the Legislation in 2010, some employees  of the entity were being paid incentive while few were paid both incentive and GOL salary;

Nevertheless, we are delighted to report that the Government of Liberia, through lengthy negotiation of the administration of the LMHRA and the Ministry of Finance and Development Planning (MFDP), has absorbed about 99.9% of staff salaries, including the newly recruited staff;

  • Within a year, under the instrumentality of the Managing Director, through the Board of Directors, the LMHRA has constructed a mini-Office Building currently in use as Quality Control Laboratory in Careysburg, Montserrado County.
  •  The MD in short a while, also ensured robust inspection by the Inspectorate Department of LMHRA for all pharmacies, medicine stores, pharmaceutical importers warehouses as well as health facilities in and outside of Montserrado.
  • MD Smith as head of the entity, also ensured that every department or unit of the LMHRA network and collaborate to ensure the core objectives of the institution is achieved.
  • As it is common knowledge, since the establishment of the LMHRA for the sole purpose of ensuring that quality, efficacious and safe medicines and health products are regulated; under MD Smith’s stewardship, the Communications Unit in consonance with the Medicines Information Unit, were able to produce and is currently airing several  jingles on street peddling, medicines registration, adverse drug reaction and as well as the discouragement of the citizenry on the purchasing of fake, expired and substandard medicines and health products from street  peddlers (Black Baggers) on several radio stations in Monrovia and around the country.
  • As was in the past, little or nothing was heard of or known by the public of the workings of the LMHRA; but under this illustrious youthful Managing Director and her technicians as well as administrative support staff, there has been several radio and/or media appearances of the MD Smith and other Technical Staffs and newspaper publications highlighting the achievements, prospects and challenges of the entity, thus so far giving the general public a broader understanding of the workings of LMHRA.
  • MD Smith leadership has also ensured that premier is placed on the sensitization of the public about the harm of purchasing from street peddlers and counterfeit medicines and health products poses to the citizenry of Liberia.
  • In adherence to the Public Procurement Law as well as the Public Financial Management Law, Madam Smith, under her administration mandated that all procurement and financial transactions of the LMHRA are in strict adherence to the PPCC and PFM Laws of Liberia.
  • MD has also ensured full collaboration and networking with other key ministries agencies and partners both in the health and Governmental sectors. Thus, leading to the Liberia Revenue Authority (LRA) confiscating and turning over to the LMHRA on several occasions, expired, sub-standard and counterfeit medicines from two of Liberia’s land border points.
  1. The LMHRA Boss through her leadership spearheaded a 5-day technical and administrative retreat that led to the production of various Standard Operating Procedures and Departmental manual for the smooth running of the authority.
  1. Madam Smith leadership was also instrumental in the establishment for the first time; a 21st century website as well as a social media platform (Facebook) page. She has likewise maintained a very cordial relation with every staffer and thus making her office accessible as well as ensure senior and general staff meeting regularly.
  1. The LMHRA under Madam Smith has also established two hotlines service for the public to make inquiries and also report the smuggling, peddling and sale of counterfeit medicines and health products.
  1.  Signed a memorandum of understanding (MOU) in March 2020 with Ghana FDA for third party testing of medicines and health products
  1. In an effort to strengthen the Authority, Managing Director Smith  also established Programs & Planning, , with the role and responsibilities: to lead the resource mobilization efforts of the LMHRA and manage donor funds; design, monitor and evaluate programs, projects and implementation of work plan; lead and keep records of approved development plans (including construction works), projects and budgets of the Authority and their execution time schedule as specified; help support preparation of annual budgets and rolling plans in collaboration with Administration and the Finance Department.
  1. For the first time the entity also secured security for head office and as well secured a private security firm for her new mini quality control lab in Careysburg, Montserrado County.
  1. For further sensitization and information dissemination purposes and as a way to further expose the working of the Authority, the administration the LMHRA also ensure the erection of five by eight meter billboards, along the Congo Town, VAMOMA House, Tubman Blvd., Robert International Airport and Freeport vicinities to acquaint the general public about the LMHRA and its workings.
  1.  Madam Smith has placed premier on the issue of employees’ empowerment thus ensuring that all employees of the authority having access to health and National Social Security and Welfare Corporation insurance schemes.
  1. During the period under review, the following trainings/seminars/workshops were attended by LMHRA staff:
    1. Foreign: Several staff attended foreign trainings and meetings during the period under review, including:
  • The MD attendance of the 7th Steering Committee Meeting of the West Africa Medicines Regulatory Harmonization (WA-MRH) Project of the West Africa Health Organization (WAHO) in Dakar, Senegal this year with the following terms of reference:Providing strategic and policy directionApproving technical documents
  • Quality Management System training in Ghana by three (3) staff members, drawn from the Lab, Internal Audit & Office of the MD. Attendance of 3rd Edition of the African Medicines Quality Forum in Nigeria from   February 24 – 28, 2020 by the Quality Control Manager.  Attendance of the Annual Meeting of the National Medicines Quality Control Laboratories \in the Ivory Coast in November of 2019 by the Quality Control Manager and his deputy.
  • Local: Several local trainings were conducted since her appointment, including:
  •  Quality Management Training for one week in March of 2020;
    •  GHPP assessment of Marketing Authorization System, leading to capacity building in February 2020;
  • Staff Retreat: A staff retreat, with the main objective of reviewing guidelines and other administrative policies and documents, was held from April 1 – 7, 2020. The final report, along with reviewed and updated guidelines, Standard Operating Procedures (SOPs) and other relevant documents were shared with Board for their perusal and subsequent approval.

