Public Health and Health Systems

Quarter of clinics experience medicine stock outs

Written by Kerry Cullinan

One in four public health facilities ran out of antiretroviral or TB medicine last year, with Mpumalanga, Gauteng and Free State being worst affected.

Nurse and ARVsOne in 10 facilities also ran out of vaccines and were unable to immunise babies, and around 70 percent of these stock outs lasted for longer than a month.

This is according to Stop Stockouts Project’s (SPP) third annual survey, which was released today (Friday 24th) in Cape Town.

However, a leading HIV expert said patients on ARVs should not panic as the ARV shortages were confined to two “second line” medicines not commonly used and that health facilities “almost never” ran out of the ARVs that 85 percent of patients are on.

The SPP set out to contact all health facilities by telephone during the last quarter of 2015, eventually managing to get information from over three-quarters of the eligible facilities (2 463 of the 3 547) and asked whether they had experienced stock-outs in the past three months.

Longest stock outs

Well over half of Mpumalanga facilities(58 percent) had ARV and TB medicine stockouts, while 39 percent of Gauteng and 36 percent of Free State facilities also did.

These three provinces also reported the longest stock outs, “indicating deficiencies in the provincial supply chain, and a lack of emergency response mechanisms”, according to the survey.

“I’ve been diagnosed with MDR-TB in September 2015,” an Mpumalanga patient told the SPP. “The facility where I get my medicine is always out of stock and I’m concerned that I will default on my treatment. I try to go to the clinic 7-10 days before my medicine is finished to inform the clinic, but this has not helped and I’ve been told to go somewhere else to get my medication. I’m unemployed and cannot afford to go there.”

The Western Cape reported the lowest proportion of facilities with such stock outs, but it also saw an increase from four percent in 2014 to nine percent in 2015.

However, both Limpopo and the Eastern Cape managed to make a huge improvements, more than halving stock outs to 12 percent in 2015. KwaZulu-Natal, home of the most HIV positive patients, also only reported a 12 percent stockout rate.

“Those most vulnerable to the effects of stock outs are usually poor and rural communities who depend on public facilities for health services,” said the SPP.

Costly clinic trips

“Patients often make repeated, costly trips to health facilities to keep up their prescriptions. Pharmacists and nurses spend more time rationing drugs instead of caring for ill patients. Babies are not vaccinated on time, or at all. Ultimately, the quality of patient care is compromised, and lives are lost.”

However, SA HIV Clinicians Society head Dr Francesca Conradie said that the ARV stock outs related to two medicines that were not part of the treatment plan for the majority of people living with HIV.

“The blanket statement that 25 percent of facilities ran out of ARVs is not quite correct, as the Department of Health almost never runs out of the fixed-dose combination that 85 percent of patients are on,” said Conradie. “Patients have no need to panic and clinics don’t need to stockpile. The vast majority of patients will be able to get their ARVs.”

The SSP acknowledged that the national Department of Health was taking steps to overcome stock outs, and a task team is “currently developing a comprehensive overview of planned interventions within a national procurement and supply chain plan”.

However, it said that the “missing link is an open and transparent dialogue with civil society organisations such as the SSP”.

The Department of Health said it was still studying the report but believed that a number of the stock outs related to problems with manufacturers. – Health-e News.

About the author

Kerry Cullinan

Kerry Cullinan is the Managing Editor at Health-e News Service. Follow her on Twitter @kerrycullinan11

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