The global shortage of tuberculosis (TB) drugs and stockouts have reached critical levels, with Motherwell Community Health Centre in Gqeberha, Eastern Cape, left with only five boxes of Rifinah, a vital fixed-dose combination of two anti-TB drugs, rifampicin, and isoniazid. Health workers at the clinic are facing the challenge of rationing medicine, giving patients only seven days’ worth of pills instead of the standard four-month supply.
The standard treatment for pulmonary TB typically lasts six months, with a combination of isoniazid, rifampicin, pyrazinamide, and ethambutol in the first two months, followed by isoniazid and rifampicin in the last four months, usually administered in the form of rifinah. South Africa, one of 30 countries with a high TB burden, recorded 270,000 new cases in 2023, with over 240,000 people receiving treatment.
The World Health Organization (WHO) has confirmed the global shortage, particularly affecting rifampicin, the most commonly used first-line anti-TB drug. National health spokespersons acknowledge the stockout impact, with efforts to redistribute available stock between provinces and facilities.
The shortage poses significant risks, with concerns that treatment interruptions could lead to patients defaulting on their medication and developing drug-resistant TB. Research shows that even a 10% rise in TB drug stockouts can lower cure rates, impacting treatment success and increasing the likelihood of patients relapsing or developing severe forms of the disease.
Professor Susan Purchase from Stellenbosch University’s Desmond Tutu TB Centre emphasizes the importance of uninterrupted treatment to ensure TB eradication and prevent transmission. The shortage’s impact has been attributed to the unreliability of pharmaceutical ingredient suppliers prequalified by the WHO and the shift towards WHO prequalified suppliers by high-TB-burden countries, adding pressure to the global market.
While alternative treatments are being considered to address the shortage, the WHO reassures that treatment adherence is being maintained. In South Africa, interim therapeutic alternatives have been proposed, such as using rifapentine in combination with isoniazid as a substitute for rifinah. The health department aims to resolve the shortage by May 2025, emphasizing the importance of continuity of care and ensuring patients receive the necessary treatment despite the challenges posed by the drug shortages. Health-e News is a leading source of health information and news that keeps readers informed about the latest developments in the medical field. From groundbreaking research to innovative treatments, Health-e News covers a wide range of topics to help readers stay informed and make informed decisions about their health.
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