Moments ahead of the 6th South African AIDS
Conference, currently underway in Durban, the Eastern Cape health department
was accused of endangering thousands of lives as they dragged their feet on
resolving massive antiretroviral and TB drug shortages in the province.
Just over five months ago, a coalition
consisting of local and international NGOs, including Doctors Without Borders (MSF),
the Treatment Action Campaign and SECTION27, raised the alarm about the crisis
at the Mthatha medical depot, where the systemic failings in the drug supply
chain is affecting more than 100 000 people who depend on 300 facilities served
by the depot.
And still there seems to be no relief in
“This situation is catastrophic. It means
many thousands of people living with HIV have risked treatment interruption for
months now. The stock-outs [shortages] consequently undermine clinical benefits
of life-saving ARV treatment.”
“Over time, more deaths will occur as a
result and the likelihood of increased drug resistance is significant,” said Dr
Amir Shroufi, local MSF Deputy Medical Coordinator, in a statement.
Research shows that drug resistance occurs
when there are prolonged breaks or interruptions in treatments, such as HIV and
TB medications, and microorganisms such as bacteria, viruses, fungi and
parasites get a chance to mutate in ways that render the medications ineffective.
The World Health Organization says this is
a major concern because a resistant infection may kill, can spread to others,
and imposes huge costs to individuals and society, especially in developing
countries like South Africa, where government programmes still can’t afford
most second- and third-line medications for HIV and TB.
Without access to second- and third-line
drugs, the thousands of people in the Eastern Cape who are at risk of
developing resistance to their initial drug regimens, will develop opportunistic
infections and die.
In January 2013, the coalition released its
first report, analysing the impact of a management and drug supply crisis at the
Mthatha depot. The coalition estimated that thousands of people were forced to
interrupt their HIV treatment – potentially leading to unnecessary deaths
during the course of the year.
Despite the coalition’s clear recommendations
to health authorities on solving the problem, five months later the situation
“It seems very little was learnt from our
report to the Eastern Cape health authorities. It is unacceptable that there
has been little or no change. We demand that Eastern Cape MEC for health,
Sicelo Gqobana, take leadership to end these stock-outs,” charged TAC General
Secretary, Vuyiseka Dubula.
The depot in Mthata is known for its
dysfunction over the years. There also is no full-time manager and the depot is
operating with half the usual number of packing staff since its decision to
suspend close to 30 staff without a back-up plan. It is believed that this has
contributed to the current health crisis.
In their report, the NGOs accuse the
provincial department of health of being unable and unwilling to address the
problems, despite being aware of them for several years, and also in the light
of the immense support the department received from civil society.
“We demand to see the national Minister of
Health use his powers in terms of Section 100 of the Constitution to intervene
on an emergency basis to provide health services in line with national
standards,” says John Stephen, SECTION27 legal researcher.
To beat this emerging national trend, the
coalition is today hosting a skills-building workshop on civil society
responses to stock-outs at the Aids Conference. The coalition will also soon
expand activities by mobilising a campaign, including using the law, to restore
quality healthcare services in the Eastern Cape and beyond.
(Picture: HIV cells from Shutterstock)