Friday, 27 November 2015
CIVIL-SOCIETY INTER-CONSTITUENCY COORDINATION COMMTTEE (CICC)
World AIDS Day Press Release
Civil Society Organisations call upon political candidates to put health services at the heart of Uganda’s 2016 Elections campaigns: No Health No Votes!
Health Sector Civil Society Organisations join other Ugandans and the International Community to observe the World AIDS Day 2015. At national level, the day is the climax of the national AIDS campaign which comprises of all-year-round series of activities implemented annually to re-energize our roles at all levels towards achieving the HIV prevention and management agenda.
This year, 2015, World AIDS Day in Uganda is being held in Kasese District under the theme: “Getting to Zero, My Responsibility”. This builds on the Global theme of Getting to Zero: Zero new infections; Zero deaths; and Zero Discrimination. World AIDS Day is an opportunity for people worldwide to unite in the fight against HIV recognizing scientific research advances both in prevention and treatment, show their support for people living with HIV and also to commemorate people who have died from AIDS related causes.
As we observe this day in 2015, we know that there are countries including our own which have enacted laws, some protective and others quite oppressive; we know that there is still discrimination leading to stigma; we know that there are many people in need of correct information on HIV and AIDS; we know that there are very many people who do not know their HIV status; and, of course, we know that there are many still being infected with HIV. This World AIDS Day, therefore, should be a great reminder to all that there is still a vital need to find more money, continue to create awareness, intensify scientific research in HIV prevention, vaccine development, and treatment; fight prejudice and discrimination; and increase participation by all, men and women.
Commenting on WAD 2015, Rev. Sam L. Ruteikara the Chairperson CICC said that true Uganda has made remarkable progress in respect to addressing the HIV and AIDS pandemic. However, the AIDS related National Indicator Survey (2011) showed an HIV prevalence of 7.3% having increased from 6.4% among people aged 15-49 years which was still very high. The total number of people living with HIV and AIDS was estimated to be 1,486,642 in 2014, and new HIV infections had declined from 128,068 in 2009 to 99,000 in 2014 while the annual HIV/AIDS related deaths had reduced from 52,799 in 2009 to 32,890. The high number of new infections in the country is compounded by challenges of social, economic and legal barriers to effective demand and uptake of HIV and AIDS preventative services.
Therefore, the health sector Civil Society Organisations would like to draw Uganda’s attention to the following issues below that are affecting the response and require immediate attention and intervention if Uganda is to achieve its vision of “Zero new HIV infections, Zero Discrimination and Zero HIV related deaths”.
Mr Wamboga, the Executive Director of the Uganda Network of AIDS Service Organisations(UNASO) also commenting on the same, said that Uganda needs to move quickly to come up with sustainable financing such as operationalization of the National AIDS Trust Fund (NATF) with sufficient funds, upfront investment and also ask donors to support new WHO guidelines by making policy and programmatic changes to ensure that resources are identified or reallocated to support the new HIV test and treat WHO guidelines.
“Uganda needs to increase its revenue to end AIDS, and this must come through the national budget and through innovative sources such as the National AIDS Trust Fund”, he added.
He also noted that Uganda must expand its national commitment while ensuring that donors continue to do their part. Currently, close to 80% of all HIV and AIDS funding in the country is donated by external governments. This is not a good sign of commitment on behalf of our government.
Mr. Wamboga concluded that securing domestic resources is the only guarantee of ensuring that those who need treatment continue to receive it and hence being able to move closer to the zero new infections.
According to a Ministry of Health report of October 2015 released by the Pharmacy Division, most of the essential supplies such as reproductive health commodities, and TB drugs, Antiretroviral medicines, anti-malarial medicines, and vaccines like polio oral trivalent, measles, hepatitis B and BCG, and other medicines that treat common diseases like HIV and AIDS related opportunistic infections, malaria, diarrhoea, TB, diabetes and hypertension are not readily available.
The supply gap for adult antiretroviral therapy alone is US $ 47,425,412, equivalent to 164 billion Uganda shillings.
This serves to act as a warning indicator for potential danger for stock outs and possible expiries of essential medicines and health supplies. The report also indicates that there will be drug stock out for one month and if government does not do emergency procurement, there will be bigger stock out in the next six months.
Consequently, health civil society organizations met with representatives from the Ministry of Health and USAID to discuss the HIV and TB drug stock out in the country. Some of the organizations included National Forum of People Living with HIV and AIDS, International Community of Women Living with HIV in East Africa, UNASO, PATH-USAID, Action Group for Health, Human Rights and HIV and AIDS and Alliance for Integrated Development and Empowerment, Coalition for Health Promotion and Social Development and others.
