Cape Town – Sifiso Mkhasibe, a 36-year-old man who has been on chronic medication for bipolar disorder since 2007, lives in fear that one of these days he would just relapse and again experience acute depression episodes.
He was one of many mental health patients across the country facing the spectre of relapsing due to the unavailability of medication.
South Africa has experienced a drugs stock problem over the last few months, which saw patients going without prescribed medication or being given substitutes.
Mkhasibe, a stakeholder engagement leader at the SA Federation for Mental Health, was one of the speakers yesterday in a webinar discussing the out-of-stock crisis.
Experts and activists for medicine access told the webinar scores of patients on chronic medication faced the prospect of relapsing as the stock drama plays out.
Mkhasibe attested to being victim to the stock shortage and said he feared the consequences of the crisis.
“Medication stock-outs means that I receive different medication that was not prescribed to me as a substitute,” said Mkhasibe.
“This prevents me from being treatment-compliant and could cause me to relapse.
“I have a fear of relapsing due to medication stockouts. This has a negative effect on my mental well-being.
“Relapsing will undo all the years of hard work it took me to reach a point where I have been stable and healthy.”
The mental health activist said he knew other patients sharing his predicament.
“I have come across a lot of people who have struggled to get access to medication, especially at local clinics or local hospitals.”
The South African Depression and Anxiety Group (SADAG) received scores of calls from patients reporting that they were not getting their chronic medication, said operations director Cassey Chambers.
“It affects so many patients. Because of Covid-19, we’ll see this issue even escalating further,” she told the webinar.
“Many of our calls we received through our suicide helpline is often patients who have recently stopped taking medication or have been forced to stop taking medication because of stock-out or even cost.”
Dr Frans Korb, a psychologist in private practice, said both the government and pharmaceutical companies should take the blame for the stockout
“I think pharmaceutical companies need to take responsibility for that. Logistically, they need to plan. They need to know how much stock is in the country,” he said.
“I think the question of stockouts from a pharmaceutical point of view is unacceptable and really something needs to be done about that.”
It could never be stressed enough that patients needed to stay on their medicine.
“If a patient does not take medication for a week or longer, the chances of relapse are so much greater,” said Korb.
Switching patients to substitutes was not the answer to the supply problem, he added.
“We’ve had patients over time where you did them to another generic (and) that generic did not work as well as the original. So, switching is not always the answer to a generic.”
The stockout problem cuts so deep that even substitutes were not available, said Ruth Dube, from the Stop the Stockout Project.
The unavailable medication she listed included Haloperidol, Lithium, Olanzapine, Diazepam, Lamotrigine and Amitriptyline.
“Some of these were alternatives to the original. It becomes a concern when an alternative also goes in the list of stockouts,” said Dube.
“We need to speak out in a voice that is audible enough on behalf of the patient.”