A shortage of critical tuberculosis medication is frustrating primary healthcare facilities in North West Province, with Kopano Klaas, project co-ordinator from the Stop Stockouts Project (SSP), accusing hospitals of hoarding the stocks of Isoniazid and Isoniazid 300mg.
“They don’t dispense medication to smaller clinics, they keep it for themselves. When the stock is about to expire, then they dispense it to the facilities – but it has expired and clinics cannot use it. This delays the delivery of critical medication,” he said.
Klaas said it was easy for hospitals to hoard the drugs “because the primary healthcare facilities order from the district hospitals; they don’t order directly from the medical depot”, reports Health-e News.
“We are still trying to investigate because it’s not easy to find the root causes of these problems. Sometimes we blame manufacturers, only to find that it’s just internal issues in facilities with unsigned contracts and order forms that affect availability.”
North West has experienced stockouts of essential medicines for years, including antiretroviral therapy (ART) for people with HIV.
In 2021, Ritshidze released a report on the state of health in the province, which highlighted the reality of patients being turned away from pharmacies and leaving empty-handed because facilities were out of stock.
Nqabutho Mpofu, policy, communications and research manager from the Treatment Action Campaign (TAC), presented research at the State of TB Report launch that showed the low administering of the TB preventive treatment (TPT) and Multidrug-resistant TB (MDR-TB) treatment in facilities.
According to the data, over the past two quarters (October-December 2022 and January- March 2023) only 35% of patients received MDR-TB treatment within a year and 39% received TPT in the monitored facilities countrywide.
Klaas said there was a desperate shortage of 300 mg Rifafour medication for TB at his local clinic in Soweto in December 2022.
“It was a big challenge for me because I really needed the medication.”
He was on his fourth week out of eight of treatment when he was forced to find alternative medicine: he was told the facility was waiting for more medicine.
The availability of this medication only began to stabilise in February.
Monitoring in facilities continues
Currently, he added, SSP does not have recorded data on the observed TB medication stockouts, as the project is ongoing and the report has not yet been concluded.
Reports of TB medication stockout in public healthcare facilities date back to 2019 – and the issue was worsened during the pandemic.
The organisation is investigating a morphine stockout that was first reported in July 2022, and also plans to conduct separate community-led monitoring surveys in primary healthcare facilities to specifically look into TB testing, treatment and follow-ups.
Department says issues resolved
However, Dr Norbit Njeka, from the National Department of Health, said the targets regarding MDR-TB patients’ diagnostics and treatment initiation were all exceeded.
“We have heard reports of imminent stockouts and shortage of items in the longer MDR-TB regimens and paediatric formulations from different facilities, but these were resolved … by requesting centres with drugs to help those running short, and urgent orders made.”
Njeka claims have not had to go without medicines. He says that drug substitutions were made for MDR-TB patients in the longer regimen.
Health-e News article – Stock-outs: north west facilities battling with TB meds (Open access)
See more from MedicalBrief archives:
Civil society report on medication collections at North West health facilities
North West Health intervention: challenges persist four years later
Fraud case opened against North West Health’s head of department