Recently, MD Smith along with other senior staff from the Inspectorate and Registration and Evaluation Departments as well as senior staff from USP-Liberia, travelled to Accra, Ghana for a study tour of the Ghanaian Food and Drug Administration (FDA) and approve on our system in Liberia. 

Decentralization of Regulatory Activities:

Her able leadership has for the first time in the history of the entity established offices at the National Port Authority (NPA) and the Robert International Airport (RIA) to streamline medicines and health products and as well confiscate illegal, expired counterfeit and banned medications or health products from entering the local market.

As the LMHRA continue to find avenues for strengthening of the LMHRA for full execution of its mandate, MD Smith also ensure the securing of office spaces for decentralization of regulatory activities by:

  • The establishment of Ports and Border Services Unit, thus leading to the opening of offices at the Freeport of Monrovia and Robert International Airport (RIA) with plans to extend next year to other border points including (Bo-Waterside in Grand Cape Mount County, Ganta-Guinea Border in Nimba); with the already existing regional office in Gbarnga, Bong County. Several staff have already been deployed at these various regional and port offices and operations smoothly ongoing.
  • Thirteen (13) staff have been assigned at the RIA after holding several meetings with the RIA Authority for permanent posting of LMHRA staff;
  • There has been a rigorous restructuring of the Regional Office in Gbarnga – with posting of additional staff with logistical support (procurement of motorbikes) to strengthened and enforced regulatory activities
  • Construction Works

In order to further improve service rendered by the LMHRA, MD Smith organized a one-day stakeholder roundtable pharmaceutical and health sector meeting with various players in the health sector in the country to discuss the construction of the quality control lab.

  1. MD Smith through her lobbying skills and collaboration with other sector of Government, was instrumental in securing a two-storey fully furnished office building for the authority up Mamba Point, in Central Monrovia, with rent being fully covered by the Government of Liberia.
  1. The illustrious and youthful LMHRA Managing Director, upon her ascendency met a logistically-challenge authority, leading to limited Post Market Surveillance (PMS) inspection due to the lack of vehicle or the entity having only old two vehicles. Through her innovation and leadership skill, Madam Smith through Global Fund, was able to acquire two brand new High-top Land Cruiser Jeeps with funding from Global Fund; one 18-seated bus for staff of the Quality Control Lab and another vehicle for the office of the Managing Director.
  • Pharmacist Smith through her lobbying power, is expected to acquire from the World Bank, reagents, chemical and equipment for the Quality Control Laboratory. Through the Madam leadership, the United States Pharmacopeia Convention (USP), Promoting the Quality of Medicines Plus (USP-PQM+) is expected to procure additional equipment, reagents and chemical for the QC Lab.
  • The LMHRA through fees collected over the years, has also procured additional equipment, reagents and chemical for the QC Lab in order to continue visual testing and physiochemical analysis.
  • Though in 2017, QC Lab was gutted by fire thus leading to only visual inspection being conducted by the LMHRA, the lab was later transferred to another location at Sophie Community where the lab graduated from just visual inspection to both visual inspection and physiochemical analysis. After few months in office again. In 2019, MD Smith ensure the laboratory moved to its current location in Kings Farm, Careysburg, Montserrado County; where a full visual inspection and physiochemical analysis are being conducted.
  • Currently, a fully fenced and furnished mini QC Lab estimated worth of US$165,000.00 has been constructed and fully operationalized; with plans for official dedication His Excellency President Dr. George Manneh Weah Sr., in early 2021.
  • Also, there is a Memorandum of Understanding with the Global Fund for the construction of US$4.3million dollars state-of-the-art International Organization for Standardization (ISO 17025) and World Health Organization (WHO) standard Quality Control Lab.