Updated 20 June 2013

Thousands expected to die in Eastern Cape

South Africans living with HIV and TB in the Eastern Cape are at great risk of developing resistance to their medications, and eventually dying.


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 sight.

Many will die

“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.

Government to blame

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 remains dire.

“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)


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Dr Sindisiwe van Zyl qualified at the University of Pretoria before working for an HIV/AIDS NPO in Soweto for many years. She was named one of the Mail & Guardian's Top 200 Young South Africans in 2012.

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