The Palliative Care Association expressed concern by pointing out that the Government has not appointed the commission responsible for supervising the sector for over a year.
The organization emphasized that it has been waiting for more than twelve months for the official designation of the commission that must oversee palliative care practices and operations in the country.
A stent is placed to relieve a blockage when heart blood vessels are obstructed, but this procedure is not mandatory in all cases. It is important to understand when stent implantation is necessary and when medication alone is sufficient. Cardiologists note that the decision to place a stent is based not only on the degree of blockage but also on the patient's symptoms, the state of blood circulation in the heart, and other factors.
Professor of Cardiology at Medanta Medicity Mulchand, Dr. Tarun Kumar, explained that in most cases, a stent is not required if the degree of blockage in the heart arteries is less than 50 percent. Patients in such situations are prescribed medication and diet. They are also advised to quit smoking and alcohol. Although the risk of a heart attack with less than 50 percent blockage is lower, these patients are identified during angiography.
Dr. Tarun emphasized that for a blockage level between 50 and 69 percent, the decision to place a stent is not made solely based on angiography results or the percentage of blockage. If the patient does not have signs such as chest pain, shortness of breath, or other symptoms, and heart circulation is normal, treatment can continue with medication. In these cases, doctors use tests such as stress tests, FFR, or IFR to determine the actual impact of the blockage on blood flow. Stent placement is considered only if a significant reduction in blood flow is found during these tests.
The probability of stent placement increases when the blockage reaches 70–89 percent, especially if the patient regularly experiences chest pain, difficulty walking, or signs of myocardial ischemia. Stents are recommended, particularly if the blockage affects a major coronary artery of the heart. Nevertheless, patients with stable conditions and no symptoms can be monitored with medication and regular check-ups.
When the blockage reaches 90–99 percent, the heart artery is almost completely closed. In such conditions, a stent is immediately placed if the patient has persistent symptoms, signs of myocardial ischemia, or has already suffered a heart attack. Dr. Tarun also noted that in the case of an acute heart attack, emergency angioplasty and a stent may be life-saving.
Health Minister Aaron Motsoaledi stated that his department has no information regarding any procurement failures or significant irregularities that arose during the evaluation and awarding process of the tender for antiretroviral drugs (ARV).
Motsoaledi refuted the suggestion of irregularities in the awarding of the R15 million antiretroviral drug tender. He emphasized that the department utilized comprehensive due diligence checks and an evaluation process that complied with applicable regulations, including the Public Finance Management Act, the Preferential Procurement Policy Framework Act, Special Terms and Conditions of the Contract, and the technical specifications issued for this tender.
He noted that the department relies on information provided by bidders in good faith during the evaluation stage, and this information is supported by documentary evidence required in the tender documentation. Therefore, the department is unaware of any procurement failures or significant irregularities, as the entire process was conducted in accordance with the existing legal and regulatory framework.
Motsoaledi responded to questions from Parliament by EFF Deputy Naledi Chirwa-Mpungose, who raised widespread public concern regarding alleged discrepancies, irregularities, and potential failures in the R15 billion antiretroviral drug tender. Chirwa-Mpungose requested information on the due diligence conducted by the Motsoaledi department during the award of the said tender, as well as the names of the companies that received the contracts.
In response, Motsoaledi explained that pharmaceutical tenders include numerous individual items covering various medications, formulations, and package sizes. He clarified that bidders have the right to apply for one or more items, and contract awards are made for each item after evaluating the submitted applications.
The Minister reported that within the ARV tender, first-line tablet products Tenofovir/Lamivudine/Dolutegravir (TLD) represented the highest volume and faced particularly strong competition due to the large number of bids submitted. He added that although Hetero Drugs SA and Cipla Medpro Manufacturing did not receive contracts for TLD after evaluation, both companies successfully passed selection for other items they bid on and consequently secured contracts within the tender.
Overall, the tender was awarded to 11 successful bidders in line with the evaluation results and applicable procurement procedures. These companies are Aurobindo Pharma, Barrs Pharmaceuticals Industries, Cipla Medpro Manufacturing, Emcure Pharmaceuticals SA, Hetero Drugs SA, Innovata Pharmaceuticals, Macleods Pharmaceuticals SA, Pharma Dynamics, Pharmacare Limited Sonke Pharmaceuticals, and Viatris Healthcare.
Five months ago, Motsoaledi approached the Health Portfolio Committee requesting a resolution recommending that the Special Investigating Unit (SIU) investigate the ARV tender. This followed Chirwa-Mpungose's assertion of another political corruption scheme related to the tender award. She insisted that the SIU investigate due to numerous red flags, noting the awarding of the tender to Barrs Pharmaceuticals Industries and Innovata Pharmaceuticals, both of which were in financial distress in December 2025.
Chirwa-Mpungose claimed that these two companies, subsidiaries of Avacare Health, received the tender despite lacking financial solvency. She also pointed out that the Public Finance Management Act requires companies participating in government contracts to demonstrate financial stability, which these two firms lacked.
Motsoaledi had previously stated that due diligence was ensured during the application evaluation process by checking all participants against the requirements specified in the tender conditions. He also mentioned that the department did not review balance sheets or other financial documents because doing so would require engaging external auditing firms, which would be extremely costly. Chief Financial Officer Phasha Mamogale stated that all application requirements were met by the companies at the time of the tender award. Mamogale added that the directors of the two companies held separate executive positions, and the ARV contract tender requirements did not mandate a check of the companies' financial health. Furthermore, he noted that at the time of selecting the companies, the department was unaware of the financial difficulties they would face.
The Ministry of Health in Gaza has warned about a serious and unprecedented shortage of vital medications for patients with oncological diseases, bringing the healthcare system to a critical state. It was noted that some drugs, including chemotherapy agents and other auxiliary treatment methods, have completely run out.
The Ministry of Health in Gaza reported via social media that chemotherapy protocols for patients with breast, colon, and rectal cancer, as well as those suffering from head and neck and gastrointestinal tumors, have been suspended. Medical workers also emphasized that the lack of oncology drugs hinders preparation for combined chemotherapy.
The Ministry warned that the absence of injections to strengthen the immune system, which should be administered after chemotherapy sessions, makes patients more susceptible to severe infections and complications. Furthermore, the shortage of palliative care and painkillers exacerbates the critical health condition of cancer patients.
This situation in Gaza is caused by ongoing Israeli attacks and restrictions on leaving the enclave, despite the ceasefire agreement between Israel and Hamas reached in October 2025. The Ministry explained that four thousand oncological patients out of 11,000 who are permitted to travel abroad for treatment are still awaiting travel permission, reiterating that the current situation in Gaza puts their lives at real risk.
In this regard, the Gaza health authorities appealed to all international and humanitarian organizations with an urgent call to respond to the pleas of these besieged patients, whose suffering grows with each passing hour due to the lack of necessary treatment.
It is worth recalling that Israel began military operations against Gaza after the Hamas attack on Israeli territory on October 7, 2023, which resulted in the deaths of over 1200 people and the abduction of about 250 people.
