Tuesday, 17 November 2015

Drug shortage hits Uganda

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.


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