At present, every drug entering Iraq has to be tested by Kimadia, the government department responsible for quality control of medicines. All drugs go through the same procedure, regardless of their origin, or even if they have already been tested by the World Health Organization (WHO).
"The quality control [system] is overwhelmed, as Iraq is now importing more medicines than before. The centralization of the administration makes quality control very slow due to bureaucracy, deteriorated security and lack of staff," said Cedric Turlan, information officer for the Non-Governmental Organisations' Coordinating Committee in Iraq (NCCI).
It can take weeks, and sometimes months, for drugs to be tested. A consequence of this has been an increase in the smuggling of untested drugs.
"The quality control laboratory was also looted and is being rehabilitated. It is currently working at a much reduced capacity," he said, adding that large-scale incidents led to shortages, and it took a long time before stocks could be replenished.
Rashid Fae'ek, an epidemiological and public health analyst, however, rejects the idea that the main problem lies with the centralized distribution system. He points, instead, to the inability of the authorities to function properly because of the security situation. This has led to attacks on health centres, and staff abandoning their jobs or not being able to get to work.
"The security situation has deteriorated in Iraq and the increase in the number of attacks against health professionals has prevented the public health system from working properly. Every decision should be taken by the Ministry of Health which is short of professionals," Fae'ek said.
"The health system in Iraq isn't neutral anymore. Different fighting factions are attacking clinics and hospitals or targeting health professionals and thereby delaying the whole process as most of the professionals abandon their work or flee the country to survive, leaving a serious gap countrywide," he added.
The distribution system was not faster under Saddam Hussein's regime but the security situation, the lack of access to some areas, logistical problems and gaps in some stages of the decision-making process were not at today's level, he said.
"There has been no insulin in Iraq for at least two months. Most private pharmacies are exploiting the situation by selling drugs with a 400 percent mark-up and poor people are forced to go without medicines," said Dr Khalid Mussawi, a physician at Yarmouk Hospital and a spokesperson for the National League of Medics (NLM).
"There is certainly no health system worldwide that can cope with 185 incidents a day when each one means tens of people are going to hospitals," Turlan said. "Obviously the use of emergency rooms is very high, and the response plan is weak."
Kimadia is the state enterprise responsible for drug and medical supplies for the Iraqi Ministry of Health. It procures, tests and distributes drugs and other medical supplies. It has 10 main storage warehouses in Baghdad, as well as depots in Basra, Mosul and Arbil, and regional warehouses in each of Iraq's 18 provinces.