Achieving 90X90X90 goal
Joshua Wamboga also noted that if 1,079,368 out of the 1.4 million Ugandans living with HIV are on treatment, that means that Uganda is close to achieving the 90x90x90 UNAIDS goal adding that with challenges of drug stock out hitting Uganda, the number of People Living with HIV cannot be sustained on treatment and this will lead to problems of drug resistance.
“If a person on first line treatment, stop taking drugs his body will become resistant to first line treatment and he will be required to immediately start on second line treatment and those who face drug resistance on second line will need to start on third line which is very expensive”, he concluded.
Rev. Sam Ruteikara noted that in the whole of Uganda, only 300 people are getting third line treatment from CDC, so the government of Uganda must ensure that there are enough medicines to avoid drug resistance among people living with HIV and AIDS and thus leading to more expensive treatment options.
Health Sector Manifesto
On 15th September, a coalition of civil society organizations working for access to essential health services in Uganda launched the “Uganda Election 2016 Health Manifesto” a platform demanding all political parties and candidates to commit to correcting massive failings of the health sector in Uganda to deliver essential and quality prevention and treatment services.
The demands contained in the Manifesto include a demand to scale up per capita health financing from current levels of only USD 10.50, to the minimum recommended by WHO (USD 44) by 2021. Other priorities include increasing the remuneration of health workers and the budget for essential medicines as well as confronting high‐level corruption that robs Ugandans of lifesaving health service delivery.
“Lack of focus on our health needs by politicians is a disgrace, and we are here to say, ‘no more”, said Rachel Nandelenga of the International Community of Women Living with HIV/AIDS Eastern Africa (ICWEA).
Ms. Nandelenge demanded that all candidates seeking elective positions should pronounce themselves on the 10 points of the Health Sector Manifesto.
“We commit to empowering citizens to choose leaders whose manifestos speak to these demands we will hold them accountable from the national level right down to the grassroots”.
She also noted that coalition pointed out that the most repeated excuse of lack of funding is not credible, since other priorities receive funding when considered politically beneficial.
Lillian Mworeko, Executive Director of ICWEA, said that as citizens of Uganda our fate is in our hands every five years we have a special power to raise the bar on health service delivery by making our demands known and making use of our vote. We pledge to do that again this time.
“We are tired of politicians prioritizing infrastructure and telling us health must wait”, said William Kidega of PATH adding that, “Health cannot wait not when our public health facilities routinely report stock outs, pregnant women suffer and die of totally preventable causes, and for example drug resistant TB is on the rise”.
Investing in health service delivery means investing in social infrastructure that is the only path to equitable economic development for ordinary Ugandans, and this is non‐negotiable.
On behalf of the Civil Society Inter-constituency Coordination Committee (CICC)
Reverend Sam L. Ruteikara| Chairperson CICC
Uganda Network of AIDS Service Organisations (UNASO), CICC Secretariat
Plot 190, Old Kiira Road, Ntinda P.O.BOX 27346, Kampala Uganda
Facebook: unaso unaso
Prepared by Ms. Esther Namirimu
Communications Officer| UNASO
1 December 2015
The world has committed to end the AIDS epidemic by 2030 as part of the Sustainable Development Goals. This ambitious yet wholly attainable objective represents an unparalleled opportunity to change the course of history for ever—something our generation must do for the generations to come.
Today, we live in fragile communities where inequities can persist when essential services don’t reach the people in need. To change this dynamic we must quicken the pace of action. We know that strengthening local services to reach key populations will lead to healthier and more resilient societies.
The good news is that we now have what it takes to break this epidemic and keep it from rebounding—to prevent substantially more new HIV infections and AIDS-related deaths and to eliminate HIV-related stigma and discrimination.
Already we have reached 15.8 million people with life-saving treatment. And increasingly we are able to refine our efforts and be more precise in our ability to reach people who might otherwise be left behind. With this attention to location and population countries are able to redistribute opportunities to improve access.
On this World AIDS Day countries are implementing the UNAIDS Fast-Track Strategy, and together with front-loaded investments we can expect to close the gaps to essential services faster. This means resources can go further to reach more people with life-changing results.
With the Sustainable Development Goals, the world has entered a new era of innovation and integration. There is a greater understanding of how the global goals are interconnected and a better appreciation for moving forward together.
