Tuesday, 9 December 2014

SPEECH BY H.E. YOWERI K. MUSEVENI,PRESIDENT OF THE REPUBLIC OF UGANDA ON WORLD AIDS DAY 1ST DECEMBER 2014


President Museveni and Omukama of Toro Oyo Rukidi IV attend the World AIDS Day 2014 at Booma Grounds in Fort Portal Kabarole

The Celebrations to mark World AIDS day in Uganda were held in Fort Portal Town, Kabarole District at Boma Grounds

Hon. Ministers Present
Hon. Members of Parliament,
The Omukama of Toro
The Chairman, Uganda AIDS Commission,
Your Excellencies, The Ambassadors,
Representatives of Development Partners
Representatives of Local Governments
Representatives of Persons Living with HIV/AIDS
Representatives of Young People
Distinguished Delegates & all invited Guests
Ladies and Gentlemen.

Let me take this opportunity to welcome you all to this important function as we commemorate World AIDS Day 2014. It is another important opportunity for us to join hands and remember our people who have succumbed to the AIDS scourge and also show solidarity with those affected by the disease. It is also the time to take stock of our achievements in our determination, identify existing gaps, and struggle to conquer the epidemic.
As you are aware, the Government of Uganda through Uganda AIDS Commission and in collaboration with and wide consultations with stakeholders, prepared the four year National HIV and AIDS Strategic Plan 2011/12 – 2014/15 (NSP) and the National HIV Prevention Strategy 2011 – 2015 which have guided the national HIV/AIDS response in the last 3 years. I am informed that these strategies have recently been reviewed and shown that we have registered significant achievements in the fight against the disease in the recent past. 

In the last three years alone, there has been a reduction in the number of people found to have new HIV infections - from 162,000 in 2011 to 137,000 in 2013. Between July 2013 and June 2014, a total of 179,468 people were enrolled on antiretroviral treatment exceeding the number of new infections in the same duration. 

At the end of June 2014, we had 680,514 people on treatment out of the 1,447,859 people who require treatment. This shows a marked improvement in coverage compared with the situation 10 years ago when only 40,000 Ugandans were enrolled on treatment. Because of this expanded coverage in treatment, AIDS related deaths have also significantly reduced. 


The implementation of other interventions under the National HIV Prevention Strategy have also gained significant momentum and yielded results. I would like to particularly mention the programme of Elimination of Mother To Child Transmission of HIV (EMTCT) which is spearheaded by Hon. Janet Kataaha Museveni. In this programme, we have worked closely with partners to implement the Elimination Plan. We have rolled out the new guidelines and reached out to more mothers and their babies in all parts of the country and averted many new HIV infections in children born to HIV positive mothers. In 2013, about 15,000 babies were born infected with HIV compared to 28,000 babies in 2008. This number is projected to fall to 8,000 at the end of 2014 with the current scale up plan. I would therefore, like to thank all those involved in the implementation of the national HIV/AIDS response and encourage them to double efforts for better results.
I commend efforts of the different cultural and religious leaders who have also been actively involved in the HIV prevention efforts. They should keep these efforts since their voices are listened to the communities that they serve.
Despite all the accomplishments, more work still needs to be done. The proportion of the population with HIV/AIDS at an average of 7.3% remains unacceptably high. The annual burden of 137,000 new HIV infections implies that every single day 380 of our people are getting infected with the virus. This situation is grossly unacceptable. I am informed that there is a disproportionate burden of the epidemic in certain populations such as fishing communities, long distance truckers, sex workers, and uniformed service men, and that they are not well covered with services because they are not easy to reach. Many of our people who are eligible for treatment are yet to be reached. We should therefore work harder to ensure that all our people are reached with HIV/AIDS services.

We need to specifically target the young people with clear HIV/AIDS messages. I am glad to learn that a message clearing committee has been set up at Uganda AIDS Commission to scrutinize all HIV/AIDS messages that are disseminated to our communities. I would therefore like to call on Uganda AIDS Commission to ensure that this committee is fully utilized.
The HIV/AIDS response requires committed, strong and sustained involvement of Political, religious as well as cultural leadership. I therefore urge all these leaders to lead by example. Make sure you test for HIV and know your status. This is the only way through which you will be able to access the appropriate services to live longer in case you test positive. You will also receive counseling and other services to assist you to stay HIV negative if your test is negative. By doing this, you will encourage the people under your leadership to follow and reap the benefits of exemplary leadership. 

