The reported shortage of bilharzia medication, which has forced public healthcare patients to purchase costly alternatives from private pharmacies, raises serious questions about medicine supply and accountability in the state health system. The Witnessreported this week that pharmacies around Pietermaritzburg have struggled for months to obtain praziquantel, the standard treatment for bilharzia. As a result, patients have been left with little choice but to turn to private pharmacies, where alternative or compounded versions of the drug can cost R600 or more.
Bilharzia, or schistosomiasis, is a parasitic disease that predominantly affects children and people living in poorer communities with limited access to safe water. It is a disease closely linked to inequality and poor infrastructure. For that very reason, its treatment should never be priced out of reach.
Praziquantel is listed by both the World Health Organisation and South Africa’s Department of Health as an essential medicine that should be readily available at public healthcare facilities. Yet, patients relying on the state system have been forced to pay unaffordable prices for basic treatment, or go without it altogether. One elderly patient described paying over R600 for alternative medication after being warned that the standard treatment was unavailable.
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The cost was not covered by medical aid and placed a significant financial burden on him. His concern is shared by many: How can treatment for a common, preventable disease be inaccessible in a country where unsafe water makes it more prevalent? While the department has denied a national shortage, citing procurement challenges and expired stock, the reality remains unchanged.
If there is no stock problem, then it is incumbent on the department to ensure medication is sourced before patients are turned away. Forcing the poor to pay steep prices for essential treatment is not just a systems failure; it is an injustice. It denies people their right to healthcare and exposes the cracks in a system that continues to let the most vulnerable fall through.
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