There appears to be no end to the problems affecting the Eastern Cape Department of Health, the latest mess coming after its account with a crucial chemotherapy provider was suspended, leaving patients once again at risk as the Port Elizabeth Provincial Hospital ran out of medication – and replacements were also delayed.
After several days of stockouts, when a new batch was expected at the hospital, the department said it was still negotiating for its account with the manufacturer to be reopened for another drug needed, reports Daily Maverick.
Several outages of chemotherapy were reported at the hospital where paediatric oncology patients are treated with the medication that includes Methotrexate, Folinate and Polygam.
Polygam is a crucial immune-boosting product used in the treatment of many paediatric oncology patients. The medication is also used to help children with certain autoimmune diseases.
Sources at the metro’s public hospitals have confirmed the stockouts.
This year alone, similar shortages were experienced in January and in May and June.
In 2024, researchers, who published data regarding the obstacles for children needing cancer treatment in South Africa, called for increased political and policy changes to address the issue, identifying a lack of access to crucial medicine as a major barrier for these patients.
Other key hurdles included the discontinuation of essential chemotherapeutics, incomplete insurance coverage for childhood cancers, the inability to access care, including travel to healthcare facilities, and low awareness of childhood cancers among primary healthcare workers.
The authors wrote: “On a local level, some healthcare providers indicated having reliable and timely procurement processes in place in their … hospitals, whereas others expressed frustration at the lack of compassion and urgency from other members of the procurement chain when confronted with stockouts.
“Participants speculated that not all members are aware that medicines on the National Essential Medicines List should always be available.
“Additionally, communication with the provincial medicine depot can be arduous, causing delays in procurement. Some healthcare providers also suggested that distribution systems are inadequate, with products not reaching treatment facilities or no ability to maintain cold chains.”
Eastern Cape Department of Health communications director Siyanda Manana confirmed the current stockout, but said two key processes have been implemented to prevent this happening again, which include weekly monitoring and reporting.
“Oncology medicines are monitored and reported on weekly. Any shortages are addressed through inter-facility stock transfers to ensure continued availability.
“A dedicated team reviews supplier payments weekly to rationalise the budget, prioritising oncology suppliers and engaging them directly to maintain supply continuity.”
He said on Thursday that Methotrexate (MTX) was made available at the provincial depot in Nelson Mandela Bay and that folinic acid (Folinate) would also be delivered on Thursday.
They have been struggling with “inconsistent supply” of Polygam since 2024 due to challenges at the contracted supplier and the temporary suspension of the department’s accounts, he added.
“Accounts are reopened through ongoing negotiations to allow delivery. The supplier currently has stock available, pending account reopening,” he said. He did not indicate when this would happen.
“The department is also conducting proactive monitoring, prioritised supplier engagement and financial management, and these have been key in mitigating oncology medicine shortages.”
In May, the hospital was also hit by an extensive stockout of chemotherapy drugs that ran into June, causing five children to miss a full cycle of treatment.
On 21 May, doctors were warned that 11 types of chemotherapy were not available, and that in four of these cases, it was due to “closed accounts”.
It is understood that companies wanted a bigger part of their overdue bills paid after an initial payment was made. Carboplatin, one of the crucial drugs, was, however, reported to be out of stock with a contracted supplier and needed to be sourced from another supplier.
In January, patients with Hodgkin’s lymphoma and other cancers had to receive a different chemotherapy, not considered to be most efficient, after a stockout of first line treatment at the Port Elizabeth Provincial Hospital. This also affected patients’ eligibility for bone marrow transplants.
At the time, the Human Rights Commission opened an investigation into the issue after a complaint was laid by the DA.
See more from MedicalBrief archives:
Cancer drugs shortage sees Eastern Cape state patients suffer
How the state is working to reduce stockouts
Doctors urge crisis management as Eastern Cape Hospitals collapse