Did the department of health submit contracts for medicines timeously and did department underestimate the amount of drugs required? These are questions Dr Wilmot James‚ the Democratic Alliance’s (DA) shadow minister of health‚ will be submitting to Parliament after his counterpart in Government‚ Dr Aaron Motsoaledi‚ on Sunday blamed shortages of anti-retrovirals (ARVs) on “circumstances beyond our control”.On Monday‚ Business Day reported that Motsoaledi attributed severe shortages of essential medicines at state hospitals and clinics to suppliers that did not inform the government in time when they experienced difficulties with supplies or decided to discontinue products.He claimed the three suppliers of Abacavir had informed the department that they had difficulties with the supply of active pharmaceutical ingredients to produce sufficient quantities of syrup and tablets.Abacavir is used for the treatment of HIV-positive children and adults whose bodies cannot tolerate the combined single pill."At no stage did any company report that the shortages were related to nonpayment for antiretrovirals despite us asking them directly‚" he said‚ adding that provincial health departments usually discovered that suppliers were experiencing problems only long after placing orders‚ because companies did not disclose them "to protect their brand".Replacing suppliers was often not practical as companies usually needed at least six weeks to deliver the first order.The latest information was that supplies of Abacavir should be normalised by the middle of next month‚ Motsoaledi said.“I must inform you that this shortage is a result of circumstances beyond our control‚" Motsoaledi said.The DA’s James‚ however‚ said that the Medicines Control Council (MCC) “is sceptical about whether the department submitted the contracts on time and if they have underestimated the amount of drugs needed”.“The minister stated that the shortages of ARVs reported in KwaZulu-Natal are limited to a shortage of Abacavir‚ used to treat children‚ and that the shortages do not extend to fixed-dose combination anti-retrovirals (FDC)‚” James said in a statement.“The DA is greatly concerned that a failure in supply chain management is being put on the companies making children’s ARVs. The minister has claimed that suppliers lack the active chemical compounds needed to make the drugs‚ shifting the responsibility on to the pharmaceutical companies.“However‚ the MCC rightly points out that if the department has submitted contracts late or underestimated the demand for the drugs‚ this raises serious questions about the efficacy of the department: Why was the Health Department unaware of these shortages of Abacavir; and who is looking after supply chain management?”On Sunday‚ the Stop Stock Outs Project (SSP) also questioned Motsoaledi’s claims‚ and said “only 20% of reported cases (of shortages) are found to be caused by manufacturing issues”.The SSP said the other “80% of cases are caused by management and logistical challenges between the medicine depot and clinics at provincial and district levels”.“These include incorrect quantities of drugs being ordered by clinics‚ inaccurate forecasting of drugs per population‚ and poor stock management at facility level‚” an SSP statement said.“The national department of health commitment to solving the problem is key to reducing stockouts‚ but it requires implementation and commitment at province‚ district and facility level if we are to see bold changes that ensure medicine is always available in every clinic‚” SPS’s Bella Hwang said...