Public vs Private Healthcare Sector: Harvesting of Amniotic Membrane

By Fikile Mnisi 2 months ago
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The development of biobanks in South Africa is still in its infancy and there is a need for both public and private biobanks to accommodate our society.

Section 27 of the Bill of Rights, requires that the State provides healthcare based on the availability of its resources. However, this can be difficult, as South Africa is faced with many healthcare challenges especially those of resource scarcity. Hence, this may be one of the reasons for the stagnation in establishment of public biobanks. Apart from that, South Africa also has a high disease burden and more pressing diseases need to be addressed such as HIV/AIDS.

Due to the current challenges, tissue banking and transplantation has never been considered a priority.

Currently, in SA there is a private biobank which harvests, processes and stores a product that may be used within the Ophthalmologic field, made from the amniotic membrane. Amniotic membrane is reported to contain bio-active factors which are beneficial in wound care treatment. Harvesting and banking of this biological product ensures a high quality, sterile product with data security and accountability. Unfortunately these recourses and expertise are not always available in the public healthcare sector.

amnion 3

Due to economic conditions in South Africa, this biological product is only available to a limited number of patients, mostly those in the private healthcare sector.  As a result, healthcare practitioners in the public healthcare sector, harvest and process their own amniotic membrane.

So why is this a bad thing?

In order to have a full overview of the Risk versus Benefit, one will have to understand the ethical implications as well as legal issues surrounding biobanks and the importance of ensuring a good quality of standard and care. This can only be possible in a facility with Good Manufacturing Practices that are accredited, which proves accountability for the processing of the product.

To date, this has not been the case in the public healthcare sector, as it has been shown to expose patients to risk.  Therefore, a need for a joint venture or collaboration between public and private amniotic membrane biobanks, is required. Especially as 70.5% of South African household’s make use of public healthcare versus the 25.3% which use private healthcare (Mabuza 2016, p.1). The South African Government will have to facilitate a system that will either provide funding for a public bank or collaboration with private biobanks.

This can only be possible with the development of policies, legislations, infrastructure, as well as allocation of healthcare funds for biobanks and making use of the current resources and expertise that are available in existing amniotic membrane biobanks. Ensuring good quality of life is a right that provides dignity to an individual and society.  “A healthy individual is a healthy community” and with health comes dignity.

References:

  1. Mabuza, E. 2016. Private doctors lose out as majority of South Africans increasingly opt for state clinics. From: http://www.timeslive.co.za/local/2016/06/02/Private-doctors-lose-out-as-majority-of-South-Africans-increasingly-opt-for-state-clinics
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About

 Fikile Mnisi

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Fikile has recently joined the Next Biosciences team as the Biologics Manager. Her interests are in the field of medical biotechnology, bioethics, policy matters, social justice and harmony of biotechnology research and developments and patents. She has been instrumental in a number of research projects: Chloroform residual in bone as well as bioburden analysis of cadaveric tissue in 2007-2008; Ethics Educator Course presenter (October 2016) and organising member for the 6th Conference of The International Association of Education in Ethics (IAEE) for 2018 in South Africa.