Question NW4679 to the Minister of Health
23 December 2022 - NW4679
Marais, Ms P to ask the Minister of Health
What are the details of the measures of intervention that have been taken recently by his department to tackle the challenge of the shortage of medication, especially antiretroviral drugs, in health facilities? NW5802E
Reply:
There are no current systems-wide shortages of medication in health facilities although facilities do run out from time to time owing to operational reasons.
It is the Departments of Health’s policy to ensure equitable access to quality healthcare through availability of safe, effective and cost-effective medicines at the appropriate level of care. The National Department of Health manages contracts of approximately 1 200 essential medicine items. Contracts are awarded to suppliers (manufacturers) following an open tender process in accordance with the Public Finance Management Act. Provinces procure medicines directly from contacted suppliers. Note that the public sector services the healthcare needs of 84% of South Africa’s population.
The NDOH continuously engages with the contracted suppliers to identify any possible supply challenges, to adjust the demand forecast (where necessary) and to work together to mitigate the risks. Furthermore, the NDOH established a decision-making forum where all provinces are represented; to identify interventions aimed at addressing any medicine supply challenges, to improve medicine availability and to reduce the potential impact of stock outs.
Where supply constraints are identified, the NDOH works with the provinces to identify and implement interventions to minimize stock outs and impact on patients. These interventions are informed by the cause of the supply challenge:
Where the supply constraint is due to operational matters e.g., machine breakdown, labor unrest, theft, post importation testing, etc. the NDOH would source products from alternative local suppliers with registered products using the quotation process.
Should the supply constraint result in a longer term supply challenge, such as regulatory matters including amendments to the dossier that requires approval from South African Health Products Regulatory Authority (SAHPRA), including a change/addition of an active pharmaceutical ingredient source and/or manufacturing site, the transfer of ownership of dossiers which results in a change of marketing authorization, delays in the issuing of the permits for imported medicines, manufactured products requiring additional quality checks by SAHPRA, etc. and no alternative local suppliers with registered products are available; an application would be made to SAHPRA for the acquisition of unregistered medicines for human use in terms of Section 21 of the Medicines and Related Substances Act.
With regard to antiretroviral medication, there are no wide-spread supply challenges. As on 05th December 2022,
Overall medicine availability across all facilities is 87.1%
Availability of antiretrovirals is 91.1% Availability of 1st line antiretrovirals is 97.4%
END.