The North West Department of Health wishes to assure patients and communities of a stable supply of medicines and other pharmaceutical Services despite the ongoing challenges which are being attended to. It is important to note that pharmaceutical Services in North West Province was placed under internal intervention during November 2023 following the system crash of the stock inventory management system at the provincial medicines depot. Since then, changes have been made in Provincial Pharmaceutical Management with the aim to improve Pharmaceutical Service Delivery and overall medicine availability.

Processes related to procurement of medicines have been upgraded and improved to ensure that there is an increase in meeting the growing demand in public healthcare in the province.

Current situation on medicine availability The medicine availability in pharmacies in the North West Province is currently monitored through manual processes from product data reports as extracted from stock inventory management systems. As things stands, the average total medicine availability in 31 public sector pharmacies in the Province is at 85.12% against a target of 80% medicine availability. This shows that medicine availability in the province is improving since the intervention plan to address the challenges identified in 2023 started to be implemented.

Alleged unavailability of cancer medication Cancer medication is procured through the National Contract for Supply and Delivery of Oncology and Immunological Agents to the Department of Health. Over the past few months the department has experienced challenges in terms of inconsistent supply of a limited number of cancer medication. The contracted suppliers for medication that is used as treatment of choice for breast cancer have reported supply constraints to National Department of Health (NDoH) and the Chief Director for Sector Wide Procurement has released a circular to all health departments explaining how treatment should be adjusted and which alternatives should be used for the treatment of breast cancer. The current situation is such that the National Department of Health has embarked on a process to obtain quotations for alternative suppliers and the matter is receiving urgent attention. Currently, patients are getting Tamoxifen as the third alternative for management of breast cancer. The challenge is that due to the side effects this item is not preferred by patients. Currently we have enough stock of Tamoxifen in our pharmacy. All changes to patient medication are made in consultation with specialists and in the best interest of patient outcome.

Factors contributing to medicine supply chain challenges South Africa is following a centralized procurement where National Contracts are awarded for procurement of medicines as contained in Standard Treatment Guidelines and included in the Essential Medicines List. The North West Province is not immune to the delays in shipping of medicines from different countries as well as production problems that can cause delays in timeous delivery of medicines to service delivery points.

From time to time, the department encounters increased demand or sudden increase in demand for certain medicines which can lead to temporary shortages. Furthermore, the regulatory delays where manufacturers have to apply for licensing of newly registered medicines can cause a slowdown in production and distribution. There are also financial challenges where companies announce discontinuation of manufacturing of medicines and this can lead to fewer available options.

These challenges are also compounded by trade restrictions, conflicts and international policy changes that can disrupt medicine supply processes. In some instances, protest actions can negatively impact on distribution of medicines where roads are closed and routes are not accessible which causes a delay in delivery of medicines to service delivery points.

Interventions from North West Department of Health to address medicine supply chain challenges Working closely with Sector Wide Procurement and Affordable Medicines Directorate at National Level to escalate medicine supply chain challenges and seek solutions to challenges. The Department is implementing a number of interventions including:

• Implementation of a stock out escalation protocol as an early warning sign to seek alternative treatment to ensure continuity of care.

• Continuous contracted supplier engagements to inform suppliers of challenges and/or increased needs to meet needs in terms of patient care.

• Improved communication to clinicians to communicate medicine stock out challenges and alternative options available to achieve same therapeutic outcomes.

• Enrolment of patients on the Central Chronic Medicine Dispensing and Distribution Program where a contracted service provider supplies medicines to chronic stable patients.

• Raise public awareness through patient education sessions, adherence clubs and radio interviews.

• Pharmacy managers meeting will be conducted weekly from 05 March 2025 going forward to ensure that challenges are communicated effectively and corrective measures are implemented without delay.

North West Health MEC Sello Lehari said that he is confident of that his department is making positive progress towards adequate medicine availability in the province and that the challenges are being addressed. “I have studied reports on the status of pharmaceutical services and medicine availability. Different stakeholders in and outside the province continue to work with the department to deal with challenges and other factors within and outside of our control”, said MEC Lehari.

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Enquiries and interviews

Mr Tshegofatso Mothibedi Departmental Spokesperson Cell: 0735035045

For any additional information: Mr Tebogo Lekgethwane Director: Media & Communications @ 0674227763 or tlekgethwane@nwpg.gov.za

Issued by North West Department of Health

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