As the furore over President Uhuru Kenyatta’s pledge to remove obstacles to Ugandan sugar exports to Kenya continues to dominate public debate, officials in Kampala see in Kenya’s head of state a partner who is committed to righting a trade imbalance that is heavily skewed in his country’s favour.

Weeks before his August 8-10 state visit to Kampala, progress had been made on a number of landmark agreements that the Ugandans see as evidence of President Kenyatta’s commitment to what he touted as “shared prosperity” during his three-day visit.

While the agreements on joint development of oil infrastructure and market access have captured the limelight, behind the scenes, the countries, among other things, inked a bilateral framework agreement on health and medicine that is being seen as a lifeline for Kampala-based pharmaceutical firm CIPLA-Quality Chemicals Ltd.

“We have had a challenge in balancing trade with Kenya, but what we are seeing now is a willingness on the other side to redress this,” said Asuman Lukwago, the Permanent Secretary in Uganda’s Ministry of Health. “Medicine will be treated as a commodity and in return CIPLA will be free to recruit qualified Kenyans to work in its plant.”

According to Dr Lukwago, Kenya is not only willing to buy Ugandan-manufactured anti-retroviral and anti-malarial drugs from Quality Chemicals, but is also interested in buying equity into the firm. Kenya would also like to supply one key input to the plant.

To that end, Nairobi, which has been exclusively depending on donor funding for its malaria and Aids programmes, will be creating a $28 million fund in its budget for purchases of medicines from Kampala.

Besides pushing Uganda’s exports to Kenya across the $200 million mark, that deal would make Quality Chemicals more price-competitive through better capacity utilisation.

The Ugandan government already spends Ush100 billion (equivalent to $40 million when the agreement was signed in 2012) annually on purchases from Quality Chemicals, but that still leaves about 40 per cent of the installed capacity unutilised.

Still, trade between the two neighbours remains unbalanced, with Kenya’s exports to Uganda standing at $700 million against $180 million in the other direction.

Technocrats from the two countries will be meeting over the next few weeks to concretise the agreements because they must have something definite to report to the EAC Heads of State Summit next month.

State Minister for Health Elioda Tumwesigye said the two countries penned the agreement on July 31, paving the way for collaboration on various health aspects including HIV/Aids, malaria, research, transfer and sharing of technologies, vaccines, test kits and cross-border surveillance for disease outbreaks.

Dr Elioda said the two governments are still working on the modalities of implementing the agreement, a move that will strengthen the region’s drug manufacturing sector, and subsequently lead to a reduction in prices of health-related products.

Kenya’s Cabinet Secretary for Health James Macharia said the government is willing to support Ugandan firms to develop local pharmaceutical manufacturing industries in the EAC.

“We visited this facility — the CIPLA Quality Chemicals Industries Ltd plant — together with President Uhuru Kenyatta and realised that the facility actually meets international standards, so we are willing to support it,” said Mr Macharia.

Mr Macharia said the CIPLA will help serve patients in Kenya and Uganda with drugs, especially those suffering from HIV/Aids.

Currently, more than 800,000 patients in Kenya are on ARVs compared with Uganda’s 750,000 According to the Health Ministry, about 1.5 million people are infected with HIV/Aids in Uganda.

The Ugandan government and donor agencies — the Global Fund and the US President’s Emergency Plan for Aids Relief (PEPFAR) — spend $140 million towards treatment of Aids patients annually.

On the other hand, the Kenyan government has allocated $28 million on the treatment of HIV/Aids, with an additional $250 million from PEPFAR.

CIPLA unveiled two Hepatitis B drugs — Texavir and Zentair or Entacavir  — raising the hopes of the millions of people suffering from the viral disease in East Africa.

Nevin Bradford, the chief executive at the Kampala-based pharmaceutical manufacturing plant, said the new development means that Hepatitis B patients will now no longer need to use a combination ARV treatment unless it is a decision of the patient’s physician since the drugs contains Tenofovir component.

“Initially, combinations of ARV drugs that contain Tenofovir have been used to treat Hepatitis B as there have been no alternatives,” Mr Bradford told The East-African. “Now that Texavir (Tenofovir) is available as a single molecule dedicated drug for Hepatitis B there is no rationale for continuing to use a combination ARVs.”

CIPLA also unveiled Trioday — an anti-retroviral drug consisting of three components — thereby reducing on the patient’s pill burden.

The production of the Trioday drug consisting of Tenofovir, Lamividine and Efavirenz, started in the first quarter of this year, reducing the patient’s intake of specific drugs by a third per day.

Trioday has been priced at $13 per month, and Tenofovir at $7 per month. Entacavir has been priced at $33 for children and $66 per month for adults.

Hepatitis B prevalence

Data from WHO shows that Hepatitis B viral prevalence is highest in sub-Saharan Africa and East Asia, where 5–10 per cent of the adult population is chronically infected.

In Uganda, 10 per cent of the 33.9 million population is living with chronic Hepatitis B infection, with the northeastern region having the highest prevalence at 21.7 per cent, followed closely by the central and West Nile regions at 19.4 and 18.7 per cent, respectively.

The east, central and south western parts of the country have the lowest Hepatitis B prevalence at 5.5 and 2.9 per cent, respectively.

In the East African region, Tanzania, Kenya, Rwanda, and Burundi have an Hepatitis B prevalence of more than eight per cent of their total population, currently standing at 47.4 million, 45 million, 12.1 million and 10.5 million respectively, according to Alberta Health Services, the health authority for the Canadian province of Alberta.

CIPLA global chairman Yusuf Hamied said the drug manufacturer plans to further expand the capacity of the plant and increase the portfolio of drugs available for patients.

“We are also looking at backward linkages, identifying some local raw materials that we require to produce medicines,” said Dr Hamied.

Uganda’s Prime Minister Ruhakana Rugunda said more access to drugs for patients will reduce the disease burdens facing the region’s health sectors.

CIPLA Quality Chemical Industries Ltd started operations in 2005 as a joint venture between Quality Chemicals Limited (QCL), a Ugandan company dealing in the importation and distribution of pharmaceutical drugs, and CIPLA Ltd, a leading Indian pharmaceutical company specialising in manufacturing anti-retroviral drugs (ARVs) and Artemisinin-based Combination Therapies (ACTs) to combat HIV/Aids and malaria respectively.

Although CIPLA has the capacity to produce 70 million tablets a month, it is currently producing at 65-70 per cent capacity due to instability in demand for drugs.

In addition to Uganda, the firm also exports its drugs to Kenya, Tanzania, South Sudan, Angola and Cameroon.