I take this opportunity to thank all our AIDS development partners and their respective Governments for generously contributing to the financing of the national HIV/AIDS response. I appeal to you to work through and align your support with the established Government systems for sustainability.
The Government of Uganda will work towards sustainability of the current HIV/AIDS investments. You are fully aware that the recently enacted HIV/AIDS act 2014 provides for setting up of the National HIV/AIDS Trust Fund. I am therefore calling on the concerned government organs to speed up the process of setting up and functionalizing this fund. 
Finally, I would like to call on all of you to re direct our efforts to prevention. The mode of spread of HIV is well known to all of us and it was through addressing this that we registered tremendous achievements in the 1990s. We should gear our efforts towards having zero new infections, zero deaths and zero discrimination in the fight against the scourge. As the National theme of World AIDS Day this year states, this is a responsibility of each and all of us.
I THANK YOU ALL

HIV may evolve to cause AIDS less frequently, researchers find

HIV may be evolving to become less aggressive, suggesting that one day it may infect humans without causing AIDS.

Women with HIV in South Africa are more likely to have AIDS than a similar group in Botswana, where the disease arrived a decade earlier. The comparison indicates that HIV eventually evolves into a less virulent form, according to the study published today in the Proceedings of the National Academy of Sciences.

“If this process is something we can see continuing as a trend, then the ability of HIV to cause disease will become less and less over time,” Philip Goulder, a professor of pediatric immunology at the University of Oxford and the study’s lead author, said in an interview.

About 35 million people are infected with HIV, according to the World Health Organization, and about one-third receive antiretroviral therapies, the standard treatment. About 1.5 million people died from AIDS last year. Currently, about half of 1 percent of people with HIV will never develop AIDS, and that proportion will probably grow, Goulder said.

In the women in Botswana, HIV had evolved to adapt to a protein that shields the body from the virus. While patients lose the “protective effect” of the protein, the adaptation means that ability of the virus to replicate is significantly reduced.

Treatment Endorsed

The study indicates that treatment with antiretroviral drugs speeds the evolution of HIV into a less virulent form.

“Anything we can do to increase the pressure on HIV in this way may allow scientists to reduce the destructive power of HIV over time,” Goulder said in a statement.

The prevalence of HIV and the genetic homogeneity of the population studied may have allowed the virus to adapt more quickly than it would in more ethnically diverse places such as North America and the U.K., Goulder said.

“If you have a very heterogeneous population, the genes acting on the virus are many and varied, and are not all working in the same direction,” he said.

The researchers studied more than 2,000 women with chronic HIV infection. The study, funded by the Wellcome Trust, was led by Oxford researchers, along with scientists from South Africa, Canada, Japan, Harvard University and Microsoft Research.

The changes in HIV are a rare opportunity for scientists, according to Goulder.
“We have the opportunity in HIV to see evolution happen before our eyes,” he said. “We haven’t ever really been able to view this evolution in so much detail.”

For Related News and Information: AIDS Could Be Ended as Threat to Global Health by 2030, UN Says Curing AIDS Moves Step Closer as Cancer Drug Rouses Virus Glaxo, Pfizer’s ViiV Wins Approval for Single-Pill HIV Regimen
To contact the reporter on this story: Oliver Staley in London at ostaley@bloomberg.net

Monday, 8 December 2014

UNASO welcomes President Museveni's launch of massive HIV prevention and treatment campaign

The Uganda Network of AIDS Service Organisations (UNASO) welcomes President Museveni's launch of massive HIV prevention. Below is the President's speech on Word AIDS Day held in Kabarole District.
 
SPEECH BY H.E. YOWERI K. MUSEVENI,
PRESIDENT OF THE REPUBLIC OF UGANDA
ON WORLD AIDS DAY 1ST DECEMBER 2014
The Celebrations to mark World AIDS day in Uganda were held in Fort Portal Town, Kabarole District at Boma Grounds
Full Text of speech below:
Hon. Ministers Present
Hon. Members of Parliament,
The Omukama of Toro
The Chairman, Uganda AIDS Commission,
Your Excellencies, The Ambassadors,
Representatives of Development Partners
Representatives of Local Governments
Representatives of Persons Living with HIV/AIDS
Representatives of Young People
Distinguished Delegates & all invited Guests
Ladies and Gentlemen.
Let me take this opportunity to welcome you all to this important function as we commemorate World AIDS Day 2014. It is another important opportunity for us to join hands and remember our people who have succumbed to the AIDS scourge and also show solidarity with those affected by the disease. It is also the time to take stock of our achievements in our determination, identify existing gaps, and struggle to conquer the epidemic.

