Patients who are not receiving chronic anti-retroviral and tuberculosis medications due to stock-outs at clinics are worried that they will develop resistance to their treatment.
In one clinic – the JJ Clinic in Soshanguve – patients are reportedly being given just 20 pills instead of the full monthly supply, while some clinics are borrowing from others, and pregnant and breastfeeding women are being prioritized for treatment in yet other clinics.
“Just last week I was given 20 Lamivudine instead of a full month’s supply. I am worried about it because those patients without it might be at risk of defaulting,” said Octavius Mdzipa of the Treatment Action Campaign in Soshanguve.
Area sister Salamina Mashigo said: “I know about the Lamuvidine problems, but they’ve been solved now. We had stocks last week.”
One patient, who wanted to remain anonymous, said he’d been given D4T (Stavudine), a drug that has been phased out because of its reported side-effects, at the JJ Clinic.
“I have been given the D4T ARVs. I didn’t know it had been phased out. Eish, I’m worried,” he said.
D4T is reported to cause peripheral neuropathy- nerve damage in the feet, legs and hands – which can cause numbness, tingling or pain in the extremities.
Mashigo said she was not aware that JJ Clinic was dispensing D4T, but that she would investigate.
However, clinic manager Isaac Moremi said: “According to protocol there is no need to switch a patient from Stavudine as long as they are not experiencing side-effects. We are still dispensing it.”
He said: “No patient from my clinic has ever received a too-small supply of Lamivudine. However, I agree that there was a shortage, but we got stock last week. Things are back to normal now.”
Meanwhile, a follow-up visit to Tlamelong Clinic in Tshwane confirmed that 3 750 packs of Lamivudine had been delivered. A staff member there told Health-e News: “We are struggling to communicate directly with the regional pharmacy to place orders and we are advised to put orders in through an official at the regional office.”
The same clinic has not had stock of Efivarenz 200mg and 50 mg, used for children, for the past two weeks, “even after submitting emergency forms”, said one sister who did not want to be named.
She said that Griseofulvin, which is used by HIV patients who developed skin reactions to other treatments, has been out of stock “for months”.
“The Fixed Dose Combination (FDC) is only given to pregnant women and women who are breastfeeding,” she said. “We decided to prioritise the ante-natal clinic.”
Other drugs that have been reported as being out of stock are family planning and pain medications.
A patient at Phillip Moyo clinic in Ekurhuleni last week reported that she travels a long distance for her medication and has to start queuing at around 4.30am. She had to wait three weeks to get her medication.
“My body was starting to feel tired and I was starting to feel dizzy. I have never defaulted on my treatment for three weeks. I am scared that I will become resistant to treatment.”
Another patient from the same clinic reported that she had been dismissed from her job for being absent every Thursday, which was the day she went to the clinic week after to week to see whether she could get her treatment.
A nurse who did not want to be named said that there was no pharmacist at Sedilega Clinic and a nurse was acting as pharmacist.
“It is now the norm for clinics to borrow medicines from neighbouring clinics, which creates bad relations.”
According to staff at Tlamelong and Sedilega, most of their patients are from Lesotho, Zimbabwe and Mozambique and had previously attended the Hope for Life Clinic in Winterveld, which closed when it lost its funding form the US President’s Emergency Plan for AIDS Relief (Pepfar).