Uganda is facing yet another shortage of lifesaving HIV drugs, health activists warned last week.
The shortage has been attributed to the failure by authorities to import enough stock of antiretroviral therapy (ART) medicines last year.
Uganda’s Ministry of Health announced in December last year that the country had run out of imported HIV/Aids drugs.
However, in an interview with Reuters, Finance Ministry Permanent Secretary Keith Muhakanizi blamed the shortage on the depreciation of Uganda’s shilling, which has affected the government’s ability to finance drug imports.
To mitigate the shortage, the Global Fund against HIV, Malaria and Tuberculosis announced it would send an advance supply of antiretroviral medicine to Uganda.
Health activists said the stockout will affect 240,000 patients, who will be forced to modify treatment plans or stop taking their medicine altogether.
The activists noted that the frontloading of Global Fund financing will create a gap in funding and another drug shortage.
“Right now, you can say that there is no stockout in this country because of frontloading by Global Fund. But that will only last until August or September this year,” said Joshua Wambogo, the head of the Uganda Network of Aids Service Organisations (Unaso).
“After September, we will have another problem. The number of people in need of ART is increasing and Global Fund financing will run out early, awhile the government of Uganda has not addressed how it will fix this. If the government does not increase allocations of funding towards health, the upcoming shortage will be massive,” added Unaso.
“President Yoweri Museveni’s administration has largely failed to address the systemic failures in the delivery of healthcare in the country,” said Asia Russell, the executive director of Health GAP, an advocacy group.
UNAids classifies Uganda as a high HIV burden country where the number of persons living with HIV continues to grow. Currently, there are 1.5 million Ugandans, or 4 per cent of the population, living with the disease. About 820,000 people receive ARVs.
“The issue of essential life-saving health services such as access to ART, consistently ranks as priority number one for Ugandan voters,” said Ms Russell. “In the mind of voters, this is the centre of gravity and neither candidates not the incumbent are treating it as such.”
Health activists in Uganda, including Ms Russell, have drawn a correlation between runaway election spending and the government’s inability to allocate funds to ensure continuous drug supplies.
Ms Russell noted that procurement of some ART medicines is done in local currency, meaning depreciation of the shilling should not have altered access to medicines bought from Ugandan-based manufacturer Cipla Quality Chemicals.
Ms Russell added that a sharp rise in inflation following Uganda’s 2011 presidential election did not lead to a stock out.
The government has also argued that new World Health Organisation guidelines, stating that drug treatment for HIV should start earlier, contributed to a sudden rise in the number of patients in need of ART, a claim Ms Russell has dismissed.
“If you look at the trend for people enrolled in ART programmes, month to month, there is no jump in the number of patients that the Ministry of Health is responsible for,” said Ms Russell, adding that support from foreign donors including the United States has increased.
Unaso further noted that at the very least, errors in planning and monitoring of stock levels were made, mistakes that will continue to have effects on patients under ART programmes.
ART treatment has been proven to reduce the likelihood of passing on of the virus by nearly 96 per cent.
A recent study by Swiss researchers shows that interruption of treatment was a major driver of new infections, accounting for up to 14 per cent of new HIV cases.
“It is simple logic that if you have been receiving treatment, the treatment is well-known to suppress the activeness of the virus.
SWhen I don’t take that medicine, the virus is going to be active in me. The disease will progress. So many people will become more sick, many people will die,” said Mr Wambogo.