Nelson Mandela Bay hospital patients left in the lurch after health department’s bureaucratic bungle

After several days of stockouts, a new batch of a crucial chemotherapy was expected at the Port Elizabeth Provincial Hospital on Thursday, but the Eastern Cape Department of Health indicated that it was still negotiating for its account with the manufacturer to be reopened for another drug needed.

Last week, several outages of chemotherapy were reported at the Port Elizabeth Provincial Hospital where pediatric oncology patients are treated. These included: Methotrexate, Folinate and Polygam.

Polygam is a crucial immune-boosting product used in the treatment of many pediatric oncology patients.

Sources at the metro’s public hospitals have confirmed the stockouts.

This year alone, similar shortages were experienced in January and in May running into June.

Read more: Eastern Cape cancer patients face more delays in getting critical chemotherapy

In 2024 researchers, who published their data regarding the barriers for children to access cancer care in South Africa, called for increased political and policy developments to address the issue given the dire situation in the country. 

They identified a lack of access to crucial medicine as one of the major barriers to medical care for pediatric oncology patients.

Other key barriers included the discontinuation of essential chemotherapeutics, incomplete insurance coverage for childhood cancers, the inability to access care, including travel to healthcare facilities, and low awareness of childhood cancers among primary healthcare workers. 

In this article, the authors remarked: “On a local level, some healthcare providers indicated having reliable and timely procurement processes in place in their respective hospitals, whereas others expressed frustration at the lack of compassion and urgency from other members of the procurement chain when confronted with stockouts.

“Participants speculated that not all members are aware that medicines on the National Essential Medicines List should always be available. Additionally, communication with the provincial medicine depot can be arduous, causing delays in procurement. Some healthcare providers also suggested that distribution systems are inadequate, with products not reaching treatment facilities or no ability to maintain cold chains.”

Eastern Cape Department of Health communications director Siyanda Manana also confirmed the current stockout.

“Two key processes have been implemented to prevent stockouts of oncology medicines, which include the weekly monitoring and reporting,” he said.

“Oncology medicines are monitored and reported on weekly. Any shortages identified are addressed through interfacility stock transfers to ensure continued availability.

“A dedicated team reviews supplier payments weekly to rationalise the budget, prioritising oncology suppliers and engaging them directly to maintain supply continuity.”

He said on Thursday that Methotrexate (MTX) was made available at the provincial depot in Nelson Mandela Bay and added that Folinic Acid (Folinate) will be delivered on Thursday.

Manana said they have been struggling with “inconsistent supply” of Polygam since 2024 due to challenges at the contracted supplier and the temporary suspension of the department’s accounts. 

“Accounts are reopened through ongoing negotiations to allow delivery. The supplier currently has stock available, pending account reopening,” he said. He did not indicate when this will happen. 

He said they are also conducting proactive monitoring, prioritised supplier engagement and financial management, and these have been key in mitigating oncology medicine shortages.

Read more: Too little, too late – lifesaving chemotherapy drugs for kids finally arrive at Eastern Cape hospitals

In May, the hospital was also hit by an extensive stockout of chemotherapy drugs that ran into June, causing five children to miss a full cycle of treatment.

Earlier this year (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.

In January, patients with Hodgkin’s lymphoma and other cancers had to receive a different chemotherapy, not considered to be most efficient, after a stockout of first line treatment at Port Elizabeth Provincial Hospital. This also affected patients’ eligibility for bone marrow transplants.

At the time, the South African Human Rights Commission opened an investigation into the issue after a complaint was laid by the Democratic Alliance. DM