Kampala — THE minimum requirement for essential medicines and health supplies per person in Uganda costs about $3.5 (about sh6,100), yet currently, the public expenditure is $0.8 (sh,1400) per capita.

"It is $3.5 per capita when you exclude CoArtem, the first line drug for treatment of malaria, antiretroviral drugs, respiratory track infections, vaccines for major killer diseases and treated nets," Emmanuel Otaala, the primary healthcare minister, said.

He was launching a report entitled: "A promise Unmet: Access to Essential Medications in Rural Uganda," at Grand Imperial Hotel, recently. Otaala said essential medicines and health supplies remain under-funded.

The report was the result of a three-month drug stock survey conducted by Action Group for Health, Human Rights and HIV/Aids Uganda (AGHA), an NGO that raises awareness of healthcare providers and communities about human rights aspects in health, particularly on HIV/Aids.The study was conducted in 30 health facilities in the rural districts of Ibanda, Lyantonde and Isingiro so as to assist policy makers in planning and advocacy.

"We focused this study on medicines to treat malaria and pneumonia, as well as other opportunistic infections, because they represent the two largest disease burdens in Uganda," said Winnie Ngabirwe of AGHA. She said about 320 children in Uganda die everyday of malaria.

The study showed that health facilities in the three districts did not have anti-malarials and antibiotics in stock. These drug supplies fluctuated significantly in the three districts, rarely reaching 100% coverage.

The scarcity was attributed to lack of human resources, training, staff, medicine, transport, storage facilities and gaps in communication.

According to the report, CoArtem is funded by development partners. However, it was often unavailable in the health facilities of the three districts.

In Ibanda, 10%-30% of health facilities did not have CoArtem. In Lyantonde, 50% of the health facilities did not have it during the period in which the survey was done. One healthcentre III in Lyantonde did not have CoArtem on every subsequent visit over the three-month study.

"The absence of this drug exposes patients to less effective treatment that could result in continued illness or death," said Dr. Margaret Muganwa.

She revealed that the ratio of health workers to patients in the three districts falls far below the recommended ratio of 2.5 doctors, clinical officers, nurses and midwives, per 1,000 people.

In Lyantonde the ratio is 0.8 healthcare workers per 1,000 and in Ibanda and Isingiro, the ratio is just 0.2 health workers per 1,000 people. "These districts neither meet WHO standards nor the Government staffing norms, which can adversely affect the realisation of the right to health as the principles of accessibility and availability are compromised," she added.

AGHA compiled a set of recommendations that address the top five challenges in medicine access. These include bridging the budget and communication gaps, purchasing and distributing drugs and monitoring and evaluating their distribution.

The Government also needs to spend more on infrastructure and human resources needed to get quality care to those in the most remote places and to guarantee that essential medicines are available.

However, the Health Sector Strategic Plan II, is not fully funded and the projections do not indicate how the gaps in funding will be filled. But Otaala says the ministry asked the National Medical Stores to increase its operational capacity to meet demands of the growing population.