Clinics in parts of the Eastern Cape are facing a Tuberculosis (TB) medication shortage. Health workers at clinics in Gqeberha tell Health-e News that they have to issue TB patients with seven days of Rifinah instead of a month’s supply. This is because the medical depot in Gqeberha that services local municipalities does not have any stock. 

Rifinah, a two-in-one combination of antibiotics rifampicin and isoniazid, is a widely used treatment for pulmonary TB.  

A nurse working in one of the clinics who asked to remain anonymous as she is not allowed to speak to the media says last week they had to borrow TB medication from Livingstone and Dora Nginza Provincial hospitals. 

“We don’t know what is going to happen because the two facilities have also run out of  this medication and we have not heard anything from the depot. Unfortunately this will affect TB patients who are due for their medication as they will have to wait because at this stage there is nothing we can do,” she says. 

She says this will lead to patients defaulting on their medication which, in turn, can lead to the development of drug resistant TB. Defaulting is an interruption of treatment of at least two months. 

TB is a leading cause of death in South Africa, claiming more than 54,000 lives in 2021. The Eastern Cape has among the highest TB burden in the country. The province has an estimated TB incidence of 692  per 100,000.

Xolile*, a nurse at a clinic in Motherwell Township says they had to ration the medication among patients. 

“We had no choice but to divide the medication among patients so that they can at least have something while we are still waiting. It’s very sad because some of these patients cannot afford to travel to the clinic every week. They will end up defaulting on their medication which will have a negative impact on their health,” he says. 

Shortage of TB drug an ongoing thing

An official from the Eastern Cape branch of  Democratic Nursing Organisation in South Africa (Denosa) who spoke on condition of anonymity tells Health-e News that it is not only Nelson Mandela Bay in Gqeberha that has run out of TB medication, but also the Sarah Baartman Region.

“The shortage of TB drugs is a serious problem in this province. There has been a shortage of ethionamide, a medication used to treat multidrug resistant (MDR-TB), for weeks. Now we are faced with the shortage of Rifinah,” he says.

He tells Health-e News that some clinics have only TB medication for adults, while others have TB medication only for children. 

“It is just a mess because healthcare workers have to borrow from other facilities. We will engage with the department to find out if this is a matter of non-payment of contractors who have to deliver the medication, or if the problem is with the manufacturers. But the situation cannot go on like this,” he says. 

Drugs to be allocated to facilities 

Eastern Cape health spokesperson Sizwe Kupelo confirms that there has been a shortage of Rifinah TB for two weeks in Gqeberha. 

He says, this week the Gqeberha depot received a total of 54,000 boxes of Rifinah which will last for a month. He adds that a patient gets one box of pills. 

“We were owing a total of 8,000 units of Rifinah to healthcare facilities around Gqeberha. So far the depot received 5,000 boxes and they will be equitably allocated across the facilities. Another consignment will be released from the depo this week. In case of emergencies pharmacies can arrange to pick up the medication at the depot,” he says.

Kupelo adds that the national health department issues a tender for medicine contracts. The provinces then procure medication from the pharmaceutical company hired by the national health department. 

“The medicine shortage happens when the supplier fails to meet the demand as the company supplies both the private and public health sector. – Health-e News 

*Not his real name