1 November 2017

Uganda: ARVs Stock-Out Sparks Fear of Mass Drug Resistance

Civil society organisations and people living with HIV/Aids have warned that almost a million Ugandans could develop resistance to first-line anti-retroviral therapy if nothing is done about the nation-wide stock-out of drugs.

Margaret Happy of the International Community of Women Living with HIV Eastern Africa, yesterday said they are extremely saddened by news that the ministry of Health has reportedly instructed district officials to cut supplies of medicines to two weeks per individual.

"While HIV treatment stock-outs caused by insufficient funding are undermining the Aids response and triggering a massive risk of treatment failure, members of parliament have been given over Shs 13 billion to facilitate consultations on the proposed amendment to the Constitution to remove the age limit for a president," Happy told journalists at the briefing called by Care Uganda.

She warned that people living with HIV are at risk of relapsing since very few people can afford the transport costs involved in frequent visits to health facilities.

Uganda has at least 1.5 million people living with HIV; 900,000 of them getting ARVs. Drugs whose supply has dropped since June include; Abacavir/Lamivudine, Atazanavir, Nevirapine 500gm and Lopinavir 125gm for children.

The NGOs attributed the stock-out on government dependence on unreliable international aid.

"The HIV funding situation is even more precarious with approximately 93 percent of the financing for the HIV response coming from donors or non-state actors with PEPFAR taking 62%; the Global Fund 28% and other sources 3%, leaving government contribution at a paltry 7%," Happy said.

If things stay this way, over 800,000 people could develop resistance to relatively cheaper first-line treatment -- because of inability to go for frequent refills.

"Uganda runs the risk of failing to meet its treatment targets and the global targets with recurrent drug stock-outs," Happy said.

"At the time Uganda is being praised for her response to HIV, it's important that we do not lose sight of what matters to sustain a meaningful and successful Aids response. To end the epidemic by 2030, the country must back up its talk with real action on HIV."

Daniel Kawooya, a person living with HIV from Masaka, said they are going through a lot of difficulty accessing drugs.

"We go to clinics expecting to get drugs for three months but we are only given drugs for two weeks yet we have no money to buy; life is becoming so hard for us," Kawooya said.

People are being forced to switch to other regimens which, according to Kawooya, might cause drug resistance.

"Today you go; they give you this, and tomorrow you get another drug. This is not a demonstration. It's not our fault that we have HIV," Kawooya said.

"We are crying out; we need your help because we are in the productive ages; we are going to transmit the virus to our babies," Kawooya said.

Teo Nakuya, another person living with HIV, said ever since she started taking ARVs, her life has improved. She can now look after her children. "Currently I'm on the second line of treatment but when I went to the health facility to pick my drugs, they gave me new ones and I'm scared of taking them," Nakuya said.

NMS REACTS

Speaking to The Observer yesterday, Dan Kimosho, the spokesman of the National Medical Stores, the agency responsible for buying and circulating drugs to all government facilities, said they are unaware of a national crisis.

"If there was a stock-out, it would be for the whole Uganda. When they talk about health facilities; which are those? As far as we are concerned, we have the medicine," Kimosho said.

He added that this is not the first time such reports have sprung up.

"Every time they say there is no medicine, we tell them to bring one person who has gone without medicine but until now they haven't even brought half a person. Unless they specify that in this facility there was no medicines, then I can crosscheck and tell you whether there was an issue on requesting or delivery. But when they make a blanket claim, it becomes very hard for me to respond."

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