SA ‘code red’ Z TAC national response

Durban - The Department of Health in KZN has been lambasted after they failed to respond to the National Medicine Stock Out report which was released on Wednesday.

Repeated attempts by the compilers of the report — Doctors without Borders, the Treatment Action Campaign (TAC), Rural Health Advocacy Project, Section27, Rural Doctors Association of Southern Africa and Southern African HIV Clinicians Society — to discuss the report’s findings with the department fell on deaf ears.

The Witness has previously reported that there are critical shortages of essential medicines in hospitals and clinics around the province.

Figures from the National Medicine Stock Out report showed that KZN had the highest number of paediatric ARVs reported out of stock and 22% of facilities in KZN reported stock outs of epilepsy medication (Sodium Valproate).

The report stated the Gauteng, Limpopo, Northern Cape, North West, and Western Cape provincial Departments of Health had engaged with civil society on causes of stock outs and potential solutions.

The Eastern Cape and Mpumalanga provincial departments of Health have also not responded.

The report was released at KZN’s seventh South African Aids (Saaids) conference following a scathing speech on the health system by the TAC’s chairperson Nkhensani Mavasa at the Saaids opening ceremony on Tuesday.

In her speech, she applauded progress in the fight against HIV/Aids and said treatment in South Africa has scaled up to over two million people and life expectancy had rebounded from 54 years in 2005 to 61 years in 2012.

But, she said, that was where the good news ended.

She said the healthcare system is “plagued with dysfunction”, with long queues, understaffed clinics, and stock-outs of medicines.

“What we see are people dying of TB — a disease that is curable; recently we have learnt that HIV is the third highest killer of South Africans through disease. This is unprecedented considering that we have the biggest antiretroviral programme in the world.

“We are at ‘code red’.”

She said strong political leadership was needed to pull underperforming provinces back into line.

“We need politicians who are willing to take risks and to say ‘no’ to corruption, to say ‘no’ to deployment of incompetent cadres, to say ‘no’ to underperforming MECs.”

She said “incompetent cadre deployment” in the healthcare system was placing the interests of political parties ahead of the interests of the people and that it was a disgrace that in 2015, people who were in need of medicine often did not have access to it.

“We don’t have time for political games.”

In an interview after her speech ­Mavasa said that often, when difficult questions were asked, the blame was passed from one person to the next, and solutions were not discussed.

“The challenge is incompetent MECs,” she said.

“There needs to be communication between provincial and national departments. We demand a plan that will address the stock outs, and we do not just want empty promises. There must be action.”

When asked why KZN had not responded to the Stock Out reports despite the report’s claims of repeated attempts to reach them, the KZN Health department MEC Dr Sibongiseni Dhlomo said there was no need to send out separate responses from each province as they were “one government”.

“If the minister called a meeting last Friday and we collectively prepared a joint statement released by the minister on behalf of all of us who attended the meeting, why should we separate [the] response?

“I met [the] TAC last week and updated them. Besides I am attending [the] Aids meeting in Durban, TAC is there, we talk.

“It is your opinion that each province must have a separate action plan, some of us don’t share your opinion,” he said.

Dr Imran Keeka of the DA said, “South Africa has come a long way from denying that HIV causes Aids, the beetroot/ garlic treatment and having a cold shower, to millions of people on ARVs today.

“The recent stock outs of ARVs and other medicines is something the KZN MEC of health Dr Sibongiseni Dhlomo has recurrently shied away from in that both his response and that of his department has been economical in the extreme.

“The recent stock out annual report cites KZN as a non-respondent. This confirms the DA’s view that the MEC and his department refuse to be held accountable by anyone.

“It also encourages the notion that there is something to hide.

“This is clearly a slap in the face of the many people that are dependent on the services of this vital department,” Keeka said.

“The standard stock answer that has always been offered, where the suppliers are blamed, is stale and simply does not fly any more.

“It all boils down to a non-caring, poorly-managed department that is simply not proactive and lurches from one crisis to another in the DA’s view.

“The MEC and his department must be held accountable for any death, disability and suffering that may follow from all of this.”

In the stock out report, the conclusion stated that the ultimate consequence of such a malfunctioning supply system was human loss and illness.

“Stock outs can lead to unnecessary suffering, costly resistance, and in the worst cases, death.

“In South Africa, stock outs remain one of the key constraints in the delivery of effective healthcare across the country with 21% of facilities in 2013 and 25% of facilities in 2014 continuing to report stock outs of HIV/TB medicines.”

“The need for action to ensure adequate access to medicine in South Africa is necessary now more than ever.”

In a media release sent yesterday, the National Department of Health said manufacturers had been ­working around the clock to address supply problems and some of the supply problems with certain medicines had been resolved.

“The supply of about 82 medicines have been resolved …”

“In the next group of 51 medicines the supply problems are not completely resolved since not all orders have been delivered, however, over the next three to four weeks all outstanding orders would have been supplied.”

The statement said supply problems remained with 21 medicines as suppliers would not be able to resolve supplies within the next four weeks and that the department would secure supplies from other international suppliers. In the interim, alternative therapeutic medicines will be prescribed.

“These medicines include certain antibiotics, cardiovascular medicines, analgesics, anaesthetic agents and central nervous system medicines.

“Antiretroviral medicines are not affected by manufacturer supply problems. Most patients on ARVs are taking the fixed dose combination tablet. This Fixed Dose Combination (FDC) is fully stocked at manufacturers’ and provincial depots. Additionally there is a buffer stock of the FDC kept by the national Department of Health to be used in the case of emergencies.

Problems with the supply of ­Abacavir, Ritonavir/Lopinavir combination and Ritonavir have been resolvedand now all outstanding orders have been delivered to depots.”

On the shortage of penicillin, the statement said penicillins, particularly benzyl penicillin, is still facing a global supply problem.

“A potential source of API supply has been identified in Germany. When the stock is made available, it will need to be used judiciously.”

“In the case of vaccines there is a shortage of the BCG vaccine (against TB) due to the usual supplier withdrawing their product from the market.

The Department of Health has imported the product from ­alternative international suppliers which is currently in South Africa and awaiting quality release from the National Control Laboratory.

The statement said the cardiac medication, Digoxin is also in short supply due to manufacturing ­problems

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