Picture: North West MEC for Health, Sello Lehari/Supplied
By OBAKENG MAJE
3 March 2025- The North West province has allegedly been experiencing persistent medicine shortages. According to allegations, there is a shortage of cancer medicine at various healthcare centres across the province.
However, the North West MEC for Health, Sello Lehari has assured patients and communities of a stable supply of medicines and other pharmaceutical services, despite the ongoing challenges which are being attended to. Lehari said it is important to note that pharmaceutical services in the province were placed under internal intervention during November 2023, following the system crash of the stock inventory management system at the provincial medicines depot.
“Since then, changes have been made in Provincial Pharmaceutical Management with the aim to improve Pharmaceutical Service Delivery and overall medicine availability. Processes related to procurement of medicines have been upgraded and improved to ensure that there is an increase in meeting the growing demand in public healthcare in the province.
“The medicine availability in pharmacies in the province is currently monitored through manual processes from product data reports as extracted from stock inventory management systems. As things stand, the average total medicine availability in 31 public sector pharmacies in the province is at 85.12% against a target of 80% medicine availability,” he said.
Lehari further said this shows that medicine availability in the province is improving since the intervention plan to address the challenges identified in 2023, started to be implemented. He added that cancer medication is procured through the National Contract for Supply and Delivery of Oncology and Immunological Agents to the Department of Health.
“Over the past few months, our department has experienced challenges in terms of inconsistent supply of a limited number of cancer medications. The contracted suppliers for medication that is used as treatment of choice for breast cancer have reported supply constraints to National Department of Health (NDoH) and the Chief Director for Sector Wide Procurement has released a circular to all health departments explaining how treatment should be adjusted and which alternatives should be used for the treatment of breast cancer.
“The current situation is such that the National Department of Health has embarked on a process to obtain quotations for alternative suppliers and the matter is receiving urgent attention. Currently, patients are getting Tamoxifen as the third alternative for management of breast cancer,” said Lehari.
He said the challenge is that due to the side effects, this item is not preferred by patients. Lehari said, currently, they have enough stock of Tamoxifen in their pharmacy.
“All changes to patient medication are made in consultation with specialists and in the best interest of patient outcome. South Africa is following a centralized procurement, where national contracts are awarded for procurement of medicines as contained in standard treatment guidelines and included in the essential medicines list.
“The province is not immune to the delays in shipping of medicines from different countries, as well as production problems that can cause delays in timeous delivery of medicines to service delivery points. From time to time, the department encounters increased demand or sudden increase in demand for certain medicines which can lead to temporary shortages,” he said.
Lehari said the regulatory delays where manufacturers have to apply for licensing of newly registered medicines can cause a slowdown in production and distribution. He said there are also financial challenges, where companies announce discontinuation of manufacturing of medicines and this can lead to fewer available options.
“These challenges are also compounded by trade restrictions, conflicts and international policy changes that can disrupt medicine supply processes. In some instances, protest actions can negatively impact the distribution of medicines where roads are closed and routes are not accessible which causes a delay in delivery of medicines to service delivery points.
“Working closely with Sector Wide Procurement and Affordable Medicines Directorate at National Level to escalate medicine supply chain challenges and seek solutions to challenges. The department is implementing a number of interventions including implementation of a stock out escalation protocol as an early warning sign to seek alternative treatment to ensure continuity of care,” said Lehari.
He said this includes continuous contracted supplier engagements to inform suppliers of challenges and/or increased needs to meet needs in terms of patient care. Lehari said they will also have an improved communication to clinicians to ensure that they communicate medicine stock out challenges and alternative options available to achieve the same therapeutic outcomes.
“Enrolment of patients on the Central Chronic Medicine Dispensing and Distribution Program, where a contracted service provider supplies medicines to chronic stable patients. Raise public awareness through patient education sessions, adherence clubs and radio interviews.
“Pharmacy Managers meeting will be conducted weekly from 5 March 2025, going forward to ensure that challenges are communicated effectively and corrective measures are implemented without delay. So, I am confident that our department is making positive progress towards adequate medicine availability in the province and that the challenges are being addressed,” he said.
Lehari said he had studied reports on the status of pharmaceutical services and medicine availability. He said different stakeholders in and outside the province continue to work with his department to deal with challenges and other factors within and outside of our control.
The Guardian 