Out of stock = out of life

by NOSIMILO NDLOVU

Provincial health departments faced with antiretroviral drug shortages are defiantly overspending on their budgets, rather than see patients die.

Limpopo anticipates shortages and is overspending to keep patients on treatment. “We are employed to save lives so we would rather overspend now and face the music later,” said Limpopo health department spokesperson Phuthi Seloba. “It’s not about how our books look, but about the people’s lives … We will not put a board up that says ‘out of stock’, because out of stock means out of life.”

Antiretroviral shortages in the Free State have led to at least 30 HIV-positive people dying in the province every day since November last year, according to Sello Mokhalipi of the Treatment Action Campaign. Mokhalipi says this figure is based on a report by the Southern African HIV Clinicians Society.

In November last year the Free State department of health announced that its dire financial situation meant that the province would not be able to supply enough ARVs. The province has since lifted the moratorium, but some clinics and hospitals in the province are still waiting to receive the ARVs.

Drugs started filtering into the province last week after drug manufacturers came forward to help government meet a shortfall of ARVs at various facilities in the Free State.

Last November the provincial health department placed a moratorium on new patients being admitted to ARV treatment regimes.

About 15 000 people needing ARVs were placed on waiting lists and others who had been on the drugs for years were told that the department had run out of stock.

But the Free State is not the only province that has experienced such shortfalls. Zale Mandonsela, director of HIV/Aids for the department of health in Mpumalanga said that because of budgetary constraints it is facing shortages of Stavudine, a reverse transcriptase inhibitor used to treat HIV infections. “The annual budget for ARVs is not adequate,” she said. Mandonsela said the department realised last September it was running out of funds to buy ARVs, so it submitted a request to the treasury during the budget adjustments in October to keep afloat.

KwaZulu-Natal has the highest HIV/Aids prevalence in the country and the highest number of accredited sites for ARV treatment, but the system is taking strain.

“More people are qualifying for ARVs [when their CD4 count drops below 200], meaning we have more people on treatment than we budgeted for,” said Desmond Motha, spokesperson for KwaZulu-Natal health minister Peggy Nkonyeni.

Motha said the department had budgeted for 195 312 people to be on treatment for the year 2008-09, but it is now treating about 215 000 people. “We have applied for an additional R127-million to make up for the growing numbers.”

National Health Department spokesperson Fidel Hadebe said Health Minister Barbara Hogan will be meeting all provincial health ministers and “will be looking at financial and budgeting matters”.