Uganda is facing fresh pressures to raise its HIV/Aids funding in the coming fiscal year beginning July, as it plans to increase the number of patients under antiretroviral (ARV) therapy and cut new infections.

The Ugandan government’s draft 2013/2014 budget has allocated $38.5 million to enrol a further 100,000 HIV positive on ARV drugs.

But activists say the money, while welcome in a country still largely dependent on donor funds for its HIV programmes, is not sufficient to meet treatment needs.

“With the current allocation and funding, we still have a long way to go,” said Raymond Byaruhanga, the executive director of the Aids Information Centre (AIC).

According to Alex Ario, programme manager at the health ministry’s Aids control programme, the financial gap in the public sector for the 2013/2014 financial year is about $29 million.

The country enrolled an estimated 65,493 new HIV patients on ARVs in 2012, bringing to 356,056 the number of those on ARV therapy, according to Uganda Aids Commission statistics. However, this figure represents less than 70 per cent of those in need of treatment.

The government has set a target of reaching 80 per cent of HIV-positive people with ARVs by 2015.

Mr Airo said the government is seeking alternative ways to fund ARV programmes.

“Strategies are being explored to increase domestic HIV funding, such as establishing the HIV Trust Fund,” said Mr Airo.

The Ugandan government recently developed a draft working paper on establishing the $1 billion fund for its HIV/Aids programmes.

“I support the establishment of a trust fund by adding a levy on such items like beer, cigarettes, airtime or introducing an Aids tax to make sure all money needed to sustain ART is available instead of depending on donors,” said Stephen Watiti, a senior medical officer at Mildmay Uganda, an HIV treatment centre near Kampala.

Monica Dea, a senior programme advisor for the US Centres for Disease Control in Uganda said: “Government efforts to increase funding is commendable but we still need additional resources to halve the new infections.”

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Uganda’s HIV prevalence rate has risen from 6.4 to 7.3 per cent over the past five years.

Experts say it means the government must work twice as hard to ensure more people are placed on treatment, especially given recent research showing ARVs have a role in preventing HIV transmission.

But limited funding, frequent drug stockouts, limited CD4 count machines — which measure patients’ immune strength — and understaffing in the public health sector continue to hamper plans to achieve universal access to ART.

“Ugandan civil society is calling on the government to increase its investment in ART for financial year 2013/14 in order to save lives, slash rates of new infections, and end the Aids epidemic,” said Asia Russell, director of international policy at the Health Global Access Project (Health GAP).

Activists have also expressed disappointment in a local pharmaceutical plant — started in 2007 and jointly owned by a local company, Quality Chemicals Industries Ltd (QCIL), and Indian generics giant Cipla Ltd that was expected to provide cheaper ARVs.

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However, the factory’s drugs have remained costly and the plant is currently embroiled in an alleged $17.8 million corruption scandal.

In a December 2011 report to Uganda’s President Yoweri Museveni, then acting government anti-graft boss Raphael Baku noted that between December 2009 and October 2010, the government’s National Medical Stores (NMS) overpaid QCIL $17.8 million for drugs, in violation of its Memorandum of Understanding (MoU) with the government.

QCIL and NMS are accused of manipulating the MoU in order to achieve a 15 per cent mark-up on imported drugs, and intended only for locally produced drugs.

QCIL is also accused of allegedly selling imported drugs manufactured by Cipla to the government at inflated prices even after it started producing its own drugs. QCIL has denied the allegations.

The Inspector General of Government, anti-corruption activists and HIV activists have demanded the government recover the funds and prosecute those involved.

“We demand immediate action on the reports of the oversight government organs to recover all the money lost. This is the taxpayers’ money,” said Cissy Kagaba, the executive director of the Anti-Corruption Coalition Uganda (ACCU).

Asuman Lukwago, the permanent secretary at the Ministry of Health, said action would be taken on the reports.