Ending the AIDS epidemic means that adolescent girls and young women have access to education and appropriate HIV and sexual and reproductive health services. It means key populations, such as people who inject drugs and transgender people, have full access to health services delivered with dignity and respect. And it means that every child is born free from HIV, and that they and their mothers not only survive but thrive.
This is an exciting time in the AIDS response. We are building momentum towards a sustainable, equitable and healthy future for all.
Executive Director of UNAIDS
Under-Secretary-General of the United Nations
Tuesday, 17 November 2015
UGANDA is facing a shortage of essential drugs in Government health facilities, according to the latest report, “Stock status report as at 1st October 2015,” by the Ministry of Health (MOH), Pharmacy division.
The report shows most of essential medicines such as reproductive health commodities, TB drugs, Antiretroviral medicines, anti-malarial medicines, vaccines like polio oral trivalent, measles, hepatitis B and BCG vaccines that treat common diseases like HIV/AIDS, malaria, and opportunistic infections, diarrhoea, TB, diabetes and hypertension are not readily available.
The supply gap for adult antiretroviral therapy is US $ 47,425,412, Equivalent to 163,617,671,400 Uganda shillings.
This serves to act as a warning indicator for potential stock outs and possible expiries of essential medicines and health supplies. The report also indicates that there will be drug stock out for one month and if government does not do emergency procurement, there will be bigger stock out in the next six months.
The report points out that National Medical Stores (NMS) has run out stock of antiretroviral medicines such as Key adult First Line (TLE &EFV 600mg), Second line (ATV/r, ABC/3TC) ARVs and pediatric AZT/3TC and EFV.
The month’s stock of 30th September indicates that Efavirenz 200mg, abacavir/lamivudine 600/300mg at Joint Medical Stores need to be closely monitored. It is only Medical Access Uganda limited which still has all antiretroviral commodities stocked.
ARVs are funded by Government of Uganda (GOU), Global fund, UNITAID, and PEPFAR. The public sector is funded by GOU and global. Public sector gaps are persistent annually since global fund and GOU do not cover 100% of the need .PEPFAR gap fill in the public sector ceased in early 2014
According to an official at MOH who did not want to disclose his identity, the government had planned to give antiretroviral treatment to 814,855 people living with HIV this year but as of 1st October 2015 they are 1,079,368 on treatment as a result of test and treat program.
The shipment of 2015/16 Global Fund consignments is expected to arrive in November 2015 to alleviate the stock out situation. However the expected Global Fund and Government of Uganda consignments do not cover the total public sector needs for the year, more funding needs to be identified to cover the missing gaps.
Joshua Wamboga, Executive Director of the Uganda Network of AIDS Service Organisations (UNASO) said that if 1,079,368 out of the 1.4 million Ugandans living with HIV are on treatment, that means that Uganda is close to achieving the 90x90x90 UNAIDS goal.
He added that with challenges of drug stock out hitting Uganda, the number of People Living with HIV cannot be sustained on treatment and this will lead to problems of drug resistance.
“If a person on first line treatment, stop taking drugs his body will become resistant to first line treatment and he will be required to immediately start on second line treatment and those who face drug resistance on second line will need to start on third line which is very expensive,” he added.
Mr. Wamboga said that in the whole of Uganda, only 300 people are getting third line treatment from CDC, so the government of Uganda must ensure that there are enough medicines to avoid drug resistance among people living with HIV.
He also noted that government should plan sustainable financing such as operationalization of the National AIDS Trust Fund (NATF) with sufficient funds, upfront investment and also ask donors to support new WHO guidelines by making policy and programmatic changes to ensure that resources are identified or reallocated to support the new HIV test and treat WHO guidelines.
Consequently, Health civil society organizations on Wednesday met with representatives from the Ministry of Health and USAID to discuss the HIV and TB drug stock out in the country. Some of the organizations included National Forum of People Living with HIV & AIDS, International Community of Women Living with HIV in East Africa, UNASO, PATH-USAID, Action Group for Health, Human Rights and HIV/AIDS and Alliance for Integrated Development and Empowerment, Coalition for Health Promotion and Social Development and others.
According to these organizations, an essential medicines crisis is looming in Uganda because a major stock-out is establishing itself in government hospitals and clinics. The Civil society organizations demanded that government of Uganda immediately reallocates funds to address stock out.
WRITTEN BY ESTHER NAMIRIMU| COMMUNICATIONS OFFICER OF UNASO