HIV/Aids patients in Uganda face tough times ahead unless $102.3 million is raised to buy antiretroviral drugs as a stockout of the life-saving drugs is imminent.
The government applied for a $200 million loan from PTA Bank to cover its expenses but it is not clear when the money will be made available as parliament is yet to approve the request.
In a phone interview on December 18, Secretary to the Treasury Keith Muhakanizi told The EastAfrican the government is currently in a difficult position because it cannot borrow domestically, and therefore looking to use part of the $200 million loan from PTA Bank to restock on ARVs.
“Because we couldn’t borrow from the domestic market, we had to find other sources. If parliament approves the loan this week, we will give the Ministry of Health the money to buy the ARVs,” said Mr Muhakanizi.
The loan was negotiated with PTA Bank as a revolving facility that would see the bank pay Uganda’s suppliers abroad, instead of the government having to constantly draw dollars from the Central Bank.
A Cabinet memo dated November 16 from the Minister of Health Elioda Tumwesigye, which The EastAfrican has seen, makes a request “for additional domestic financing to procure emergency drugs to fill a critical gap for the November-June 2016 period.”
According to the memo, the money is required in two tranches — $10 million for an emergency order for ARVs for the November-June 2016 period, and $92.2 million for the 2016/17 financial year.
Last month, health activists questioned the government’s lack of planning after a Ministry of Health drug status report showed that ARV stock levels in public health units were low.
The ministry report showed that Efavirez600mg/ Tenofovir/ Lamivudine and Lopinavir/ ritonavir 200/50mg were out of stock in most health units.
Some people on ARV treatment also claimed that due to particular drug combinations running out in public health units, they were being switched to different drug combinations.
But Moses Kamabare, the general manager of the National Medical Stores, the agency that supplies medicines to all public health units, denied this, saying government hospitals still have ARVs and a crisis will only be felt if there is no money by February 2016.
He said the Ministry of Health planned to have 892,000 people on antiretroviral treatment by the end of this financial year. But right now, the number of people on lifesaving drugs has hit one million, a development that has impacted on stocks in public health units.
The government and key donors, especially the US government’s Pepfar and the Global Fund to fight HIV/Aids, tuberculosis and malaria are keen to reduce new infections in children from 14,200 annually to 4,040 between 2014 and 2023. In addition, the government plans to use treatment to avert 570,000 deaths by 2025 and save 42,620 children from Aids related death by 2025.
“The care and treatment programme is an essential component of the interventions needed to achieve these targets,” the memo reads, urging the Cabinet to endorse it and allow the government and the Global Fund to front load funding and bridge the financing gap.
The Global Fund has agreed to the request, which will bridge but not completely close the gap.
“However, this front load will now result in a bigger public sector gap for the second year [2016/17] of the Global Fund grant,” reads the memo.
However, health rights activists blame the government’s slow planning for the impending crisis. For instance, while the Cabinet memo was raised last month, no decisive action has been taken on it, Asia Russell of the Health Global Access Project argued.
“That question has to be asked; What really caused the stockouts? Why was this allowed to happen? We knew around October that the medicine would run out,” she added.
Ministry of Health estimates show that at the end of this year, Uganda will have 1.54 million people living with HIV/Aids.