In South Africa, the price of survival is rising. As fuel prices soar, load shedding persists and urban populations swell, the cost of essential medicines is quietly climbing, threatening the accessibility of healthcare for millions of citizens.
While these issues may seem disconnected, their convergence is creating a perfect storm in the pharmaceutical supply chain, particularly in Gauteng, the country’s economic and healthcare nerve centre.
Every tablet, vial and bottle of medicine travels a long road before reaching a patient. That road is paved with petrol costs, which keep on rising.
Rising fuel prices have a direct impact on the cost of transporting medicines from manufacturers to wholesalers, and from pharmacies to clinics.
In a country where logistics already account for a significant portion of the final medicine price, any increase in fuel costs reverberates through the entire supply chain, eventually hitting the end-user in their pocket.
For patients in rural and peri-urban areas, the impact is even more severe.
Transport costs to access healthcare facilities are rising, making it harder for low-income households to collect chronic medication or seek timely treatment.
The result?
Delayed care, worsening health outcomes, and increased pressure on an already strained public health system.
Another factor is electricity, the lifeblood of pharmaceutical manufacturing and distribution.
From temperature-controlled storage to digital inventory systems, the industry relies on uninterrupted power supply.
Load shedding disrupts production schedules, damages sensitive equipment, and compromises the integrity of temperature-sensitive medicines such as insulin and vaccines.
Pharmacies and hospitals are forced to invest in costly backup power solutions – generators, inverters, and uninterrupted power supply systems – just to keep the lights on and the fridges cold.
These costs inevitably trickle down to the consumer, inflating the price of medicines and eroding the affordability gains made by policies such as the single exit price (SEP) system.
Gauteng, South Africa’s most populous province, is buckling under the weight of rapid and relentless urbanisation.
Overcrowded clinics, long queues, and medicine stock outs are becoming the norm.
The demand for healthcare services and pharmaceuticals is outpacing supply, creating bottlenecks in procurement and distribution.
Overpopulation also exacerbates the spread of communicable diseases and increases the burden of chronic conditions, further straining the pharmaceutical supply chain.
In such a high-demand environment, even minor disruptions – like a delayed shipment or a power outage – can have cascading effects on medicine availability and pricing.
To address these challenges, we need more than price controls – we need systemic reform. Government must invest in resilient infrastructure, including reliable energy and efficient transport networks.
Local pharmaceutical manufacturing should be incentivised to reduce reliance on imports and buffer against global supply shocks.
Moreover, policies must be adaptive.
The SEP system, while effective in curbing price inflation, must evolve to account for the real-world costs of doing business in a volatile environment.
Transparency in logistics fees, tax relief for essential medicines, and subsidies for rural distribution could go a long way in protecting both patients and providers.
The rising cost of medicine is not just a healthcare issue – it’s a socio-economic one.
If we are serious about achieving universal health coverage and reducing inequality, we must confront the structural forces that make medicine unaffordable.
That means tackling fuel inflation, ending load shedding, and planning for sustainable urban growth.
Because in the end, the true cost of medicine is not just measured in rands – it’s measured in lives.
• Fentse Maseko is a PhD candidate at Wits University, She writes in her personal capacity
