Pharmacy in South Africa: The Forgotten Lifeline of Healthcare

"The question is no longer whether pharmacists can help heal our healthcare system; it is whether we will empower them to do so."

Imagine if you will a healthcare system; a living body, intricate and interdependent. Within this body, pharmacy is one of its vital organs, entrusted with the noble duty of protecting and distributing medicines, educating communities, and ensuring their proper use. Like the heart that pumps life and gives blood through the body, pharmacy plays a significant role and it touches every part of the healthcare system. Yet in South Africa, this vital organ often struggles to function as it should, its potential remains untapped and its importance is overlooked.

I must admit, though I am a pharmacist, I speak not only as a professional grappling with the uncertainty of unemployment, but also as someone shaped by personal experiences that have sparked an unwavering resolve within me, I write out of a deep desire to understand, to question, and hopefully to inspire. My story is not unique, It is the story of countless South Africans who have witnessed the frustrations, inequities, and losses within our healthcare system.

A Healthcare System in Crisis

Imagine if you were a mother in a rural part of South Africa, walking for hours under the unforgiving sun to reach the nearest clinic, only to find empty shelves where medicine should be. Picture her child, waiting for the care that never comes. Imagine the frustration of a pharmacist, fully trained, ready to serve, yet confined to roles that fail to reflect their expertise. Imagine the countless patients, young and old, caught in a system that promises care but struggles to deliver it.

As someone raised in a rural area, I deeply understand the frustration of lacking access to adequate healthcare. In 2015, I sat with my father in the outpatient department at our nearest hospital from 2 a.m. to 6 a.m., waiting desperately for help during a medical emergency. Help did not come in time, and we lost him. And now, years later, I find myself grappling with a similar loss; my mother, passing in an ambulance, for reasons I will never fully understand. These moments are seared into my memory, and constantly shaping how I view a healthcare system that too often leaves those in need waiting.

I’ve seen skilled, passionate colleagues nearing the end of their contracts, uncertain if they’ll find opportunities to continue serving in a system that desperately needs them. I’ve heard the stories of rural patients walking miles to reach a clinic, only to face empty shelves where medicine should be. And I’ve spoken to pharmacists confined to roles that fail to reflect their training or the full scope of their expertise.

These experiences are constantly compelling me to ask: why do we have a healthcare workforce brimming with potential, yet so many gaps in delivering care to those who need it most? And how many more families, must go on suffering?

The Untapped Potential of Pharmacy

Pharmacy is said to be a “dynamic, patient-oriented profession,” yet reality in South Africa tells a different story. The National Drug Policy for South Africa (1996) envisioned equitable access to medicines and the rational use of drugs as cornerstones of healthcare. It emphasized the need for competent pharmaceutical personnel and multidisciplinary collaboration to improve outcomes. However, decades later, these ambitions remain only partially realized.

Stockouts persist in public clinics, leaving patients without life-saving medicines, especially in rural areas where resources are already stretched thin. Urban centers often oversupply pharmacists, while underserved communities struggle to fill even the most basic roles. Even in well-staffed areas, the potential of pharmacists often goes untapped, with their contributions limited to dispensing, rather than the broader roles they could play in public health, patient care, and system reform.

The Reality of Unfulfilled Promises

The promises of the National Drug Policy and Section 27 of the Constitution, which guarantees the right to healthcare, remain unfulfilled for many. Think back to the mother in rural South Africa, walking for hours to reach a clinic, only to leave without the medicine her child desperately needs.

Think back to the mother in rural South Africa, walking for hours to reach a clinic, only to leave without the medicine her child desperately needs.

Now consider this: somewhere, an unemployed pharmacist is ready and willing to serve; a professional trained to:

• Ensure the availability of the right medicines at the right time.
• Manage supply chains to prevent stockouts.
• Counsel patients on proper medicine use.
• Contribute to public health initiatives
• Influence healthcare policy

“Injustice anywhere is a threat to justice everywhere.” – Martin Luther King Jr.

These are not isolated or abstract challenges; they are the lived realities of countless South Africans, underscoring the untapped potential within pharmacy to bridge these gaps.

Why, does pharmacy remain an untapped resource in our country? What is the role of pharmacists in a system struggling to meet its promises? What would it take to align the noble vision of pharmacy with the pressing needs of our people?

"Health is a human right, not a privilege to be purchased." – Unknown

The healthcare system is, indeed, a patient in need of healing. But healing begins not with quick fixes, but with a deeper understanding of the roots of our challenges. It begins with asking the right questions. What does pharmacy have to teach us about equity, justice, and the true meaning of care? And are we ready to listen?

“What do you think needs to change in South Africa’s healthcare system? I’d love to hear your thoughts and ideas below.”

Siphokazi B.K. Dludla

Proudly South African | Professional | Aspiring Advocate for Equitable Healthcare

References

Constitution of the Republic of South Africa (1996). Section 27: Right to Healthcare. Pretoria: Republic of South Africa.

Masvawure, T. B., & Foley, E. E. (2024). Pharmaceutical distribution and structural inequalities in global health. Routledge Handbook of Anthropology and Global Health.

National Department of Health. (1996). National Drug Policy for South Africa. Pretoria: South African Department of Health.

Pfleger, S. (2024). The climate, nature, and pollution crises—how more sustainable medicines use can make a difference. International Journal of Pharmacy Practice, 32(3), 191–195.

Steele, P., Otieno, L., Opon, S., Graham, M., & Wharton, B. (2024). Localization of pharmaceutical manufacturing in Sub-Saharan Africa.

Stop Stockouts Project. (2019). Medicine stockouts in South Africa: Addressing systemic gaps. Stop Stockouts Project Report. Retrieved from https://stopstockouts.org

South African Pharmacy Council. (2010). Good Pharmacy Practice Manual. Pretoria, South Africa: South African Pharmacy Council

World Health Organization (WHO). (2007). Everybody's business: Strengthening health systems to improve health outcomes. WHO's Framework for Action. Geneva: World Health Organization.