South Africa’s public hospitals and clinics are facing severe shortages of essential medicines, forcing healthcare facilities to find alternatives or send patients to private pharmacies. The Health Department’s October shortage “hotlist” identified 165 critically scarce products, including cancer and psychiatric medicines, while its broader November list contains 1,135 medicines provinces can procure.
According to experts the crisis is being worsened by port congestion, global supply disruptions, Middle East conflicts, manufacturers discontinuing unprofitable older medicines and provincial payment delays.
Tender cycles also create uncertainty because demand forecasts may not match actual provincial needs, discouraging manufacturers from bidding and limiting supplier competition.
The department is seeking alternative suppliers, special Section 21 imports and substitute medicines, while helping provinces resolve payment problems. Regulatory breaches have also resulted in some production-line closures.
Psychiatrists warn that shortages of schizophrenia and bipolar medicines are particularly dangerous. Switching patients to alternatives can cause side effects, treatment failure and relapse, potentially leading to hospitalisation. – Business Day 5 November 2026)