As the Covid-19 pandemic ravages the globe, there are fears of a possible spike in the level of disruption of health care services and the medical supply chain especially for essential medicines.
This fears have forced some of the countries to take precautionary measures to ensure a constant supply of medicines for treatment of certain health conditions that could be exacerbated either by the constraining of the health care systems or possible restrictions in trade of such medicines in the world market.
South Africa is one of the African countries that has announced export restrictions on selected medicines, vaccines and Covid-19 protective gear for the period that the pandemic will remain a national health threat.
The country’s Minister for Trade, Industry and Competition Mr Ebrahim Patel has effected the restrictions Gazetting amendments to South Africa’s export control regulations that will see hydroxychloroquine, selected human vaccines and selected Covid-19 control products grouped under the restricted export items under the International Trade Administration Act of 2002. (1)
The Act controls the import and export of goods among five countries that form the Southern African Customs Union including Botswana, Eswatini, Lesotho, Namibia and South Africa.
“We have to ensure that there are adequate supply of key pharmaceutical and medical supplies so that we can prevent and treat those get sick during this next period,” said Mr Patel in a statement on March 27, 2020. (2)
Minister Patel said the export restrictions on hydroxychloroquine, human antisera, vaccines against BCG, Polio, diphtheria, tetanus and polio alongside face masks, hand sanitizers, is not a ban on trading on these productions but a temporary measure to guard against possible shortage at a time when Covid-19 remains a threat to South Africa’s health care system.
South Africa’s trade including that on pharmaceutical products is strongly tied to that of 16 other neighbouring countries that are members of the Southern African Development Community (SADC), an inter-governmental organization for promoting socio-economic cooperation and integration as well as political and security cooperation, probably explaining why a total ban on exporting the products was not an option.
South Africa’s restriction of exportation of hydroxychloroquine, largely used for treatment rheumatoid arthritis and other inflammatory conditions, coincides with increasing global pressure to hasten the process of approving the medicine for the treatment of Covid-19.
The US Food and Drug Administration has for example allowed, under the Emergency Use Authorization, the distribution and use of hydroxychloroquine by licensed healthcare providers for the treatment of certain groups of Covid-19 patients on condition the medical personnel conclude the “potential benefit outweighs the potential risk.” The drug is not yet approved by FDA for Covid-19. (3).
The agitation to have hydroxychloroquine approved for treatment of Covid-19 has sparked fears of panic buying that would lead to shortages hence the restrictions to export the product by producing countries including South Africa.
According to Minister Patel, all that the government of South Africa is doing is to “control the level of exports to ensure that we have sufficient supply within our borders.”
However, for the estimated 174 South African pharmaceutical companies with existing or new supply orders from medical drug consumers, retailers and wholesalers from neighbouring countries, the restrictions now require them to apply to the International Trade Administration Commission (ITAC) for permission to export the products. ITAC has been established under the International Trade Administration Act of 2002.
Once ITAC receives an export request from the drug makers, it will liaise with South Africa’s Department of Trade, Industry and Competition and also Department of Health for before issuing the export license.
The country’s pharmaceutical industry output was estimated at ZAR48.6 billion (USD2.9 billion) by 2017 with 69% and 31% of the production coming from private and public sectors respectively. (4)
With the high number of pharmaceutical companies and substantial annual output, which government estimates will grow at 7% by 2021, makes South Africa a key player in Southern Africa region’s pharmaceutical market and hence the new restrictions are likely to have ripple effects in drug supply in many neighbouring countries in the short term.