 

As you are aware, the Government of Uganda through Uganda AIDS Commission and in collaboration with and wide consultations with stakeholders, prepared the four year National HIV and AIDS Strategic Plan 2011/12 – 2014/15 (NSP) and the National HIV Prevention Strategy 2011 – 2015 which have guided the national HIV/AIDS response in the last 3 years. I am informed that these strategies have recently been reviewed and shown that we have registered significant achievements in the fight against the disease in the recent past. 



In the last three years alone, there has been a reduction in the number of people found to have new HIV infections - from 162,000 in 2011 to 137,000 in 2013. Between July 2013 and June 2014, a total of 179,468 people were enrolled on antiretroviral treatment exceeding the number of new infections in the same duration. 

 

At the end of June 2014, we had 680,514 people on treatment out of the 1,447,859 people who require treatment. This shows a marked improvement in coverage compared with the situation 10 years ago when only 40,000 Ugandans were enrolled on treatment. Because of this expanded coverage in treatment, AIDS related deaths have also significantly reduced. 


The implementation of other interventions under the National HIV Prevention Strategy have also gained significant momentum and yielded results. I would like to particularly mention the programme of Elimination of Mother To Child Transmission of HIV (EMTCT) which is spearheaded by Hon. Janet Kataaha Museveni. In this programme, we have worked closely with partners to implement the Elimination Plan.

 

We have rolled out the new guidelines and reached out to more mothers and their babies in all parts of the country and averted many new HIV infections in children born to HIV positive mothers. In 2013, about 15,000 babies were born infected with HIV compared to 28,000 babies in 2008. This number is projected to fall to 8,000 at the end of 2014 with the current scale up plan. I would therefore, like to thank all those involved in the implementation of the national HIV/AIDS response and encourage them to double efforts for better results.


I commend efforts of the different cultural and religious leaders who have also been actively involved in the HIV prevention efforts. They should keep these efforts since their voices are listened to the communities that they serve.


Despite all the accomplishments, more work still needs to be done. The proportion of the population with HIV/AIDS at an average of 7.3% remains unacceptably high. The annual burden of 137,000 new HIV infections implies that every single day 380 of our people are getting infected with the virus. This situation is grossly unacceptable. I am informed that there is a disproportionate burden of the epidemic in certain populations such as fishing communities, long distance truckers, sex workers, and uniformed service men, and that they are not well covered with services because they are not easy to reach. Many of our people who are eligible for treatment are yet to be reached. We should therefore work harder to ensure that all our people are reached with HIV/AIDS services.


We need to specifically target the young people with clear HIV/AIDS messages. I am glad to learn that a message clearing committee has been set up at Uganda AIDS Commission to scrutinize all HIV/AIDS messages that are disseminated to our communities. I would therefore like to call on Uganda AIDS Commission to ensure that this committee is fully utilized.


The HIV/AIDS response requires committed, strong and sustained involvement of Political, religious as well as cultural leadership. I therefore urge all these leaders to lead by example. Make sure you test for HIV and know your status. This is the only way through which you will be able to access the appropriate services to live longer in case you test positive. You will also receive counseling and other services to assist you to stay HIV negative if your test is negative. By doing this, you will encourage the people under your leadership to follow and reap the benefits of exemplary leadership. 



I take this opportunity to thank all our AIDS development partners and their respective Governments for generously contributing to the financing of the national HIV/AIDS response. I appeal to you to work through and align your support with the established Government systems for sustainability.
The Government of Uganda will work towards sustainability of the current HIV/AIDS investments. You are fully aware that the recently enacted HIV/AIDS act 2014 provides for setting up of the National HIV/AIDS Trust Fund. I am therefore calling on the concerned government organs to speed up the process of setting up and functionalizing this fund. 


Finally, I would like to call on all of you to re direct our efforts to prevention. The mode of spread of HIV is well known to all of us and it was through addressing this that we registered tremendous achievements in the 1990s. We should gear our efforts towards having zero new infections, zero deaths and zero discrimination in the fight against the scourge. As the National theme of World AIDS Day this year states, this is a responsibility of each and all of us. 


