Health Minister Dr. Aaron Motsoaledi reported ongoing issues with medicine shortages in South Africa. He specified that among the medications frequently experiencing supply disruptions are antibiotics, tuberculosis drugs, oncology agents, insulin, and certain pediatric antiretroviral drugs.
Medication Stock Report
In response to questions from Mariam Muhammad of the MK party, the minister highlighted whether an audit of medical supplies in public hospitals and clinics had been conducted over the past 12 months. Motsoaledi stated that a nationwide audit has not been carried out in all public institutions within the last year.
Nevertheless, the availability and storage of medicines are monitored through regular reporting systems, including RxSolution and the Stock Visibility System (SVS). These systems transmit data weekly to the National Surveillance Centre (NSC), providing necessary information for continuous monitoring and drug availability management.
Control and Response Methods
Furthermore, scheduled semi-annual inventories are conducted at provincial warehouses, along with targeted assessments and stock visibility reporting at warehouses, hospitals, and clinics to identify, track, and resolve supply chain disruptions. Motsoaledi emphasized that the most frequently affected medications include specific antibiotics, anti-tuberculosis agents, oncology products, insulin, and selected pediatric antiretroviral drugs.
Antibiotic Issues
Specifically, Ciprofloxacin (200mg/100ml, injection) faced a shortage due to increased demand, leading to the use of an alternative—Ciprofloxacin 400mg/200ml injection. Problems were also observed with Fluconazole (500mg, tablets), where 100 packs were affected by rising demand and production delays; in this case, Amphotericin B deoxycholate injection was used. For other items, such as Phosphomycin (granules) and Mebendazole (tablets), the shortage was caused by increased demand or a lack of Active Pharmaceutical Ingredient (API).
Tuberculosis and Oncology Drugs
Regarding anti-tuberculosis agents, supply interruptions mainly concerned products containing Rifampicin, due to a global shortage of this component, as well as provincial payment delays. Concerning oncology drugs, for example, Bleomycin injection (15IU) could not be supplied due to production limitations, and the stock was obtained through the Section 21 process. Carboplatin (450mg/45ml, injection) and Docetaxel (20mg/ml, injection) also faced production delays or restrictions, with alternatives such as Paclitaxel being utilized.
Pediatric Antiretroviral Agents
Pediatric antiretroviral drugs, including Nevirapine (50mg/5ml, suspension), experienced shortages due to insufficient API. Additionally, due to a shortage of 100ml packaging, the demand for Nevirapine suspension in 240ml volume increased. A temporary issue with Lamivudine (10mg/ml, solution) was resolved after supply restoration.
Causes and Countermeasures
Motsoaledi noted that ensuring the supply of oncology medicines remains challenging due to reliance on a limited number of international manufacturers. According to the NSC, the Eastern Cape, Mpumalanga, and North West provinces were the hardest hit. To minimize the impact, the ministry has taken several measures: continuous monitoring through the NSC and other systems, engagement with suppliers to ensure supply continuity, redistribution of stocks between provinces, procurement from alternative suppliers, and the use of therapeutic substitutes, as well as facilitating Section 21 applications through SAHPRA for unregistered medicines.