The North West Department of Health has noted with concern various reports in the media regarding the alleged unavailability of medication for patients on Antiretroviral (ARVs), tuberculosis (TB) treatment and family planning following the release of the Second Edition of the Retshidze report recently.
The Department deems the media reports as misleading as they do not provide an accurate impression of the state of health in the North West Province particularly the current status of medicine availability in the province.
Therefore, the NWDoH refutes, with the contempt that it deserves the distorted information that has made its way into the public space as a result of the Retshidze report, an assessment compiled based on observations and interviews without soliciting facts from the department which is the custodian of public health services in the province.
The Department has as part of Section 100 (1) (b) interventions made significant strides in addressing the shortages of medicine stock in provincial public health.
The overall provincial medicine availability has reached 81% as per the national essential list in the 3rd quarter of 2021/2022. The availability of Antiretrovirals (ARVs) and vaccines for the Extended Programme on Immunization has been maintained above 92%, while Tuberculosis (TB) medicines are above 82%.
The Province has developed and put in place a system to track medicine availability in the province. This system allows for stock to be transferred between facilities depending on the individual needs of each facility.
Stock availability in the province currently stands as follows:
ARVs
The media reported the Lamivudine drug as having the highest number of stockouts (44%) in facilities. The Department refutes these reports and can confirm that the medicine availability for lamivudine 150mg 56 tablets, improved from 76% at the beginning of the year to 83% in July 2022. This improvement in availability followed a departmental intervention where concern was raised with the National Department of Health pertaining to the shortages of Lamivudine in January this year and was assisted to acquire two months of stock from Aspen and Adcock.
The department has resolved to solicit Lamivudine stock for the provincial depot from Gauteng province in the interim in line with the Inter-Provincial stock transfers as approved by the National Department of Health until the matter of stock levels of this particular drug are stabilised.
The NWDoH can confirm that the stock availability of Dolutegravir has constantly been above 90% since the beginning of 2022 despite media reports which claimed severe unavailability of the drug and subsequently placed it as the second highest number of stock outs.
department of Health is in discussions with Hetero, Mylan and Sonke to supply stock this month and will ensure all Provinces get an equal share.
The TLD drug was reportedly on stock out rate of 7% according to publications, however, the accurate availability trend is above 97% for the 28 pack. Health facilities also stock the 90-day pack, but it is not on the National or Provincial formularies as this item was donated by USAID and Global fund and no NSN number was allocated.
The reports have further alleged severe shortages of the Abacavir/lamivudine, Efavirenz, Abacavir, zidovudine medicines placing the stock out at between 5 and 7%. As a Department we can confidently report that the availability trend for Abacavir/Lamivudine 300/600, 28s has been constantly above 95% since the beginning of this year. The availability of Abacavir/Lamivudine 300/600, 28s has been above 95% while Abacavir Medicine availability trends for the 20mg/ml solution as well as the 300mg tablets are constantly above 95% for 2022, with the 60mg dispersible tablets achieving mid to high eighties. Zidovudine on average trends at roughly 87% medicine availability with the 100mg 100 capsule pack achieving an availability upwards of 90% for the entire 2022.
TB treatment
The overall TB medicine availability at the end of July 2022 is 81.6%.
Rifampicin/ Isoniazid received a reported stock out the percentage of 47% in the media, however provincial availability trends for the 300mg/150mg 56s stand above 94% for the entire 2022 thus far, the 150mg/75mg 56s singles stand between 89% and 91% for 2022 as well. Acquiring Refinah 60/60 28s & 56s was a challenge for the province earlier this year due to suppliers being out of stock, however, the challenge was resolved in May and we currently range between 70 and 80% in terms of stock availability.
Province never experienced any supply challenges with Rifafour which currently ranges between 80% and 90% in terms of stock availability.
The availability of family planning drugs and injectables in our facilities ranges between 88 and 95% with Depo Provera (medroxyprogesterone) registering a drastic availability improvement of 67% in January to 95% In July this year. Oral contraceptives which include Ovral, and Triphasil have recorded an 85-87% stock availability in the province. We have further recorded 92% availability of sub-dermal implants at facilities which were reported to be experiencing stock shortages.
The Department will experience shortages of specific items from time to time when there is a national problem with that specific medicine. However, information regarding a departmental process of lodging general complaints is available at various health facilities. Through this process, persons who experience medicine shortages can escalate their challenges should they believe they do not get cooperation from the health facilities they are visiting.
