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The South African Department of Health's decision to invalidate certain awards in a multibillion-rand ARV (antiretroviral) tender has drawn attention from the country's high court. The court ruled that various irregularities marred the procurement process, leading to the orders to reevaluate the tender split and award within a 120-day window. During this time, existing suppliers must maintain current deliveries to avoid any potential shortages.

The ARV medicines considered some of the most important in South Africa are Tenofovir, lamivudine, and dolutegravir. These three drugs form the first-choice standard ARV regimen in treatment guidelines for adults. Millions of South Africans rely on these drugs, commonly taking them in a single pill each day. Stockouts of these medicines could have severe consequences, potentially posing life-threatening risks for many patients.

The total value of the ARV tender is R15.5-billion, with R12.6-billion allocated for fixed-dose combinations of the drugs in one-month and three-month package sizes. The tender was distributed among various pharmaceutical companies, with one local manufacturer, Cipla Medpro Manufacturing, and another unsuccessful bidder, Hetero Drugs South Africa, contesting the awards.

Cipla and Hetero approached the Gauteng Division of the High Court in Pretoria, with Cipla requesting specific awards to be invalidated and Hetero seeking its bid to be reconsidered. Judge Graham Girdwood delivered a lengthy ruling, setting aside the awards and directing the Department of Health to redo the split and award within 120 days. Current suppliers will continue deliveries while the department investigates possible bid collusion and rectifies scoring errors.

Certain manufacturers, such as Innovata Pharmaceuticals and Viatris Healthcare, were excluded from reconsideration based on Judge Girdwood's finding that they failed to qualify during the initial bidding stages. Additionally, Barrs Pharmaceuticals and Aurobindo Pharma's final bid prices must be restored to their pre-negotiation prices, as they did not meet the criteria for local manufacturing preference.

The judge also ordered an investigation into potential collusion between Innovata and Barrs. He dismissed Hetero's application, stating that the department's suspicion of collusive bidding warranted further investigation before making a final determination.