The Eastern Cape Department of Health is dealing with about R1-billion in unpaid bills to pharmaceutical companies, leading to the suspension of 21 accounts and shortages of vital medicines. Officials maintain that there is no widespread collapse in service delivery, but concerns over patient safety persist. Mitigation efforts include alternative sourcing and engagement with national authorities.
The Eastern Cape Department of Health owes approximately R1-billion to pharmaceutical suppliers, resulting in the temporary suspension of 21 accounts with major companies such as Aspen, AstraZeneca, Adcock Health, Sandoz, and Novartis. Department spokesperson Siyanda Manana described the situation as stemming from financial pressure that has delayed payments, but emphasized that it does not represent a complete breakdown in medicine supply. He noted that isolated shortages are occurring, including for inexpensive treatments like scabies medication and beta blockers, and that measures such as redistributing stock and prioritizing essential drugs are in place.
Correspondence indicates limited funds available, with R60-million to R70-million for March payments and possibly R500-million at the new financial year's start. Manana added that nine other accounts have been reactivated following negotiations, and discussions with suppliers continue. The Auditor-General's November 2025 report revealed total unpaid bills of R7-billion, with 69% of the 2025/2026 budget allocated to settling these debts, highlighting risks to healthcare delivery.
This issue builds on prior challenges; last year saw chemotherapy and needle shortages, while the previous year involved ambulance service disruptions due to unpaid Telkom bills. In April of the prior year, Finance MEC Mlungisi Mvoko announced a task team to address financial instability in the health department. By January, the provincial legislature unanimously adopted a motion from Democratic Alliance member Jane Cowley, urging MEC Ntandokazi Capa to form a multi-disciplinary team for supply continuity and to develop a payment plan. The motion also called for Premier Oscar Mabuyane to integrate the health department into the "Have I Been Paid?" tracking system for better transparency.
Additionally, supplier Afrox has initiated national legal action to recover R360-million in unpaid medical gas invoices, with the Eastern Cape department owing about R90-million. The Auditor-General warned that such deficits could disrupt medicines, equipment, and services, potentially compromising patient wellbeing.
