HIV drug shortage in Uganda

HIVaids

The lives of hundreds of thousands of Ugandans living with HIV are being put at risk as the country runs out of a drug given to people on antiretroviral drugs (ARVs) to fight infections.

Sarah Achieng Opendi, state minister for health, told the Guardian the country’s national medical stores were running out of the antibiotic Septrin, which is used to treat and fight conditions like flu, malaria, diarrhoea and tuberculosis.

Most of the public health facilities and ARV-accredited sites in the country haven’t received Septrin for the past five months.

“We had a funding gap and could not procure Septrin in time,” said Opendi.

She said a supply is expected in July, after the government received money from the Global Fund to fight Aids, Tuberculosis and Malaria. That supply is expected to last until December.

Uganda relies on the Global Fund, the US president’s emergency plan for Aids relief (Pepfar), and the pharmaceutical company Pfizer to boost drugs stocks.

Activists fear the scarcity will weaken immunity among people with HIV. “According to feedback from the field, the shortage of Septrin is countrywide, and this has been the case since the year began,” said Sylvia Nakasi, policy and advocacy officer at the Uganda Network of Aids Service Organisations (Unaso).

“In order to curb this problem, I think there is a need to revise the national test and treatment guidelines to streamline who should access Septrin, or not, at the health facilities,” she said.

According to the ministry of health, at least 1.4 million people are living with HIV in Uganda – activists put the figure at nearer 1.6 million – with children and women disproportionately affected. Not all people who are HIV positive are on a treatment programme.

“The stock-outs of essential medicines are a ping-pong game in Uganda, with no one wanting to take responsibility for their actions,” said Milly Katana, a public health specialist and HIV prevention campaigner. “This is very sad given that Septrin is one of the cheapest drugs on the market, and is recommended to all people living with HIV to ward off opportunistic infections including respiratory complications like pneumonia, and is known to reduce the susceptibility to malaria infections.

“Septrin is a first-line regimen for many other conditions in people who do not live with HIV. So such a prolonged stock-out does not only affect people living with HIV but all peoples of Uganda,” she said.

She added that Septrin can be produced in-country so doesn’t need to be imported, and puts the problems down to poor administration.

“The ministry of health must put their house in order and fulfil the constitutional responsibility they have on behalf of the government of Uganda, to the people of Uganda who are the voters and taxpayers,” said Katana.

Activists said the government needed to invest more in its HIV response. “More than ever, we need to increase our domestic funding to the HIV response if we are to sustain gains and end Aids by 2030,” said Nakasi.

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