Report suggests ARV and TB drug supply woes a ‘national crisis’

At least in one in every five public health facilities has run out of HIV and/or tuberculosis (TB) drugs in  the last two months, with medicine shortages in the country being "far beyond previous estimations", according to pressure group Stop Stock Outs Project’s latest report, which was released on Thursday. 

During September and October this year the group conducted telephonic interviews about drug shortages with senior nurses and pharmacists at 2 139 of the 3 826 public health facilities that provide HIV treatment to patients in the country.

The Stop Stock Outs Project has urged the health department to develop a "concrete high level national strategy with clear timelines" to address drug shortages.

But ministry of health spokesperson Joe Maila, has slammed the report as "an extreme exaggeration". "We know for a fact that this report is inaccurate because the department already has a monitoring system in place which shows otherwise."

'National crisis'
According to the report, the drug shortages might, however, be even worse than the survey had found, as a two month survey is "likely to underestimate the true extent of stock-outs and number of patients affected over time".


Describing the situation as a "national crisis", Stop Stock Outs warned that the situation is a threat to the lives of patients as well as to the government's extensive antiretroviral (ARV) programme through which an estimated 2.4-million people receive treatment. South Africa’s treatment programme is the largest in the world. 

The group, which includes organisations such as Section27, Medicines Sans Frontieres (MSF) and the Treatment Action Campaign (TAC) found that while more than a third of facilities borrowed drugs from nearby hospitals or clinics to give to patients, 20% sent patients home with no medication at all.

The Free State is the hardest hit by drug shortages with over half of the facilities in the region reporting stock-outs, followed by Limpopo and Mpumalanga respectively.

"Patients in the Free State are frustrated – people are defaulting on treatment because they have no choice when they go to facilities and they are turned away without drugs," said Sello Mokhalipi the TAC’s provincial spokesperson.

He said these patients have a high risk of developing resistance to the drugs, which means they have to be switched to a more expensive, less available combination of ARVs with more initial side effects. "What if the second line regimen doesn’t go well with them? They might even end up losing their lives because of this negligence."

Vaccine shortage
Facilities’ stock of vaccines were also surveyed by the group with 33.5% of facilities surveyed in Limpopo reporting shortages which, according to the report, "could contribute to avoidable disease, particularly in children".

MSF medial coordinator Gilles van Cutsem said that while stock-outs of HIV drugs are a serious problem the "massive growth" of the ARV programme is "unprecedented" and "the health system had to very rapidly adapt to this enormous pressure".

However, according to Van Cutsem, there is "no excuse" for vaccine or TB drug shortages.

North West faired best in the report with only 4.4% of facilities affected by stock-outs in the last three months, followed closely by the Western Cape with 4.9% of sites reporting shortages. The North West’s single depot supplies all health facilities in the province via hospital pharmacies.

"Numbers of patients in the North West are much smaller than in other provinces but it’s been reported that the province keeps buffer stocks and this has mitigated the impact of supply and demand mismatch," said Van Cutsem.

Recognise progress
The consortium had previously investigated HIV medication stock-outs at the Mthatha depot in the Eastern Cape and found that 28 of the 70 facilities surveyed experienced drug shortages between March and May this year.

Maila accused the Stop Stock Outs Project of failing to acknowledge the health department’s progress, such as the improvement in the Eastern Cape, in the report.

In response, Van Cutsem said: "It seems the situation in Mthatha has indeed improved after the two previous reports – one of which found that 40% of facilities served by the depot experienced stock-outs. That has dropped to less than 20% now. But the situation is not yet satisfactory."

Health Minister, Aaron Motsoaledi had previously stated his intention to do away with the depot system altogether in favour of a system where hospitals order drugs directly from suppliers. This new approach is currently being piloted in Limpopo and KwaZulu-Natal.

 "We have the biggest ARV programme in the world so we are bound to have some problems but we completely reject the notion that this is a national crisis," Maila said. 

                                                         

Subscribe to the M&G

These are unprecedented times, and the role of media to tell and record the story of South Africa as it develops is more important than ever.

The Mail & Guardian is a proud news publisher with roots stretching back 35 years, and we’ve survived right from day one thanks to the support of readers who value fiercely independent journalism that is beholden to no-one. To help us continue for another 35 future years with the same proud values, please consider taking out a subscription.

Related stories

Q&A Sessions: Frank Chikane on the rainbow where colours never meet

Reverend Frank Chikane has just completed six years as the chairperson of the Kagiso Trust. He speaks about corruption, his children’s views and how churches can be mobilised

Stop the ‘war on drugs’, it doesn’t work

Punitive measures simply drive drug use underground. A more effective way is to adopt harm reduction interventions

Six injections a year could stop new HIV infections

New research from seven countries in Africa signals the future of HIV prevention — but what can it learn from its past?

‘Probe Free State tenders under Magashule’

A centralised procurement programme in the province allegedly operated under the former premier

‘Let ANC deal with its leaders facing corruption charges,’ Ramaphosa tells parliament

The president was answering questions before parliament, where he also told the EFF to allow the courts to decide on the matter of the CR17 bank statements

Ramphosa extends national state of disaster

As the president extends the state of disaster for another month, other restrictions will be eased, including those on alcohol sales and international travel
Advertising

Subscribers only

FNB dragged into bribery claims

Allegations of bribery against the bank’s chief executive, Jacques Celliers, thrown up in a separate court case

Dozens of birds and bats perish in extreme heat in...

In a single day, temperatures in northern KwaZulu-Natal climbed to a lethal 45°C, causing a mass die-off of birds and bats

More top stories

North West premier goes off the rails

Supra Mahumapelo ally Job Mokgoro’s defiance of party orders exposes further rifts in the ANC

Construction sites are a ‘death trap’

Four children died at Pretoria sites in just two weeks, but companies deny they’re to blame

Why the Big Fish escape the justice net

The small fish get caught. Jails are used to control the poor and disorderly and deflect attention from the crimes of the rich and powerful.

Koko claims bias before Zondo commission

In a lawyer’s letter, the former Eskom chief executive says the commission is not being fair to him
Advertising

press releases

Loading latest Press Releases…