Eastern Cape state haematology units hit by severe shortage of chemotherapy drugs

16 May 2023

Doctors working at two Eastern Cape hospital units, treating patients with blood and bone marrow cancers, have been scrambling to find chemotherapy drugs. Patients are being turned away as stockouts impact on their treatment. Some families have turned to online fundraising or hoping for benefactors to fund their loved ones’ treatments.

Eastern Cape doctors treating blood and bone marrow cancers are in a fight for their patients’ lives as the Eastern Cape Department of Health has been unable to provide some of the chemotherapy drugs that they need.

Myron Leonard, the chairperson of the Igazi Foundation, an organisation advocating for patients with haematological conditions, said they have learnt “with shock” of the unavailability of critical medicines at state facilities.

“This places all patients at risk, but for haematology patients, this could prove fatal. The haematology unit that we support is unable to provide chemotherapy. This is a vital treatment option, as, without it, patients will die. It is indeed heartbreaking to see patients coming for their scheduled appointments, only to be turned away as the medical staff is unable to administer this vital treatment.

“The causes of this crisis need to be addressed urgently, but of more seriousness are the effects that this lack of vital medicines will have on our patients and communities.

“We appeal to all in authority, and those who have a specific responsibility in ending this crisis, to expedite their efforts in reversing this life-threatening situation,” Leonard added.

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But provincial health department spokesperson Yonela Dekeda said it was untrue that the department had had not paid its bills for one specific type of chemotherapy, cytarabine, used to treat bone marrow cancer. She said the dapartment had now received permission to use an unregistered chemotherapy drug through a special process providing for this, as its supplier was out of stock.

One patient’s family launched an online fundraiser to privately procure cytarabine for her. In another case, a benefactor sourced cytarabine for a young patient from a private cancer facility in the Eastern Cape.

Dekeda said: “The supplier of the specific product used in the treatment of acute myeloid leukaemia is the sole supplier in the country. Through the depot procurement unit, we have established that this sole supplier currently does not have any stock of cytarabine (100mg or 500mg). The department has managed to secure stock from another supplier that is not registered to supply cytarabine. The stock is expected to arrive next week,” she said.

She confirmed that state doctors were administering cytarabine to a patient who had privately procured it.

Other chemotherapy drugs that have been out of stock for weeks are vincristine, asparaginase, methotrexate and doxorubicin, an antibiotic administered to cancer patients. Some of these have now become available to doctors after months of stockouts.

Asparaginase is most often used to treat paediatric patients with blood cancers and has been out of stock for three months. Hospital sources said this was because the department’s account had not been paid, but that R46-million out of an outstanding R64-million had been paid last week.

So far the department had only responded to the stockouts of cytarabine. No response has been forthcoming on the other shortages.

Similar shortages are not experienced in other provinces. Salome Meyer from the Cancer Alliance said they also only received reports on chemotherapy shortages from the Eastern Cape.

The department is also in the process of addressing a shortage of medicine in the region, including ARVs, antibiotics, some chronic medications and vaccines.

In April, a truck delivering medicine to the NU 8 clinic in Motherwell was hijacked in Nelson Mandela Bay. After the incident, the Department of Health admitted that it had become dangerous to work in parts of the medicine depot because the roof was collapsing.

The department has admitted on more than one occasion that it cannot pay its big accounts within 30 days. At the beginning of the new financial year, a total of R361-million had been paid – roughly 73% of the total amount owed as of 31 March 2023. DM/MC

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