I THANK YOU ALL


Wednesday, 3 December 2014

Museveni tells Ugandans to lock their private parts


President Yoweri Kaguta Museveni

“Those NGOs and whites come deceiving you that circumcision and condom use are the best ways to protect yourself against HIV/Aids.
But for me I advise you to put padlocks on your private parts.
A man wears an iron underpants.

I told my children that once someone is affected by HIV/Aids , they have betrayed their families because of the high hopes we usually have in children.
So whenever my children would return for holidays, I would ask them whether the padlock is still on"

Tuesday, 2 December 2014

Museveni disputes circumcision and condom use.

According to Museveni, the only safe prevention method against HIV/AIDS is delaying sex by the youths and aggressive sensitization about the dangers of the epidemic.

He said this during celebrations to mark the World Aids day at the Boma grounds in Fort Portal municipality on Monday under the theme, “Zero Infection, my responsibility”.

It came after various speakers including people living with HIV/AIDS, Richard Rwabuhinga, the Kabarole district LC5 Chairperson and Aids activists advocated for continued use of condoms and urged men to embrace safe male circumcision. Scientific trials have in the past shown that male circumcision can reduce the risk of HIV infection by up to 60 percent. As a result, UNAIDS and the World Health Organization (WHO) recommend circumcision as an important element in HIV prevention.

However, Museveni wondered if circumcision can prevent the spread of HIV, why there are many Muslims, Bakonjo and Bagisu dying from Aids. The Bakonzo like the Bagisu, have circumcision as one of their most entrenched cultural practices. Museveni also said that, whenever he attends international conferences on HIV/AIDS, he is irritated by health experts supporting circumcision and condom use.

He said if Aids is to end in Uganda, people should avoid contracting the disease, the sick should seek treatment and women should embrace Prevention of mother to child transmission (PMTCT), which is a key intervention in curbing the spread of HIV.

Museveni attributed the new infections of HIV/AIDS, especially among the youths to failure by parents to talk to their children about the dangers of Aids.

Asked about the comments by the president, Sarah Achieng Opendi, the minister of state for Primary said that Ministry of Health will continue advocating for Safe Male Medical Circumcision and condom use, since they are part of the ministry’s prevention strategy.

She, however, warned medical workers against misleading people that Safe Male Medical Circumcision -SMC completely prevents infection of Aids.

Courtesy of Crooze FM

Why we celebrate World AIDS Day


 
 
 
 
World AIDS Day is about increasing awareness, fighting stigma, improving education, mobilizing resources and raising funds to better our response to HIV and AIDS. 2.5 million people continue to be infected with HIV each year, with 2,400 young people newly infected every day.
 
Raising awareness and knowledge of HIV is crucial to get these figures to zero.
 
This year's celebrations were held at Booma grounds in Kabalore. The World AIDS Day 2014 theme was “Getting to Zero in Africa- Africa’s Responsibility, Everyone’s Responsibility” resonates with the global theme (2012-16) Getting to Zero- Zero new HIV infections, Zero Discrimination and Zero AIDS-Related deaths.
The guest of honour was president Yoweri Kaguta Museveni.
 
World AIDS Day is held on 1st December each year and is an opportunity for people worldwide to unite in the fight against HIV, show their support for people living with HIV and to commemorate people who have died. World AIDS Day was the first ever global health day and the first one was held in 1988.    
 
 
World AIDS Day is an opportunity for you to learn the facts about HIV and put your knowledge into action. Find out how much you know by taking our online quiz: Are you HIV aware? Test your knowledge and awareness by taking the quiz and act aware by passing the quiz on and sharing it with your friends on Twitter and Facebook.

If you understand how HIV is transmitted, how it can be prevented, and the reality of living with HIV today - you can use this knowledge to take care of your own health and the health of others, and ensure you treat everyone living with HIV fairly, and with respect and understanding.
Click here to find out the facts.
You can also show your support for people living with HIV on World AIDS Day by wearing a red ribbon, the international symbol of HIV awareness and support.

World AIDS Day is also a great opportunity to raise money for people living with HIV and AIDS and show your support to them.
 
But what about after World AIDS Day?
Although World AIDS Day is a great opportunity to get the public talking about HIV and fundraise, we need to remember the importance of raising awareness of HIV all year round. Why not use what you have learnt on World AIDS Day to Act Aware throughout the year and remember, you can fundraise at any time of year too.


Courtesy of Flashmob and Namirimu Esther
 

HIV's ability to cause AIDS is weakening over time


LONDON, Dec 1 (Reuters) - Rapid evolution of HIV, the human immunodeficiency virus, is slowing its ability to cause AIDS, according to a study of more than 2,000 women in Africa.

