Nationwide lack of essential medicines in South Sudan

Médecins Sans Frontières (MSF) wants to express its frustration that, in an already dramatic context of protracted violence and displacement, the warning we formulated a year ago to the humanitarian community and donors did not lead to any structural or decisive action to prevent a countrywide shortage of essential drugs.

The conflict in South Sudan has now continued for over two years, heavily impacting its population and putting as always the most vulnerable at risk. On top of this already dire humanitarian situation, an additional and preventable medical emergency is unfolding.

The discontinuation of the Emergency Medicines Fund (EMF) - the program which ensured the funding, procurement and provision of essential medicines for the whole in South Sudan – has now led to unacceptable and devastating outages of drugs throughout the country.

While the program’s objectives had officially been handed back to the Government, there was little doubt that they would not be able to fill this gap amidst the continued crisis in the country.

‘The road ahead’

Efforts to prevent the worst have been temporary without acknowledging the wider impact of these massive drug shortages. Reserves have been distributed and reassigned which have not prevented our teams from witnessing shortages in the majority of primary healthcare facilities in the areas around where we work. As an example, in and around Aweil we visited 42 medical centers and units of which 12 were completely closed and 23 experienced closures and were sending patients to the market to purchase their prescribed medicines.

All this was aggravated by a malaria outbreak last year in which we treated more severe malaria cases than ever before despite donations and distribution of tests and treatments. Still many patients arrived in progressed stages of the disease because of the lack of access to basic medication at the local level.

However predictable at the time of our warning, these findings have now been reflected and confirmed by official reporting mechanisms. Still no structural approach has been formulated for the road ahead while drug outages are now a reality around the country. A new rainy season is approaching fast, promising new outbreaks as well as complicated logistics. It is not a situation that one actor can resolve on their own but concerted efforts seem to be lacking.

We are therefore calling upon all donors, actors and authorities again to come together to avert a complete medical crisis, which adds to an already dire humanitarian situation. The population can least afford to be denied lifesaving medication. Failure to come together will put the lives of thousands in jeopardy and again disproportionately impact the most vulnerable in this country, particularly women and children.

Having already raised these concerns in writing to all major donors and after numerous bilateral meetings, I feel compelled to reiterate our appeal publicly, in the form of this now open letter.
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Dr. Joanne Liu is International President of Médecins Sans Frontières (MSF) since 1 October, 2013. Her time with MSF started in 1996, when she worked with Malian refugees in Mauritania. Since then, she has provided support after the tsunami in Indonesia, assisted people affected by the earthquake and cholera epidemic in Haiti, and worked with Somali refugees in Kenya. She tweets @JoanneLiu_MSF