Failure to sign new contracts before old ones expire is one of the main reasons patients in the public healthcare system are left without medicine.

The other factors are an absence of contracts for certain medicines and suppliers failure to meet contractual agreements a team from the school of public health at the University of the Western Cape has found.

Writing in the South African Medical Journal team leader Bvudzai Magadzire said the shortcomings uncovered by questioning 70 health workers and managers in the Western Cape posed a critical problem.

The challenges imposed by stock-outs are becoming more evident against the backdrop of increased demand for chronic disease treatment but they are not new said Magadzire.

Minimising stock-outs requires action at a national level where procurement takes place to ensure that tenders are awarded timeously and supplier performance is monitored.

Magadzire and her team looked at the availability of five popular medicines between 2012 and 2014 and the health staff they questioned said late tender awards caused problems every two years when contracts expired.

One respondent told the researchers: The national Department of Health know exactly when the tender is going to end but the process takes so long.

Then they have to ask the current tender companies to extend their contract for one or two months. The companys response could be I dont want to do it and I dont have the capacity.

Another respondent said: I think there is a lack of understanding with our tender guys that these pharmaceutical manufacturers sometimes plan two years in advance.

Poor communication about medicine requirements was also a problem. A case in point: about 70 items were excluded from the most recent national tender at the time of the study without first consulting provinces said Magadzire.

Suppliers often failed to deliver the drugs required. One official told the researchers: The most we can do is inform the Department of Health. But history has shown us ... that those suppliers do get reappointed and we sit with the same problems again.

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Missing some medicine? You've been caught in the tender trap - Times LIVE