Drug stock-outs: Inept supply-chain management and corruption
The National Health Department is urgently trying to source and install a countrywide computer software system that will link healthcare facilities with drug depots and suppliers in order to relieve ongoing essential drugs stock-outs which threaten the lives of thousands of patients. The issue has become a national crisis, affecting districts in 8 of the 9 provinces.
Contributing factors include a shortage of pharmacists, protracted labour disputes, dismal management, corruption, and woeful communication between suppliers, depots and facilities. Reports from HIV clinicians and fieldworkers, plus a collective probe by 4 influential NGOs, reveal that only adept clinical management of patients is preventing the emergence of widespread drug resistance and a rise in morbidity and mortality. According to the NGO report – compiled by the Rural Health Advocacy Project, Médecins Sans Frontières, the Treatment Action Campaign and +Section 27 – one of the worst examples is the Mthatha depot. In November last year the depot was described as ‘anarchic and beyond redemption’ by the then Eastern Cape Health Superintendent General, Dr Siva Pillay. This January, 24% of drug-prescribed patients were turned away from the 300 facilities the depot serves across 17 districts of the sprawling Oliver Tambo region, while 53% of the clinics and hospitals it serves suffered antiretroviral (ARV) or tuberculosis (TB) drug stock-outs, including shortages of the new fixed-dose combination (FDC) ARVs. These stock-outs lasted on average 45 days at a time and remained ‘almost as common and severe as they were 5 months ago’, according to the report.
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