Dicey denial: Inside the drug shortages crisis

Nnasaretha Kgamanyane | Monday January 23, 2023 06:00

This situation is terrible for people living with chronic illnesses such as diabetes, HIV, hypertension and others, as the long-running shortage of drugs in public hospitals and clinics has forced them into an impossible choice: Buy your own or risk death.

Government says the crisis is the result of supply chain troubles across the world, as well as its own rigorous checks and standards that have resulted in the cancellation of some orders.

Opposition parties say the cause is ruling party corruption where funds for drugs have been diverted for personal enrichment.

Whatever the cause, like the grass when elephants fight, Batswana are the ones suffering.

Even though only a handful can afford to buy their medicines at pharmacies and chemists the duration of the drug shortage crisis has meant that after many visits, many have stopped taking their treatment. For Rrabanna Molefe,* who is living with diabetes and hypertension, there is another choice besides buying one’s own or risking death. The 62-year old last took his diabetes treatment in October last year and says he feels he has recovered from the chronic diseases.

The Mochudi native said he had being going up and down looking for his diabetes medicines for the whole of November with no luck. After seeing that he was “wasting” money on transport moving from one clinic to another with no luck of getting his pills, he gave up.

“Ever since then I have not bothered myself going around the clinics in search of the meds.

“I feel light and okay without them anyway. I am completely healed.

“I don’t even see the need to waste the little money I have on medicines.

“All I need to do is pray that I continue living healthy like I am today.

“I can even eat my favourite food, not those tasteless foods the doctors prescribed for me,” he confidently says.

These are the dangers that shortage of medicines has led some senior citizens to find themselves in. Many are hoping against hope that somehow the effects of skipping their medication will not worsen their conditions, while others are dicing with death and denial.

The majority of Batswana however are living in fear of losing their lives due to the shortage of medicines and pills more especially those with chronic illnesses. Those living with HIV who have had an undetectable viral load due to faithfully adhering to their treatment, may see spikes and end up falling sick due to the drug shortages.

HIV activist, Bonosi Segadimo, says the shortage of ARVs is a huge drawback for them. She adds that the shortage of meds will take them back to days of high viral loads which in turn means new infections will rise.

“Our mission of zero new infections and ending HIV will be futile.

“Our hard work of convincing people on testing, starting treatment and adhering to medication so that they have undetectable loads to save their negative sexual partners, will be unfruitful. “The Ministry of Health is failing us.

“We are trying to help at all costs but this is what we get, shortage of medicines?” she says with disappointment.

Political parties have been amping up the pressure on government to resolve the situation. Botswana National Front secretary-general, Ketlhalefile Motshegwa recently said with that state of the health sector, the ruling Botswana Democratic Party (BDP) government was “sentencing people to death”. He added that the BDP government is responsible for and must be held accountable for all deaths that will result from people not being able to take their medication properly.

“Most people die not because of severity of their illness, but due to lack of proper medical attention attributed to shortage of medicine and relevant equipment,” the secretary-general said.

“Our economy is capable of giving top notch or world class public health system in terms of infrastructure, equipment, personnel and medication.

“This is failing under BDP as they don’t have the humanity to save people’s lives.

“Funds that could be used for quality public health system are diverted to corruption, which is collapsing this country to the suffering of Batswana.”

However, in an update this week Health Minister, Edwin Dikoloti, said government has been pulling out all the stops to resolve the drug crisis, including putting in place short term interventions while working on more sustainable solutions.

“We had engaged Baylor College of Medicine to assist us to get some of our most required medications quicker,” he told the media on Monday.

“Since my last address in November, this collaboration with Baylor College of Medicine is bearing fruits.”

According to Dikoloti, a consignment of cancer medication worth P1.67 million has been received, while another batch worth over five million rands, is on the way. More consignments for various diseases are either being dispatched or finalised across the world and due to arrive in Botswana, the minister said.

“In realising the dire state of availability of medicines in the country and the challenges with sourcing, towards the end of last year, my Ministry made an appeal to our foreign missions through the Ministry of Foreign Affairs to assist with identifying and connecting us with manufacturing companies that could provide us with medicines.

“Our efforts on stabilising the medicine situation in the country are however not only focusing internationally.

“Procurement of readily available medicines and medical supplies from our local suppliers is ongoing,” he said.

He further assured the public that the issue of medications supply remains his Ministry’s top priority.

According to Dikoloti’s own assessment, the current medicine stocks around the country are stabilising and the minister expects the return to normal soon. Batswana on the ground, meanwhile, are reporting no change in the crisis, as they keep up with prayers that their diseases will not worsen while waiting for relief.