HIV activists and health workers are demanding an inquiry into shortages of critical antiretrovirals (ARVs) that are central to the government’s treatment programme.
The shortages endanger the lives of the patients who have been placed on regimens containing these drugs, they said.
On Sunday Dr Anban Pillay, the deputy director-general for health regulation and compliance, confirmed there were shortages of tenofovir (TDF) in Gauteng, Eastern Cape, Limpopo and Mpumalanga because of changes to drug tenders, but said that this was being sorted out.
The Treatment Action Campaign (TAC), the Southern African HIV Clinicians Society, the Rural Health Advocacy Project, the Rural Doctors Association of Southern Africa, SECTION27 and Médecins Sans Frontières (Doctors without Borders) said in a joint statement that there had been shortages of ARVs, specifically TDF and abacavir (ABC) since March in facilities across SA.
“These shortages are compromising the health of patients taking these medicines. We call for urgent resolution of the shortages and for an inquiry into their cause,” the groups said.
They said TDF and ABC were essential medicines.
“South Africa’s antiretroviral treatment guidelines provide for TDF in first- and second-line treatment of adolescents and adults. ABC is provided for in first- and second-line treatment of infants and children.”
The health department said the shortages were because of the changes in drug tenders.
Last year the department received ARVs donated by USAid but that ended in December.
The two companies that have the ARV tender – Aspen Pharmacare and Sonke – now have to supply all the ARVs. About 1,7 million people rely on ARVs.
“Early in the year both suppliers battled to keep up with the orders they received,’’ Pillay said.
‘‘In the past month, Aspen has been able to get the necessary ingredients and systems in place to increase its production significantly,” said Pillay.
‘‘It is now keeping up with the orders. The same cannot be said for Sonke, though, since they have huge back-orders to fill and this is causing the shortage.”
He said Aspen delivered more stock last week on Friday and was due to deliver more on Monday.
Two other suppliers – Adcock and Cipla – will also help out.
Pillay said department staff at pharmacies and depots should monitor supplies and alert the department as soon as there was a supply problem.
He said some provinces had prescribed abacavir for adults, although it was supposed to be prescribed to children. This added to the depletion of stock.
“The issue of abacavir can easily be resolved by prescribers restricting its use to children as per the guidelines,” he said.
The Southern African HIV Clinicians Society wrote to Minister of Health Dr Aaron Motsoaledi on March 29 calling for an urgent investigation into the cause of these shortages.
In response to a request from the department of health, the society wrote a clinical guidelines for health-care workers dealing with TDF and ABC drug shortages.
A copy of those guidelines is available on the website at www.sahivsoc.org and on the TAC’s website at www.tac.org.za
Pillay said the department had not adopted the protocol as the shortage was limited to a few institutions and had been resolved.
In the guidelines, the HIV Clinicians emphasised these were a short-term solution and that drug shortages could harm patients’ health, as interrupting ARV therapy could lead to drug resistance.
The Rural Doctors Association said that to switch to some drugs required a viral-load test on the patient, but that the turnaround time for this in rural areas was too long, resulting in complications with substituting treatments. – additional reporting by Health-e News Service