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Report: Emergency Intervention at Mthatha Depot: The hidden cost of inaction

In early December, the Mthatha medical depot – serving more than 300 medical facilities in the North-eastern region of the Eastern Cape for medical supply needs – faced severe supply and delivery disruptions of life-saving HIV and tuberculosis [TB] treatment for over 100,000 patients. Stripped of 70% of its workforce due to suspensions in a labour dispute, the faltering management of the depot collapsed and critically compounded existing stock shortages at the depot, hospitals and clinics in the area. Orders had not been processed, supplies not received and, ultimately, drugs not dispensed to patients most in need. As a result, the danger of treatment interruption for HIV and TB patients was a perilous reality.
After Section27 and the Rural Health Advocacy Project (RHAP) received pleas for help from distressed health care workers on the ground and with the consent of the responsible health authorities, MSF and TAC started a coordinated response. MSF hired a temporary workforce and cleared the backlog of drug orders by coordinating stock reception, order processing and deliveries to affected facilities. TAC set up and maintained a drug stock-out hotline and monitoring network to help prioritise essential drug delivery to clinics. The Department of Health complemented the MSF/TAC intervention by sending three experienced pharmacists to assist at the Mthatha depot. Read the full report here

IST reports on the state of the health system and the public's right to know

More than a year after their finalisation and after many frustrated attempts by civil society organisations and the media to access them – including through the Promotion of Access to Information Act, 2000 – SECTION27 and the Rural Health Advocacy Project (RHAP) have finally been leaked copies of all the provincial reports compiled by the Integrated Support Teams (ISTs). Up to this point, the only report we have received officially is a consolidated report available here. This report is important, but lacks the necessary detail to allow civil society to engage with different challenges in different provinces.

The IST reports on each province were commissioned by the former Minister of Health, Barbara Hogan, in response to the massive budgetary shortfalls that over-whelmed provincial departments of health (PDoHs) in the 2008/2009 financial year, which reached crisis levels when the Free State Department of Health issued a moratorium on the initiation of new patients onto antiretroviral treatment in November 2008. After civil society pressure, that moratorium was finally lifted in February 2009.

Reports of the Integrated Support Teams

The reports on this page are those of the Integrated Support Teams (ISTs) which have been provided to SECTION27 and the Rural Health Advocacy Project (RHAP). The IST reports were commissioned by the former Minister of Health, Barbara Hogan, in response to the massive budgetary shortfalls that over-whelmed provincial departments of health (PDoHs) in the 2008/2009 financial year, which reached crisis levels when the Free State Department of Health issued a moratorium on the initiation of new patients onto antiretroviral treatment from November 2008 to February 2009.

10 reports were commissioned in total, one for each provincial department of health and one for the National Department of Health – which we have not been able to access as of yet. In addition, a Consolidated Report was produced that pulled together findings from the individual department reports. These reports contain an honest, sobering assessment of the inadequate financial capacity of provincial departments of health that have led to the development of over R7.5 billion in provincial debt as of April 2009. The findings in these reports reveal fundamental failures in political and bureaucratic leadership, inappropriate financial management systems, inadequate monitoring and evaluation systems, and a failure to plan appropriately for human resources, amongst others.

Current OSD offer still disadvantages rural communities

The Rural Health Advocacy Project, Rural Doctors Association of Southern Africa, SECTION27 and Wits Centre for Rural Health support SAMA’s rejection of the final OSD offer to public sector doctors. By accepting the Government’s OSD offer, collective labour in the Public Service Coordinating Bargaining Council will be contributing to a major setback in Government’s strides to achieve health for all. By offering only marginal increases to medical officers in particular, rural communities are likely to see a further exodus of rural doctors to urban areas, the private sector, and overseas.
Rural patients are disadvantaged in many ways: poverty levels are higher, access to basic services and education is poor, travel to health facilities is costly, facilities are understaffed and waiting times are out of control; now they can expect even fewer doctors to attend to their needs.