SA hurdles cause medicine crisis

12 June 2020 | Health

Windhoek • [email protected]

Urgent work by private and government parties is underway to address a crisis that has led to depletion or severe scarcities of a wide range of chronic and specialist medicines in Namibia following Covid-19 induced export regulation amendments in South Africa two months ago.
“We are experiencing a shortage of medicine in the country which I in my more than 20 years of practice, have never experienced before,” Ulrich Ritter, vice president of the Pharmaceutical Society of Namibia (PSN) says.
Ritter said last week alone he was informed that South African authorities had rejected more than 100 permits for exports of medicines, including crucial chronic medications, into Namibia.
At one point, he said, of more than 60 products ordered by his pharmacy, only eight were received.
Ritter stressed that the interruption of available medicine for patients reliant on chronic or specialised medicine is significant and worrying.

Import battle
The import battle began in March when South Africa introduced new regulations around the export of medicines, which has changed the average time it takes from point of order until goods arrive in Namibia and created additional permit application hurdles.
And, while pharmacists have worked together to share available medicines for patients and increased the amount of stock held on-site to compensate for shortages, this has burdened the entire supply chain costs amidst an already struggling economic situation for businesses.
Ministry of Finance spokesperson Tonateni Shidhudhu on Monday confirmed the ministry is aware of the problem after the matter was brought to their attention by the health industry forum of Namibia, who have requested an urgent intervention.
“The problem is not with our customs but on the side of South Africa, because of the new regulations by the South African Revenue Services (SARS) which requires distributors of medicines and certain identified items to apply for a permit from the International Trade Administration Commission (ITAC) to export medicines to other neighbouring countries,” Shidhudhu explained.
He added that the ministry is taking the matter “very seriously, and we are currently engaging with SARS to find amicable solutions”.

The import problems are two-fold, those in the know explain.
The new ITAC export control regulations, implemented in late March by the South African department of trade and industry, muddled the waters concerning certain categories of medicine and the permits required to import them into Namibia. Moreover, SARS required further permit documentation which added to the red tape to bring medicines across Namibia’s borders.
In addition, once the problems began, the lockdown regulations both in South Africa and Namibia confounded to the problem.
The most worrisome challenges for health professionals and patients are the depletion and scarcity of chronic and specialist medicines related to HIV, blood pressure, cancer, diabetic, contraceptive and mood disorder treatments.
“The problem is not a Namibian issue but a South Africa problem. It is not a stock issue, it’s a permit issue,” a pharmacist explained.
“We are trying to remain positive but for the past eight weeks, there has been practically no medicine coming in. Last week we started getting some of the medicines, and we are trying to remain hopeful that the issue will be resolved soon,” a spokesperson for Nampharm said on Monday.

The spokesperson said over the past week permits and stock for diabetic, HIV and organ transplant medicines were green-lighted or finally arrived in Namibia.
Nevertheless, the red tape is still preventing medicines for TB, cancer, blood pressure and contraceptives being processed.
“We pharmacists have created Whatsapp groups where we can alert each other to medicinal needs, and invariably someone can help. But it’s a very worrying problem. With some medicines there are no substitutes and when changing a patient’s medicine, you don’t know how they will react,” a pharmacist said on condition that he not be named.

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