Uganda is facing limited supply of HIV/Aids life-saving medication, particularly for third-line patients. The stock-outs and shortages of HIV drugs have increased the risk of antiretroviral resistance, treatment failure, sickness and death of people living with HIV/ Aids in the country.
According to UNAIDS, there are 1.5 million people living with HIV/Aids in Uganda. At least 1.3 million know their HIV status while 1.2 million are on treatment. Last week, Civil society Organizations (CSOs) under the Uganda Coalition for Access to Essential Medicines petitioned the ministry of Health over the persistent stock-outs of Antiretroviral drugs (ARVs) in the country.
The CSOs claimed that since January, there has been a persistent stock-out of antiretroviral drugs, especially for third-line patients in the country. Currently, there are over 2,500 patients on the third line of HIV medication. However, the majority are on the first and second line.
They claimed that the ministry of Health confirmed to them that there was a low stock level of Raltegravir 400mg and Raltegravir 100mg and Darunavir 75mg. The available stock of Ritonavir 100mg and Darunavir 600mg are outdated.
Despite the country’s considerable progress against the HIV/Aids epidemic, the activists said that there are widespread fears, panic and worry over potential risk of disease progression and drug resistance.
Kurish Mubiru, the executive director of Uganda Young Positives said: “We stormed the ministry of Health and HIV/Aids control program to get adequate answers over the stock out of HIV medicine particularly for third Line patients.”
“They told us that the programs manager of HIV/Aids control program is on leave and the head of treatment who gave us information about two week ago traveled to Montreal, Canada for Aids 2022 conference.”
Salome Atim, a human rights activist, said uninterrupted and adequate supplies of lifesaving antiretroviral treatment are essential to achieving Uganda’s goal of defeating HIV/Aids and achieving 95-95-95 target of 95 per cent of people with HIV/Aids knowing their status, 95 per cent on treatment and 95 per cent having durably suppresses viral load.
“All babies, children and adults living with HIV/Aids need to access antiretroviral treatment that suppresses their viral load and keeps them healthy. But universal access to treatment is becoming a mirage for people living with HIV/Aids,” she said.
“We were excited to hear that the stock-out issue will be worked on by July 22. When we consulted our partners at the health facilities, the ministry of Health had fulfilled its pledge,” she said.
PEOPLE LIVING WITH HIV REACT
Moses Nsubuga aka Super Charger, who has lived with HIV/Aids more than three decades, said people with HIV/ Aids need to take their medication every day to control the viral load, mitigate the chances of infecting their sexual partners.
“We contacted the Global Fund about the HIV/Aids refill gap, however, they said the money was released a long time ago. What happened to the money, who is supposed to procure these drugs and didn’t do so? People are beginning to die. You can’t be off treatment for three months and you survive” he said.
“Third line patients are supposed to take Raltegravir, Darunavir and Ritonavir as a booster. We are receiving reports that some centers only get Ritonavir yet that medication is supposed to be taken in combination. Patients are receiving medication that is about to expire. You find that a patient is give a dose of three months but it is expiring in two weeks,” he said.
“I am a second line patient. I take Ritonavir, Lamivudine and Didanosine. So, I take it in combination. One is supposed to attack the enemy, protect your internal organs and boost your immune system,” he said
Laura Angel Kyankunzire, who was born with HIV/Aids, said as someone who has faced drug resistance from line one to line two and was told that in case line two fails, line three will be hard for her to access because of the inconsistency.
MINISTRY OF HEALTH SPEAKS OUT
Emmanuel Ainebyona, the ministry of Health spokesperson, said there are adequate HIV Aids drugs in government health facilities.
“I consulted National Medical Stores (NMS) and they said that all HIV/ Aids drugs are available. They have been working with their partners to distribute those drugs. Maybe there was a period when NMS was undertaking stock-taking… maybe it should have been that period where some of the arrangements were not available,” he said.
RECOMMENDATIONS
The activists urged the NMS to deliver medicines with longer shelf life which will reduce the volume of expiries, strengthen inventory management practices, and optimize supply chain management of medical and pharmaceutical products for commodity security with minimal stock-outs of essential products.
“The Global Fund must step up with an emergency procurement of medicines for third-line treatment, doubling current investments to ensure all people with HIV/Aids on the third line of continuous access to highly active therapy,” they said in a statement.