The government's flagship HIV anti-retroviral programme has hit a major snag, with the health department instructing provinces not to put any more children on treatment.
Dr Nono Simelela, head of the HIV unit in the department, on Monday said the government had instructed provinces not to put children on treatment until it was clear that the anti-retrovirals could be supplied without interruption.
Simelela said the glitch was as a result of an "apparent incapacity" of the pharmaceutical industry to cope with the demand for anti-retrovirals.
"Demand for the anti-retrovirals far outstrips supply," she told The Star regarding the challenges brought by the rollout, announced by the cabinet in March.
Simelela said even adults who needed the "life-prolonging" drugs had been waiting to be put on the anti-retroviral treatment. In the Free State, for example, about 269 were put on hold, she said.
The reason they had to wait, she emphasised, was because it was important for the government to ensure that pharmaceutical companies were able to cope with the demand.
"This is important, because once you start treatment, you can't afford to miss your medication for a single day," Simelela said.
What also troubled the pharmaceutical industry, she noted, was that the number of those willing to be put on the programme kept on increasing.
Concerning problems on the provision of drugs to children, Simelela said children received either a tablet (which must be crushed before consumption) or a syrup.
"A major problem here is that these drugs, known as paediatric formula, may not be stored for a longer period. It is a challenge for the pharmaceutical industry to ensure that the medicines are manufactured, packaged, bought, distributed and used in a short space of time," said Simelela, cautioning that if this was not strictly adhered to, the body develops resistance to the drugs.
Dr Humphrey Zokufa, the health department's cluster manager for pharmaceutical policy and planning, added that delivery problems were compounded by two critical factors.
"Some of the companies dealing with generics either did not have voluntary licences to manufacture drugs locally, whose patents were held by international companies or their medicines were not yet registered with the Medicines Control Council. This has caused a major delay."
Stavros Nicolaru, vice-chairperson of the National Association of Pharmaceutical Manufacturers, said the claim that the pharmaceutical industry was failing to cope was true only to the extent that the government failed to provide consistent figures of the supply needed.
Zokufa said this was because new people came forward daily requesting to be put on the programme.
Nicolaru said: "If the government says it needs, say, 10 000 Simelelas in three months and for how long, then the industry will be able to provide. There is sufficient capacity."
"If you say you need 10 000 anti-retrovirals next week, you will not get them because that process takes time."
Zackie Achmat, of the Treatment Action Campaign, disputed the government's claims and said he hoped April's anti-retroviral rollout announcement was not an election gimmick.
"The national ministry and Dr Simelela, who is deserting a sinking ship, is placing the lives of children and people living with HIV at risk by playing games and manufacturing scarcity where none exists."
"The national ministry and Dr Simelela have been completely derelict in procuring the medicines. Our own investigations show that both the generic manufacturers and the brand-name pharmaceutical companies have sufficient stock supplies."
"We urge the government not to put us in the position to take it to court again," Achmat said. - Political Bureau