Covid Causes Shortage of Psychiatric Drugs in South Africa

South Africa has been hit by a shortage of mental health medication and contraceptives as the coronavirus outbreak and the associated lockdown disrupted manufacturing and imports.

The number of so-called stock-outs, when a medicine is unavailable, has doubled this year to over 1,400 reports, according to Ruth Dube, project coordinator at the Stop Stockouts Project, a non-profit that campaigns to end medicine scarcity. Medicines that have run short include lithium, used to treat bipolar disorder, as well as the injectable contraceptives Depo-Provera and Nur-Isterate, made by Aspen Pharmacare and Bayer AG respectively, according to Dube.

Regarding lithium, “my understanding is that there is an inadequate stock for the country, possibly less than half of what we need for the numbers of patients we’re treating currently,” said Lesley Robertson, a psychiatrist and head of the clinical unit at the state’s Sedibeng District Health Services.

South Africa, the country in Africa with the highest number of confirmed coronavirus infections, embarked on a strict five-week lockdown in March to try and prevent the spread of the pathogen. Some restrictions are still in place and the closure of factories and ports has affected a range of goods.

Aspen Pharmacare, which supplies lithium under the name Camcolit, said there is no shortage.

Teenage Pregnancy

The Gauteng Department of Health, which oversees health matters in South Africa’s most populous province, said the scarcity is due to a shortage of ingredients needed to make the medicines. Demand also rose during the lockdown, while local manufacturers had their operations interrupted, the department said in an October statement.

A third of 242 public health facilities surveyed in May had shortages of injectable contraceptives, according to Dube.

“Sexual reproductive health is essential and a right to all women, any violation can lead to a life-threatening position for the women and serious consequences to the communities,” Dube said by email. “These stockouts contribute to teenage pregnancy statistics” and lead to girls dropping out of school, she said.

The mental health medication shortage has been exacerbated by an announcement by Pfizer Inc. in September that the manufacture of intramuscular haloperidol, used to treat mood disorders, has been discontinued in South Africa. Pfizer stopped producing the anti-psychotic medication for “reasons beyond its control,” Vuyo Mjekula, the company’s communications chief in South Africa, said by email.

“The shortages and stockouts of medicines often lead to interruptions of treatment in which some patients end up disengaging from care, risking loss of lives,” Dube said. Appropriate generic alternatives can’t always be found.

Bayer AG could not be reached for comment.

©2020 Bloomberg L.P.

BQ Install

Bloomberg Quint

Add BloombergQuint App to Home screen.