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The National Department of Health would like to provide the following update in respect of the limited supply of approximately 155 medicines mainly due to the global shortage of Active Pharmaceutical Ingredients.

Following the meeting convened by the Minister of Health, Dr. Aaron Motsoaledi, manufactures have been working around the clock  to address these supply problems and some of the the supply problems with certain medicines have been resolved.

The supply of about  82 medicines have been resolved since:
• the suppliers have started delivering,
• there are other suppliers of the medicine (split contracts),
• alternative pack sizes are available
• alternative strength are available

In the next group of 51 medicines the supply problems are not completely resolved since not all orders have been delivered. However, over the next 3-4 weeks all outstanding orders would have been supplied.

In the next group of 21 medicines the supply problems remain since suppliers would not be able to resolve medicine supplies within the next 4 weeks and therefore the National Department of Health will secure supplies of medicines from other international suppliers. In the interim, alternative therapeutic medicines will have to be prescribed. These medicines include certain antibiotics, cardiovascular medicines, analgesics, anaesthetic agents and central nervous system medicines.

Certain pack sizes of furosemide tablets are in short supply. However, alternative pack sizes are freely available and alternative suppliers are also available. (e.g. a pack of 28s can be combined to make 56)

Anti-Retroviral Medicine.

Antiretroviral medicines are not affected by manufacturer supply problems. Most patients on ARVs are taking the fixed dose combination tablet. This FDC is fully stocked at manufacturers and provincial depots. Additionally there is a buffer stock of the FDC kept by the National Department of Health to be used in the case of emergencies.

There were problems with the supply of Abacavir, Ritonavir/Lopinavir combination and Ritonavir however suppliers have resolved these problems and now all outstanding orders have been delivered to depots.

Penicillins:

The penicillins, particularly benzyl penicillin, is still facing a global supply problem as also reported on the websites of the FDA, EU and Australia. A potential source of API supply has been identified in Germany. When the stock is made available, it will need to be used judiciously. In the interim clinicians will be advised on how to manage infections with appropriate alternatives.

Vaccines:

In the case of vaccines there is a shortage of the BCG Vaccine due to the usual supplier withdrawing their product from the market. As a result, the Department of Health has imported the product from alternative international suppliers. This stock is currently in South Africa and awaiting quality release from the National Control Laboratory.

Cardiac Medicine:

Digoxin is also in short supply due to manufacturing problems - limited availability of the Active Pharmaceutical Ingredients. The local manufacturer has, however, received supplies and released some stock into the market last week. Patients may receive less stock than usual due to supply constraints.

Issued by GCIS on behalf of the National Department of Health