Strike threatens HIV drug supply in E Cape

Just days after the World Aids Day, South Africa’s battle against the pandemic suffered a setback when more than 50000 patients, on anti-retroviral (ARV) drugs, were put at risk following a long-standing labour dispute between the Eastern Cape government and civil servants at the Mthatha medicines depot.

The provincial health department’s Sizwe Kupelo says the dispute, which degenerated into a full-blown strike last week, emanates from non-payment of bonuses to staff dating back to 2007.

Areas affected by the interruptions at the depot, which provides ARVs and other medicines to almost 400 healthcare facilities in the eastern part of the Eastern Cape. To illustrate the extent of the problem, Lusikisiki-based Noloyiso Ntamehlo, speaking on behalf of the Treatment Action Campaign (TAC), Aids treatment lobby group, says patients in rural areas, such as hers, travel long distances for medicines only to be turned away from the clinics because the “there is no stock”. The problem, she says, has been ongoing for several months.

“Staff at the Mthatha depot engaged in an illegal strike chased away trucks, which led us to suspending 29 of them. Unions have distanced themselves,” Kupelo says, referring to Nehawu, Denosa and Hospersa. To make up for staff shortages amid attempts to salvage the situation, national government has sent two pharmacists to Mthatha. The civil sector has also stepped in with Medicins Sans Frontières (MSF), for instance, responding by sending a 30-strong emergency team.

The establishment of the team, comprising of medical practitioners and other healthcare workers –backed by volunteers from the TAC, Section27 and other NGOs – looks set to ameliorate the effects of a cocktail of issues facing the depot. Kupelo expects the treatment delivery situation will be brought back to normal in two weeks. However, noting long-standing staff shortages, the TAC’s Ntamehlo says “the department should implement a clear long-term plan. This ‘out-of-stock’ [scenario], has been going on for months and is saddening. People are suffering.”

Backing this up, the MSF, which entered the fray last Thursday, reports it’s been weeks since the Mthatha clinic supplied treatment.

This scenario, acknowledged by health authorities, confirms the province was already hit by backlogs even before the strike at the depot. Broadly, contends the civil sector, if left unchecked the situation threatens adherence to treatment by many of the Eastern Cape’s patients. Failure to manage the crisis, here and elsewhere, could take government a few steps back.

On the eve of the December 1 World Aids Day, Health Minister Aaron Motsoaledi announced that Government had dished out a R5.9bn two-year HIV treatment tender in the public sector. “(We) have 1.7m patients on treatment currently and we hope to expand this to 2.5m by the end of 2014,” he said. The new innovative method, “in pursuit of affordability”, is commendable as it saves the taxpayer R2.2bn (from an original cost of R8.1bn). On the downside, there’s still no sustainable strategy to prevent stock crises.

“This [R2.2bn] saving means we can treat more patients with the same budget,” Motsoaledi said as he unveiled winning bidders, including Abbott, Adcock Ingram and Cipla Medpro. Still, until his team devises a holistic approach, which entails bolstering human resources and tapping into a willing civil sector, patients will continue bearing the brunt of a disparate strategy. That will also leave the root of the mounting burden of disease will be left untreated.

– Shoks Mnisi Mzolo

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