South Africa's New National Drug Policy

Abstract

What kinds of social policy interventions will enable South Africa to offer a universal, free and sustainable antretroviral treatment programme? Some commentators assert that government's best chance at offering such a programme will require the use of compulsory licenses and that the state's failure to make use of such a weapon is a failure to discharge its constitutional duties. The authors demur. The threat of a compulsory license is only as good as the ability to make use of such a license. South Africa currently lacks the basic science community, reverse engineering capacity and fine chemicals industry necessary to make good on such a threat. The government's best hope for discharging the duties imposed by the Constitution is a systematic, structural intervention: the implementation of a socio-industrial policy that leverages existing industrial capacity and voluntary licenses in a manner that generates price reductions and offers an uninterrupted sustainable local supply. However, voluntary licenses will only create downward pressure on prices when South Africa is able to establish a robust generics pharmaceutical industry. Such an industry can be created with appropriate tax relief, investment credits, technology transfer and assured access to active pharmaceutical ingredients. South Africa's industrial, legal and financial resources can thereby be profitably exploited in a manner that progressively achieves a comprehensive and coordinated antiretroviral treatment programme.

Quality of generic medicines in South Africa: Perceptions versus Reality – A qualitative study

“…This study shows that the gap appears to lie in how these strategies have been communicated to consumers and healthcare providers. The South African government, through the National Medicines Policy and the Essential Medicines Programmed has recommended that tertiary institutions introduce concepts like generic medicines, essential drugs and standard treatment guidelines into undergraduate medical, nursing and pharmacy curricula [22]. These concepts must be embraced by all: students, academics, professional councils and associations to ensure there is a common understanding and for common messages to be shared with the public regarding quality and safety of generic medicines.…”

The process of changing national malaria treatment policy: lessons from country-level studies

“…Availability of donor money, global/national importance of the specific health condition, political stability within a country, competing health and other priorities, differential influence of the Ministry of Health (MoH), previous policy success, and opportunistic timing, all influence receptiveness. Politicians' personal values and other potential conflicting interests, for example the pharmaceutical industry's profit motive, may also influence policy success (Zuma 1997). Systems of political governance and the degree of decentralization are additional influential factors.…”

“…It is essential to include representatives from the distribution and logistics component of the MoH early in discussions about drug policy changes to ensure that the new drugs are available when needed, stock-orders are filled, and previously recommended treatment is physically removed from health facilities. Issues for consideration include distances to facilities, frequency of deliveries, vehicle maintenance, management skills in pharmaceutical stock inventory and the ability to forecast periods in which additional drug supplies may be needed, such as during epidemics (Zuma 1997).…”

An Exploratory Study Into the Use and Pricing of Schedule Zero Medicines Post Exemption From the Single Exit Price Policy in South Africa

“…In 1996, the then Minister of Health, Dr Nkosazana Dlamini Zuma, expressed dissatisfaction at medicine pricing in South Africa and spoke of a new medicines policy, at a time when the country's medicine pricing was amongst the five highest in the world (Zuma, 1997). A National Drug Policy was developed that outlined initiatives to make medicines more affordable and for prices of medicines, from the manufacturers to the point of sale to the patient, to become transparent (Zuma, 1997).…”

“…In 1996, the then Minister of Health, Dr Nkosazana Dlamini Zuma, expressed dissatisfaction at medicine pricing in South Africa and spoke of a new medicines policy, at a time when the country's medicine pricing was amongst the five highest in the world (Zuma, 1997). A National Drug Policy was developed that outlined initiatives to make medicines more affordable and for prices of medicines, from the manufacturers to the point of sale to the patient, to become transparent (Zuma, 1997). which manufacturers shall sell medicines... to any person other than the state", with pharmacists and dispensing practitioners being allowed to charge a "dispensing fee", these provisions coming into effect in 2004 (Berger, 2004;Gray, 2009).…”