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Health Minister Aaron Motsoaledi shows off the AG report on the G-Commerce system as he briefs journalists. With him is his MEC in Limpopo, Phophi Ramathuba. (Photo: Endy Senyatsi)

Political tension hides behind… Medicine shortages

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Alleged ongoing political tension between Health Minister Aaron Motsoaledi and his MEC in Limpopo, Phophi Ramathuba reportedly necessitated mediation by Premier Stan Mathabatha this week as the provincial government had to avert a threatening crisis of drug stock-outs in public healthcare in the province.
From reliable sources it was learnt that a battle of national and provincial forces is seemingly characterising a state of cooperation between the political figureheads at different levels. Prior to Monday’s high level meeting with Mathabatha and officials from the Health Ministry, the Department of Health and National and Provincial Treasury, a source close to the matter classified the state of affairs as “a real fight”.
The source referred to Mathabatha allegedly having been brought in to mediate in the matter pertaining to the shortage of medicines in Limpopo, a situation that impacted scores of state patients in the province. A recently introduced pilot programme for dispensing of medicine in Limpopo, initially introduced in the Northern Cape, was top priority on the agenda of the meeting with Mathabatha and representatives of the departments, as well as the government’s information technology division.
The sole purpose of the meeting, as set out in a media advisory issued by the Ministry of Health on Monday, was to understand the nature of the problem with regard to the shortages of medicines and find an everlasting solution. In a media statement issued the following day Health Ministry spokesperson Popo Maja referred to reports in the media about drug stock-outs especially in Limpopo the past few weeks, the issue being the new pharmaceutical warehouse management system, whether it worked and the right system able to solve the challenges at hand.
Last Monday Ramathuba reportedly constituted a rapid response team with the mandate to ensure that all medicines destined to reach clinics did so as soon as possible. The team was also beefed up by pharmacists from various hospitals, it was learnt. Ramathuba allegedly instructed the staff at the depot to “pack away” the new system for the time being and revert back to the old one to ensure that medicines reached health facilities, especially in remote areas.
When briefing journalists about the new system and a shortage of certain drugs during a presser at the Premier’s Office late Monday, Motsoaledi insisted that the new system called Government-Commerce also known as G-Commerce was working and that the department should continue with it.
He indicated that the system was piloted in the Northern Cape instead of Limpopo because the Northern Cape was experiencing a lot of problems and reiterated that they could have introduced the system in Limpopo in September last year, but had to delay the process as IT experts were still busy trying to fix glitches. G-Commerce was introduced in the province in July this year and clinics started experiencing a shortage of stock since then, it was learnt.
He stated that every IT system came with glitches, which was why they were going to deploy a team of six IT experts to the province to deal with such problems and reiterated that three officials would be stationed at the provincial pharmaceutical depot in Seshego while the other three moved between Northern Cape and Limpopo.
The Auditor-General of South Africa (AG) has recommended that all government warehouses should deviate from the old systems to the new one because the old ones had problems such as massive corruption, wastage and failure to detect expired drugs, he stated.
Motsoaledi confirmed that a shortage of certain drugs was a countrywide crisis, adding that they struggled to get antiretroviral (ARV) and Noristerat contraceptive injection with Lamivudine combination. “Most active pharmaceutical ingredients (APIs) are produced in China but the factories had to halt production about six weeks ago because they were not following the correct environmental standards. We had to look for a temporary supplier of the two aforementioned drugs and we found it in India. The Global Fund is still negotiating with China for the factories to reopen,” Motsoaledi explained.
According to Motsoaledi over 4 million people who take ARVs use a fixed-dose combination (FDC), making the number of those depending on Lamivudine combination less. He added that they would engage medical experts to convince patients to switch to the available combinations. Motsoaledi concluded by saying switching from one medication to the other came with temporary complications, but added that patients should consider using available medicine to deal with their diseases.
Following a visit to the departmental depot in Seshego last Monday, Ramathuba said the new system affected distribution of medicines to health facilities and had to revert to a manual system but during the briefing she outlined that the decision was just a temporary measure and they would go back to G-Commerce. Although some clinics and hospitals experienced a shortage of medicine, Ramathuba insisted that this was not due to lack of stock at the depot but because of problems faced by the system, which made it impossible for health institutions to order medication from the depot.
During Monday’s media briefing she said Pietersburg Provincial Hospital has also experienced a shortage because they had to distribute some of their medicine to other facilities. She was confident that a team deployed to the province would help deal with the problems.
Health Department spokesperson Neil Shikwambana said they were not aware of any political tension between the Minister and the MEC, adding that it was purely a health issue that the two heads had to deal with.
At the time of going to print Maja could not be reached for comment on any of his two cell phones.

Story:
YOLANDE NEL
>>observer.yolande@gmail.com
ENDY SENYATSI
>>endy@observer.co.za