From: PlusNews <no-reply@irinnews.org>
Date: Thu, 14 Mar 2013 18:02:13 -0000
Subject: Uganda government under pressure to boost ARV funding
To: Hermengild Mayunga <drmayunga@gmail.com>
PlusNews logo <http://www.plusnews.org/> PlusNews
Global HIV/AIDS news and analysis
Uganda government under pressure to boost ARV funding
<http://www.plusnews.org/report.aspx?Reportid=97651>
lead photo<http://www.irinnews.org/images/2012/201210031338410066.jpg>
KAMPALA, 14 March 2013 (PlusNews) - The Ugandan government's draft
2013/2014 budget allocates US$38.5 million to enrol a further 100,000
people living with HIV on life-prolonging antiretroviral (ARV) drugs.
But activists say the money, while welcome in a country still largely
dependent on donor funds for its HIV programmes, is not sufficient to
meet treatment needs.
"With the current allocation and funding, we still have a long way to
go," said Raymond Byaruhanga, the executive director of the AIDS
Information Centre (AIC). "We need the government's commitment to
increase the number of people on ARVs and decrease the number of those
getting HIV if we are to achieve universal access."
The country enrolled an estimated 65,493 new HIV patients on ARVs in
2012, bringing to 356,056 the number of those on ARV therapy (ART),
according to Uganda AIDS Commission statistics. However, this figure
represents less than 70 percent of those in need of treatment. The
government has set a target of reaching 80 percent of HIV-positive
people with ARVs by 2015.
"The government efforts to contribute more funding for adding more
patients on ART is commendable. However, we still need additional
resources for scaling up on evidence [-based] interventions in order to
be in position to halve the new infections," Monica Dea, senior
programme advisor for the US Centres for Disease Control in Uganda,
told IRIN.
Playing catch up
Uganda has seen its HIV prevalence rise from 6.4 to 7.3 percent over
the past five years. Experts say the rising prevalence
<http://www.plusnews.org/Report/95116/UGANDA-Higher-HIV-rate-cause-for-c
oncern> means the government must work doubly hard to ensure even more
people are placed on treatment, especially given recent research
showing ARVs have a role in preventing HIV transmission
<http://www.plusnews.org/Report/93251/HIV-AIDS-Treatment-as-prevention-t
he-tough-road-ahead> .
But limited funding, frequent drug stocks outs, too few CD4 count
machines - which measure patients' immune strength - and understaffing
in the public health sector continue to hamper plans to achieve
universal ART access.
According to Alex Ario, programme manager at the health ministry's AIDS
control programme, the financial gap in the public sector for 2013/2014
is about $29 million.
"WHO [the UN World Health Organization] is changing its treatment
guidelines in the coming months in order to act on exciting new science
that shows that treatment saves lives and is one of the most powerful
HIV-prevention tools available. This means that in 2013, the number of
people in Uganda clinically eligible for treatment will expand beyond
just those whose CD4 is less than 350," Asia Russell, director of
international policy at the Health Global Access Project (Health GAP),
told IRIN. "Despite this, the draft Budget Framework Paper for the
health sector proposes no increase in investment for HIV treatment."
"Ugandan civil society is calling on the government to substantially
increase its investment in ART for financial year 2013/14 in order to
save lives, slash rates of new infections, and begin to end the AIDS
epidemic," she added.
Corruption
Activists have also expressed disappointment in a local pharmaceutical
plant
<http://www.plusnews.org/Report/74715/UGANDA-Factory-to-boost-ARV-rollou
t> - started in 2007 and jointly owned by a local company, Quality
Chemicals Industries Limited (QCIL), and Indian generics giant Cipla
Limited - that was expected to improve treatment access by providing
cheaper ARVs locally. However, the factory's drugs have remained
overpriced, and the plant is currently embroiled in a $17.8 million
corruption scandal.
In a 20 December 2011 report to Uganda's President Yoweri Museveni,
then acting government anti-graft boss Raphael Baku noted that between
December 2009 and October 2010, the government's National Medical
Stores (NMS) paid $17.8 million more than it should have to QCIL, in
violation of its Memorandum of Understanding (MoU) with the government.
The funds allocated for ARV procurement in the budget are intended for
purchasing drugs manufactured by QCIL.
QCIL and NMS are accused of manipulating the MoU in order to achieve a
15 percent mark-up on imported drugs; the mark-up had actually been
intended only for locally produced drugs. QCIL is also accused of
continuing to sell imported drugs manufactured by Cipla to the
government at inflated prices even after it started producing its own
drugs.
QCIL denies the allegations.
The inspector general of government, anti-corruption activists and HIV
activists have demanded the government recover the funds and prosecute
those involved.
"Our government is good at creating institutions, but when it comes to
implementing their recommendations, it fails," said Cissy Kagaba, the
executive director the Anti-Corruption Coalition Uganda (ACCU). "We
demand for an immediate action on the reports of the oversight
government organs to specifically recovery all the monies lost. This is
the taxpayers' money."
Asuman Lukwago, the permanent secretary at the Ministry of Health, told
IRIN that action would be taken on the reports.
"[ARVs] should be readily available to all who need them because they
are life-saving drugs. I think it is treacherous for someone to
overprice the drugs because this makes them inaccessible to the most
vulnerable, who will most likely end up dying," said Stephen Watiti, a
senior medical officer at Mildmay Uganda, an HIV treatment centre close
to the capital, Kampala.
New ways to fund HIV programmes
According to Ario, the government is seeking alternative ways to fund
ARVs. "Strategies are being explored to increase domestic HIV funding,
such as establishing the HIV Trust Fund," he said.
The Ugandan government recently developed a draft working paper on
establishing this $1 billion fund
<http://www.plusnews.org/Report/96443/UGANDA-HIV-trust-fund-in-the-works
> for its HIV/AIDS programmes.
"I support the establishment of a trust fund by adding a levy on such
items like beer, cigarettes, airtime or introducing an AIDS tax to make
sure all money needed to sustain ART is available instead of depending
on donors [for] 80-90 percent, as is the case at the moment," said
Watiti.
so/kr/rz
Read report online <http://www.plusnews.org/Report.aspx?Reportid=97651>
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