Scientists said the research suggests a less virulent HIV could be one of several factors contributing to a turning of the deadly pandemic, eventually leading to the end of AIDS.
An image of the HIV virus/ courtesy of Reuters

"Overall we are bringing down the ability of HIV to cause AIDS so quickly," Philip Goulder, a professor at Oxford University who led the study, said in a telephone interview.

"But it would be overstating it to say HIV has lost its potency -- it's still a virus you wouldn't want to have."

Some 35 million people currently have HIV and AIDS has killed around 40 million people since it began spreading 30 years ago.

But campaigners noted on Monday that for the first time in the epidemic's history, the annual number of new HIV infections is lower than the number of HIV positive people being added to those receiving treatment, meaning a crucial tipping point has been reached in reducing deaths from AIDS.

Goulder's team conducted their study in Botswana and South Africa -- two countries badly hit by AIDS -- where they enrolled more than 2,000 women with HIV.

First they looked at whether the interaction between the body's natural immune response and HIV leads to the virus becoming less virulent or able to cause disease.

Previous research on HIV has shown that people with a gene known as HLA-B*57 can benefit from a protective effect against HIV and progress more slowly than usual to AIDS.

The scientists found that in Botswana, HIV has evolved to adapt to HLA-B*57 more than in South Africa, so patients no longer benefited from the protective effect. But they also found the cost of this adaptation for HIV is a reduced ability to replicate -- making it less virulent.

The scientists then analyzed the impact on HIV virulence of the wide use of AIDS drugs. Using a mathematical model, they found that treating the sickest HIV patients -- whose immune systems have been weakened by the infection -- accelerates the evolution of variants of HIV with a weaker ability to replicate.

"HIV adaptation to the most effective immune responses we can make against it comes at a significant cost to its ability to replicate," Goulder said. "Anything we can do to increase the pressure on HIV in this way may allow scientists to reduce the destructive power of HIV over time."

The study was published on Monday in the journal Proceedings of the National Academy of Sciences (PNAS). (Editing by Alison Williams)

By Kate Kelland, Health and Science Correspondent

Couples demand PrEP for HIV prevention


In Uganda, we have had a mixed experience in our efforts to address the HV epidemic – from reductions in the 90s and now a rise in new cases. We need to treat this urgently and provide tools to people – depending on what they need – to help them reduce their risk of HIV.
I am writing today about expanding HIV prevention options for serodiscordant couples (where one partner is HIV positive, the other negative). We know that there are many Ugandans in serodiscordant relationships. Sixty percent of the reported 124,000 new HIV infections in Uganda each year are among discordant couples. They clearly have special needs for HIV prevention.
I have worked with these couples for many years, first as part of research studies and currently as an HIV advocate. I’m an AVAC Fellow and I have spent the past 12 months trying to lay the ground for the development of guidelines for pre-exposure prophylaxis or PrEP roll out among discordant couples and other key populations in Uganda. While there is a call from many couples for this new option, and interest from stakeholders at every level, there are no concrete strategies. We urgently need a plan!
PrEP is a strategy in which an HIV-negative person takes antiretroviral medications (ARVs) to reduce their risk of HIV infection. ARVs are the drugs traditionally used to treat people living with HIV.  In the case of PrEP, ARVs prevent HIV in those who are not infected. Studies conducted in Africa – including right here in Uganda - and elsewhere have proven that PrEP works if used correctly. They show that taking the drugs Truvada or Viread daily can reduce HIV risk by as much as 90 percent or more when taken as prescribed.

What can couples use now? They can use male and female condoms. But we know there are periods when most people experience condom fatigue or when condom use cannot be negotiated with a partner. We know this is the case or we would not have high rates of HIV transmission among the married.

Discordant couples can also benefit from Treatment as prevention (TasP). This is simply when a person with HIV is on antiretroviral treatment and the virus is so diminished that the risk of transmitting HIV to a sexual partner is almost none. However, there are many couples in which the HIV-positive partner has not initiated HIV treatment for reasons ranging from personal preference to lack of accessibility. PrEP can also be used by the HIV-negative partner until their HIV-positive partner is ready to start treatment, or to take control of their own protection.

“We want government to avail these [PrEP] drugs in all the health facilities such that we don’t have to only rely on our infected partners to take ART,” said a Mukono District resident with an HIV-positive wife.

