The Ministry of Health (MoH) is currently only “partially prepared” to respond to natural disasters, emergencies, and health crises. Therefore, active work on this issue is still ongoing, ministry representatives informed during a meeting of the Saeima’s Social and Labour Affairs Committee on Tuesday.
The MoH stated that an informative report on ensuring strategic access to medicines in crisis situations will be reviewed on the 15th or 26th of June, after which it will be submitted for coordination and approval by the Cabinet of Ministers.
At present, thanks to budget reallocations and support from the Ministry of the Interior, the overall situation regarding medicine stockpiling is good. Funding is available, and medicines are being procured in sufficiently large volumes in accordance with signed contracts.
The full requested sum for this purpose cannot be disclosed due to its limited access status, but ministry representatives emphasized that the amount is “significant.”
Representatives from the pharmacy sector and primary healthcare stressed that much remains to be done in terms of emergency preparedness.
Dr. Ainis Dzalbs, representing the Latvian Association of Rural Family Doctors (LLĢĀA), also pointed out several issues.
“Currently, emergency planning focuses more on hospitals, yet in crisis situations, fewer people will turn to hospitals compared to primary healthcare,” he emphasized.
In his view, primary care as a system is currently not prepared for disasters or crisis situations.
Healthcare providers must be informed about response protocols in such events, but there is currently no unified action algorithm, Dzalbs stressed.
He also noted that family doctor practices should be electricity-independent. As Dzalbs explained, even floods or storms can prevent doctors from functioning. Therefore, certain essential items should already be provided to practices to ensure readiness not only for military crises but for other potential emergencies as well.
Meanwhile, Raina Dūrēja-Dombrovska, Executive Director of the Latvian Association of Pharmaceutical Manufacturers, stated that some discussions were held last year about the idea of manufacturing a few critical medicines domestically. So far, however, there has been only one informative report on the matter.
Agnese Ritene, Chair of the Pharmacists’ Association, highlighted the importance of a national pharmacy network plan—especially in regions where the pharmacist is often the closest point of contact for health advice. She noted that pharmacies do not currently store large stocks of medicine and that stockpile requirements should be clearly defined.
Jānis Lībķens, Board Member of the National Pharmaceutical Wholesalers Association, stated that there is still a lack of information about which pharmacies should receive which medicines and how they should be stored.
Aside from the section on material reserves, he expressed doubts that other parts of the emergency preparedness plan will be significantly improved this year.
MoH representatives denied accusations from the pharmacy sector about inadequate communication and meetings, stating that enough consultations have taken place.
However, as committee chair Andris Bērziņš (ZZS) pointed out, “One can meet a hundred times without results. What matters here is the outcome.”
Laila Eglīte, head of the Pharmacy Department at Riga East Clinical University Hospital, noted that logistics problems already exist in hospitals, for example, in securing infusion solutions, where hospitals have to compete for specific volumes.
Going forward, one must also consider the large physical storage space required for such supplies: “The total volume of solutions might resemble Lake Gaiļezers—where would we put that?” she asked.
MoH Parliamentary Secretary Dace Kļaviņa explained that healthcare is an essential part of the national defense system, but “not everyone hears that.”
As a result, the MoH often encounters funding limitations in daily operations.
Kļaviņa assured that the ministry is doing everything within its power, including cooperation with the Ministry of Defense (MoD), but added, “At this point, I cannot say with certainty that we’ll have the necessary funding for everything.”
MP Ingrīda Circene (New Unity) proposed that once the MoH’s report is reviewed at the end of June, an action plan should immediately be adopted to strengthen preparedness and reduce bureaucratic delays.
She also emphasized that if health as a part of security and defense is not universally understood, dialogue with the State Chancellery must take place to ensure alignment.
MoD Parliamentary Secretary Liene Gātere underlined the ministry’s role in supporting and overseeing critical infrastructure and services.
In her view, much work remains to expand Category D critical infrastructure, including the development of a national pharmacy network plan.
“There are many needs, and the government will have to decide which to prioritize in the areas of security and internal affairs,” she said.
She noted that the MoD’s primary focus is meeting NATO’s strategic military objectives.
“Each ministry has its own mandate—we cannot finance the readiness of all ministries from MoD’s budget,” Gātere stressed.
There are three levels of medicine stockpiling in Latvia:
- Individual level (home medicine cabinets), including basic drugs like painkillers, allergy relief, gastrointestinal medications, and essential prescriptions for chronic illness, for which citizens are responsible.
- Institutional level: hospitals, ambulance services, outpatient clinics with in-house pharmacies, and care facilities maintain medicine stocks for 1–3 months of operation.
- National material reserves include medicines, infusion equipment, dressings, life-support devices, protective gear, and other critical supplies.
In July 2023, the Cabinet allocated 1.5 million euros for essential goods procurement within national medical reserves. The National Emergency Medical Service (NMPD) manages these reserves, with funding also planned for their replenishment in future years.
Latvia has established a critical medicines list, which is not publicly available. It contains 230 specific medicines and 20 medicine groups, including formulations suitable for pediatric patients and user-friendly administration forms.