Médécins Sans Frontières: SA could be sans critical drugs


Médécins Sans Frontières: SA could be sans critical drugs

The drugs alarmingly include live-saving pills for HIV and TB patients


Medicine shortages may reverse the gains SA has made in fighting the HIV scourge by forcing patients to interrupt their treatment, a new study warns.
Research by Médécins Sans Frontières (MSF) at antiretroviral therapy centres found 20% had run out of drugs used to treat HIV and tuberculosis, putting patients at risk of treatment failure, drug resistance and ultimately death.
The study, carried out in 2015 at 2,463 health facilities and just published in the journal PLOS One, found that stockouts meant one in four HIV-positive patients were either turned away without medication or given an incomplete regimen.
More than one in three health facilities ran out of ARV or TB medicines in the three months preceding the survey, and one in five reported stockouts on the day they were contacted.
But health minister Aaron Motsoaledi and nongovernmental organisations that monitor stockouts said the situation had changed in the four years since the study was done.
SA no longer experienced nationwide stockouts of ARVs and TB drugs, and the problem had become medicine shortages caused by inefficient municipal and provincial clinics.
Speaking to Times Select, Motsoaledi said: “As far as I know we don’t have stockouts on fixed-dose combination drugs which are used by 70% of HIV-positive people. We suffered stockouts on the second-line treatment, which covers only 10%.
“Even there, the stockouts were not caused by us but rather by manufacturers who couldn’t cope. Very recently we obtained a Section 21 certificate [on clinical compliance] to deal with that. This means that we acquire drugs elsewhere that are not necessarily registered in SA as ARVs are life-saving medication."”
Motsoaledi said the government always had a 10% buffer stock of ARVs and TB drugs in case of emergency.
“The only time we will say that we have a stockouts of drugs in SA is if that 10% is depleted, and it has never been. So our biggest problem has been around logistics,” he said.
Another headache was clinics that did not monitor their medication stocks, even after the introduction of an electronic system that monitors stocks by requiring clinic staff to scan barcodes on drug packaging.
“We have discovered human problems. Some clinics just don’t scan, because when they scan and the stock is low we hold them to account and ask why is the stock low. So they tend to run away,” said Motsoaledi.
“This week I was given information that some nurses report wrong figures deliberately. When they have two packets and realise they are going to get into trouble, they just send information that they still have 20 packets. We are looking for answers on what do you do when there is this human element occurs.”
Kopano Klass from Stockouts Project, a consortium of civil society organisations that closely monitors shortages of  essential medicines, said the situation had improved since 2015.
“We don’t have the problem of nationwide stockouts anymore, but challenges are at provincial level. At times suppliers refuse to deliver medicines at clinics because they had not been paid at provincial level,” he said.

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