At a recent community meeting, men and women from Kampala, Luwero, Wakiso, Mpigi and Kayunga districts voiced their desire for PrEP to officials from the Uganda AIDS Commission.  Unfortunately, they were and continue to be answered with inaction from the government, which has yet to come up with guidelines to implement this new and potentially powerful tool.

 “The opportunity costs of scaling up [PrEP provision] are high but can bring wider benefits beyond HIV infections and lifelong treatment averted. We need a coherent strategy, to be sure that the investment pays off,” Uganda AIDS Commission Director General, Dr. Christine Ondoa said in October.  There is no question that such statements are important. But government must move beyond statements, and move from evidence to policy, and from policy to programming.

It’s more than the three years since PrEP was proven to work. The resounding question from couples is still: Why are we not provided PrEP when we know very well that the drugs work? Maybe this World AIDS Day, Uganda’s discordant couples will get an answer from the Ministry of Health.

Written by Charles Brown. 
Brown is an HIV prevention advocate. He’s one of AVAC’s Advocacy Fellows, based at the Infectious Diseases Institute. He was part of the research team that conducted the Partners PrEP study that provided some of the evidence that PrEP works to prevent HIV infection among discordant couples.

Contacts:  cb2charles@yahoo.com

 

 

 

 

Bitter-Sweet findings from the 6th annual national monitoring of ARVs, TB medicines and diagnostics survey by HEPS Uganda


The Coalition for Health Promotion and Social Development (HEPS Uganda) under the umbrella of the Uganda Coalition for Access to Essential Medicines (UCAEM) annually conducts national surveys on availability of ARVs, TB medicines and diagnostics surveys in accredited ART services providers in Uganda. The findings from the survey are used to inform access to treatment policies.

 Against this background HEPS conducted the 6th in a series annual survey on availability of ARVs, TB medicines and diagnostics in Uganda, the survey was conducted in 118 public, private and private-not-for-profit (PNFP) health facilities accredited by Ministry of Health to provide ART in four regions of Uganda (Central, Eastern, Western, and Northern). A basket of 67 essential medicines for tuberculosis and ART was surveyed: 57 ARVs and 10 anti-tubercular’s.

 Results from the survey

Of the 57 medicine formulations assessed by the survey, a total of 14 medicines were not found in any of the facilities surveyed. Most of the medicines that were not found in the surveyed facilities were monotherapies. This suggests that patients are receiving combination therapies, which reduces the pill burden and hence increasing chances of adherence.

The triple combination therapy of Zidovudine+Lamivudine+Nevirapine was the most available medicine, found in 69% of public facilities, 70% of private facilities and 67% of mission facilities.

Availability of double combination Tenofovir+Lamivudine has grown from complete unavailability in 2011 to 62% of facilities in this survey. At the same, results show that the highly toxic combination of Lamivudine+ Nevarapine + Stavudine (commonly known as Triomune) has phased out completely as it was not found at any treatment site.

Availability of medicines for children remains was very poor. The only triple combination medicine available Lamivudine+Nevirapine+Stavudine was in less than 3% of public facilities; in none of the private facilities; and only 8% of mission facilities.

On eMTCT medicines, the preferred first line treatment for pregnant mothers,
Tenofovir+ Lamivudine+ Efavirenz 300mg+300mg+300mg, was available in only 26% of public facilities; 62 of private facilities and 50% of mission facilities.

Medicines for TB treatment initiation phase (Rifampicin/ Isoniazid/ Pyrazinamide/

Ethambutol tab/cap 150mg/75mg/400mg/275mg) were the most available TB medicine, found in 81% of facilities in the public sector, in 77% of facilities in the private sector, and in 60% of the facilities in the mission sector.

In summery
It was established that the toxic combination of Triomune have been totally phased out which is a positive development and means that clients are now receiving safer and more tolerable medications

However universal access to treatment is still a challenge, even the most available triple combination medicine was not available in all facilities
Continued use of non film coated tenofovir+lamivudine; a two drug combination used with a third medicine, typically efavirenz or nivirapine. This two-drug combination is notoriously bitter and was recalled by NDA in January 2014 following widespread complaints by people living with HIV and their providers when it was being used in 2013, this drug has continued to used.

The low availability of ARVs in rural private facilities is an indicator of skewed access to HIV treatment
Management of HIV in children remains a major gap in the national response

Poor availability of anti-TB medicines in rural private facilities poses equity challenges