Too little, too late – lifesaving chemotherapy drugs for kids finally arrive at Eastern Cape hospitals
A month after the Eastern Cape Department of Health promised that they had paid the overdue bills that delayed the delivery of chemotherapy drugs to Nelson Mandela Bay hospitals and that the issue would be solved, crucial chemotherapy drugs finally started arriving at Port Elizabeth Provincial Hospital. But it was too late for some children, who have missed a cycle of treatment, leaving them at high risk.
A month ago, the Eastern Cape Department of Health assured the public that it had paid the overdue bills for pediatric chemotherapy drugs and that the problem was solved.
Only it wasn't. And medical teams were thrown into a race against time to prevent their little patients from defaulting on their treatment.
Crucial chemotherapy drugs needed to treat five children, who have already missed a full cycle of treatment, only arrived at Port Elizabeth's Provincial Hospital on Thursday, 12 June. The five children were just the most serious of cases – many others also missed a day or two of treatment and newly diagnosed patients could not receive their initial treatment.
The additional month's waiting could have devastating consequences for the patients.
One pediatric oncologist, who works in another province, said they have seen cancer returning if a child misses a cycle of chemotherapy, and sometimes the returned disease will be resistant to first-line drugs.
On 19 May, the department indicated that overdue bills, which were the reason for the outage, were paid and that drugs will be delivered.
Documents from senior officials in the department that have been confirmed with three sources as authentic, however, show that on 21 May, doctors were warned that 11 types of chemotherapy were not available, and in four of these cases it was due to 'closed accounts'.
It is understood that companies wanted a bigger part of their overdue bills paid after an initial payment was made. Carboplatin, one of the crucial chemotherapy drugs, was, however, reported to be out of stock with a contracted supplier and needed to be sourced from another supplier.
On 2 June, outages were still not addressed and the hospital had no Betamethasone, no Carboplatin, no Dacarbazine, no Methotrexate, no Leucovorin, no Polygam – either 6 grams or 12 grams – no Melphalan and no Spironolactone.
Pharmacies had received Vinblastine (two months of stock) and Vincristine (commonly given as an IV injection – six months of stock).
For the next 10 days, patients needing chemotherapy drugs that were out of stock were sent away. Yesterday, on 11 June, an entire contingent of patients were again sent away – five of them have by now missed an entire cycle of chemotherapy or three weeks of treatment.
The South African Human Rights Commission (SAHRC) has launched an investigation into the repeated interruptions of cancer treatment for public healthcare patients in the Eastern Cape.
Dr Eileen Carter from the SAHRC said the Democratic Alliance (DA) had laid a complaint with them about the matter.
The oncology units in Gqeberha previously ran out of chemotherapy medication in January after the Eastern Cape Department of Health's account with a supplier was suspended due to a delayed payment.
At the time, the medicines that were in short supply were Docetaxel injection vials and Anastrozole tablets.
On Sunday, Sizwe Kupelo, the spokesperson for the Eastern Cape MEC for Health Ntandokazi Capa, said the department 'wishes to reassure members of the public that drug availability in our facilities is one of the top priorities'.
'An amount of R284-million has been made available to pay pharmaceutical companies and order medicines. As of the past two weeks, R60-million was disbursed and various suppliers have already started deliveries. This week, orders and payments will continue to be made. To monitor progress, the head of the department, Dr Rolene Wagner, has established a task team led by a chief director to coordinate the whole ordering and delivery of medicines, with oncology being a priority.
'Pharmacists from all oncology departments in all three of our major hospitals also had a meeting with the HOD and pharmaceutical services in Bhisho to discuss their stock levels. We wish to re-emphasise that payment of service providers is no longer an issue at this stage and medicines are being delivered.
'However, we have been made aware that some companies that are on the national contracts do not have certain products available, due to global supply chain issues.
'To address this, the task team and relevant managers are liaising with the national department to seek permission to procure outside the contracted companies,' he said.
This process appears to only have been started two weeks after the out-of-stock chemotherapy drugs crisis was confirmed.
'Once again, this is a priority to both the MEC and the HOD, and both offices will continue to monitor and provide support to colleagues on the ground,' Kupelo said. DM
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