Psychiatrist for the South African Depression and Anxiety Group, Doctor Frans Korb, says non-adherence to the correct medicines due to drug shortages, could have an impact on the long-term mental health of patients. This emerged at a webinar on the impact of medication stock-outs on mental health.
Korb was addressing a webinar on the impact of medication stockouts.
NGOs – Section 27 and Stop The Stock-Outs Project – say logistical issues and inadequate stock control methods contribute to stockouts.
Korb says patients could even suffer a regression if the correct medicines are not available over a long period of time.

“If we do not treat people with psychiatric diseases from the beginning properly, aggressively and get the disease under control as soon as possible. The long term prognosis becomes much worse. In the long term, the prognosis is poorer if they don’t treat them properly with psychiatric medicines. Most of these diseases are life long diseases. The taking of medication, staying on it, being compliant and adherence is absolutely important.”

A drug stock-out refers to a situation where an item – in this case, medication for mental healthcare – is out of stock and not available to be dispensed to a patient.

While this online discussion focused on the issue related to drugs for the use of mental healthcare management, medical experts say that the availability of ARV and TB drugs is also a challenge in South Africa.

Korb has also cautioned against patients simply accepting generic medicine options without consulting a doctor.

Dealing with depression and anxiety during the pandemic: 

Right to health

Tendai Mafuma is a legal researcher at the non-profit organisation, Section27. Section27 is a public interest law centre that advocates for the right to health and basic education.

Mafuma says the State has a responsibility to ensure proper monitoring and distribution systems.

“Because we know that sometimes, there are issues with active pharmaceutical ingredients. We’ve got issues with strikes but we need a supply chain that is flexible enough to respond to those issues. We need to be able to monitor stocks in facilities because unless we do that we don’t know what people are using and needing. Ideally, it should be an electronic system we are quite advanced now we shouldn’t be using pen and paper to be checking stock in our facility.”

Ruth Dube is with The Stop Stock-outs Project. The consortium of six civil society organisations assists South Africans who cannot access essential medicines. They play a critical role in monitoring drug stock-outs and understanding why this happens. Dube explains some of the challenges from local to national level.

“We have been getting a report on ordering issues, logistics and staffing. These have been affecting the local stock-outs. At the provincial level, we see supplier and payment issues arising. Then with the national stock-outs, you start realising production backlogs come in, price hikes as they are involved in pricing negotiations. Production issues in the global area.”

SADAG’s Cassey Chambers shared some practical tips on how patients on critical chronic medication can manage when there is a stock-out.

“If there is not stock or they don’t have availability then ask when is it going to be available? It could be a week or 2 away. And to ask how many tabs they have right now? Do they have a week’s stock for at least seven days they will have medication? Another thing we also try to help patients with regards to compliance is not to wait to the last day to refill your script. It’s also important that if there is a stock out that the patient notifies the doctor. And to check with the doctor first before just switching at the pharmacy.”

Families are also encouraged to play an active role in assisting their loved ones who experience stock-outs with their chronic mental health medicines, to ease the panic and manage the situation through proper planning.