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By Elvis Basudde
Uganda is running out of AIDS drugs (Anti RetroVirals - ARVs) and some major service providers are closing down outlets, leaving many people living with HIV/AIDS stranded.
The two biggest providers, the Joint Clinical Research Centre (JCRC) and Mildmay Uganda, are scaling back their services. Recently, Mildmay announced the closure of some treatment sites while the JCRC is closing down some treatment sites soon.
Denis Mock, from ADFPHA Apac District forum of People living with HIV/AIDS, said 17 people have died since May due to lack of drugs.
According to a press release issued by the Uganda Red Cross, Masindi branch last Monday, the Antiretroviral Therapy Clinic in Masindi Hospital is closing in September due to lack of funds.
The clinic was established in 2003 to provide care for people living with HIV and other chronic illnesses. It has been supported by JCRC.
According to the release, the clinic has enrolled 2,093 adult patients and 135 children under 18. Five hundred patients are on ARVs and 466 are receiving other drugs.
A statement, signed by George William Barigye, the branch coordinator, said the clinic is closing due to lack of drugs. It has been run by volunteers headed by Dr. Chris Jay, who is leaving in September.
Mildmay has stopped registering all people who test positive for HIV at their site in Lweza, Entebbe Road, due to limited funds. TASO, Infectious Disease Institute, Makerere Mbarara Joint AIDS Programme and other providers are facing similar situations.
Milly Katana, an HIV activist, says many donors like PEPFAR, the Global Fund and others, who had been providing ARVs, are reducing the assistance because of the current credit crunch.
The US President’s Emergency Plan for AIDS Relief (PEPFAR), directly serves 150,000 people with antiretroviral care.
According to Dr Michael Strong, the PEPFAR coordinator, there are problems with the supplies of ARVs in the national programme.
“We expect that PEPFAR funding for Uganda will continue at its current level of around $280m annually through 2013. But this will still leave a gap between national treatment needs and the funds available. Uganda needs to identify other resources to fill this gap.”
Strong says while PEPFAR will institute a blanket freeze on new patient enrolment at this time, treatment partner organisations have been instructed to avoid enrolling new patients.
“They were asked to be cautious and responsible and to refocus their emphasis on care in order to postpone the time when infected people will need ARVs.”
According to Dr. Stephen Watiti, 1.3 million Ugandans are living with HIV. Out of these, 350,000 are eligible for ARVs because their CD4 count is below 250 cells/mm. Out of these, about only 180,000 (about 40%), are getting ARVs. This means that most of the people who need the life-saving drugs do not get them.
Since the initiation of ARV treatment programme in public health facilities in 2004, hope had increased and many people had been motivated to test for HIV. The number of people seeking testing services increased from 200,000 to 1.5million in 2007.
Closing down service outlets means that people with HIV will only be picked up by the care system in the very late stages of their infection. At that time, chances of survival are very low. This is scaring many individuals living with HIV, their families and other people who depend on them for livelihood.
Watiti, who is the chairperson of the National Forum of People living with HIV AIDS Network, says such treatment interruptions could lead to new HIV epidemic that is drug resistant.
Last Wednesday, Watiti presided over a meeting of more than 44 people living with HIV and activists from different parts of the country to discuss the way forward. The emergency meeting was held in Mengo, Kampala.
Major Rubaramira Ruranga, Milly Katana, Canon Gideon Byamugisha were among the activists who attended.
“This is jeopardising the universal access goals for Uganda and threatening to make new infections even higher. Fewer people will be motivated to seek for testing services, just as it was in the pre-ART era, where the majority of people with HIV were only reporting for care in the final stages of their infection,” Katana said.
She said our neighbours in the region, which built its capacity after us, are doing better. Her statistics indicated that Kenya has gone ahead of us with 60% ARV coverage of the people who need them. Rwanda is about 70% while Uganda is below at 50%.
Katana suggested that people living with HIV should be empowered beyond hand-outs. “The dependence syndrome is just too much. People think that Government should be sending them donations,” she said.
The activists resolved to petition Global Fund and other major funding partners about the drug crisis. They also want to start a multi-sectoral “Think-Tank” and an advocacy- committee for increased treatment. They resolved to mobilise all districts to organise a day for prayer.
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