Clinics in Mpumalanga have been facing a medicine shortage for several months now, resulting in chronic medication being rationed among patients. 

According to the HIV advocacy organisation, Positive Women’s Network (PWN) community members have been complaining since mid-March. Patients say they have not been getting full months’ supplies of antiretroviral (ARVs) drugs and blood pressure medication, as is the norm. 

Sibusiso Nkosi, who is a patient and chairperson of the Matsulu clinic committee near Mbombela, says he could not get his medication when he went to the clinic in May. 

“I had gone a month without ARVs, high blood and TB treatment. When I asked about the situation, I was told that the problem was caused by the fact that the clinic had changed its service provider that delivers medication,” he tells Health-e News.

“I saw many people, including [other] HIV patients, being turned away. It is dangerous for those [of us] who have already started the treatment.”

In the middle of June, Nkosi was able to get a full bottle of ARVs – enough to last him a month. But he still doesn’t have medication for his blood pressure and TB. 

‘’I woke up at 3am so that I could be at the clinic gate by 5am. I was the first one in the chronic medication queue. I was given a prescription for my TB and hypertension  medication but I was only able to buy the TB tablets,’’ adds Nkosi. 

The clinic has been giving some patients prescriptions to buy the medicine they need from retail pharmacies. 

‘’The shortage of medication in our health facilities is a violation of human rights. Most community members don’t have money for private doctors and depend on government health services when they are sick,’’ says Thandi Maluke, PWN executive director.    

Several clinics affected

A nurse at Lilydale clinic in Bushbuckridge, who asked not to be named out of fear of losing her job, confirms that the clinic has also been struggling with the delivery of medication.

‘’We have been ordering medication, however the supplier has not delivered any medication. This has caused frustration for us as nurses and as well the patients,’’ says the healthcare professional. She says the issue has been happening since February this year. 

The National Department of Health is responsible for medicine procurement tenders and contracts. Provincial health departments then procure the medicine from a pharmaceutical company that is hired by the national department. Medicine shortages happen when the supplier fails to meet the demand. 

On some days, she says nurses turn patients away without medication. Sometimes they give patients 15 tablets out of 30 as a way of trying to accommodate everyone. 

In June 2023 a report by Ritshidze, a coalition of non-profit HIV advocacy organisations, showed that more than 39% of clinics in the province reported ARVs shortages. And one in 10 people who took part in the study left or knew someone who had left a clinic without getting the medication they needed.  An earlier report by the group showed similar findings.   

A community health worker from KaNyamazane clinic in Mbombela says that her job has become difficult in the past months because of the shortage. When she goes on her daily home visits to patients, she finds that most are sick. 

‘’When a patient is placed on ART or TB medication they need to take the tablets everyday without skipping a day. But now patients go weeks without medication, and there is nothing that I can do. Some patients even end up getting admitted in hospital because of how seriously ill they are,’’ says the community health worker.  

‘No medicine shortage’

The Mpumalanga department of health spokesperson Dumisani Malamule says that there is no shortage of medication. Speaking to Health-e News Malamule says that no patient was turned away due to shortages of ARVs. 

“When there is no medication that a patient normally gets, we give them an alternative medication. By doing so, a patient is not defaulting.

‘’As a department we are going to investigate the individual cases that have been brought to our attention to make sure that our people are safe. The issue of the clinics not having medication is not true,” says Malamule.

He further explains that the department has a system in place where health facilities make emergency orders for medicine that are out of stock. And the responses from the monitoring system will alert the medicine depot of any shortages.

Patients still without treatment

For Beatrice Mgidi* from Ngodini just outside of Mbombela who has been living with HIV for seven years says that she has been struggling to get a full month’s supply of ARVs when she goes to the Ngodini clinic. 

‘’Since January I have been struggling to get a full bottle of medication. Sometimes I only get enough for a week, or they send me to other clinics,” she says. 

Mgidi says that her survival depends on this medication and now lives in fear of falling ill and being unable to provide for her family only because of the government. 

It is important that a person who is living with HIV stays on treatment once they start taking it daily. Interrupting treatment is a health risk that allows the virus to multiply in the body making it detectable in the bloodstream again, and there’s the added risk of ARV resistance developing. – Health-e News