Amlodipine, metformin and a list of up to 50

The medicines running short in South Africa are not rare drugs. They are amlodipine for blood pressure and angina, rosuvastatin for cholesterol, metformin for type 2 diabetes, olanzapine for schizophrenia and bipolar disorder, pregabalin for nerve pain and anxiety, and mebendazole for worms¹. These are pills people take every day, and they are only part of the list.

The National Department of Health has confirmed the shortage to IOL. Its spokesperson, Foster Mohale, said the causes include geopolitical tensions in the Middle East, and in some cases local manufacturers not meeting the requirements of the medicines regulator, SAHPRA¹. The department says it is buying alternative medicines from other sources, and that “some patients may be temporarily switched to clinically appropriate alternative medicines” until supply recovers¹.

The opposition Democratic Alliance says up to 50 critical medicines are affected¹. It has asked Parliament’s Health Committee to call in the health minister, the department, SAHPRA, the local manufacturers’ body and the pharmacists’ society¹. Its health spokesperson, Michele Clarke, named the risk that matters most: patients “might be fearful of replacement medication or confused by replacements and then stop their treatment”¹.

She has a point, and the answer to it is not exciting. A switch from one blood-pressure pill to another is routine for a clinician. It is unsettling for a patient who has been handed the same box for years. Supply rarely fails at the ship. It fails at the counter, when nobody explains the new box.

If you or someone you look after is handed an unfamiliar replacement, anywhere, ask the pharmacist two questions: is this the same kind of medicine, and what should I watch for? Then keep taking it. Shipping lanes and factory inspections are out of your hands. Staying on your treatment is the part you control.