More and more people are demonstrating against the lack of antiretrovirals (ARVs) in Mubende District, Central Uganda. Demonstrators want ARVs to be made available in local health centers as many people living with HIV currently have to walk, cycle or hitch a lorry ride for miles in order to reach Mubende Hospital to get these lifesaving drugs. At the demonstration, people said they would sometimes go without ARVs for up to a week due to the shortage.
Despite efforts by Ugandan NGO Integrated Community Based Initiatives (ICOBI) to provide ARVs in the area, HIV drugs have only been distributed to hospitals not to health centers.
Uganda is currently experiencing ARV drug shortages in most parts of the country, with people in the north also going without drugs in recent weeks. Private hospitals such as the International Hospital in Kampala has begun asking some registered clients to pay for ARVs as the government has been unable to provide for all registered patients at their facilities.
In a meeting on the shortage of ARVs, held recently at Masaka Hospital, it was reported that the ARV shortage had spread to both Masaka and Rwengo districts in Central Uganda. So far, people living with HIV in these areas have only received referrals to nearby clinics to go and buy the drugs, leaving most to go without. Those at the meeting asked whether ARVs were now to be paid for or provided free in health units.
Dr. Watiti, Chairperson of National Forum for People Living with HIV/AIDS (NAFOPHANU), revealed that national the supply of ARVs is a big problem. Only 200,000 people living with HIV in Uganda can access ARVs, yet more than 500,000 people need of them.
He added that this the growing demand is also a result of changes in health guidelines, which have been altered in order to better manage HIV. Previously, people living with HIV with CD4s less than 200 were to be started on ARVs, this was then moved to those with a CD4 count of 250. Now the advice is to start people on ARVs with a CD4 count of 350.
Dr. Watiti also said that Ugandan health systems are weak, which means healthcare workers cannot support the constant need for ARVs and their distribution. For instance, in Lira District, people went without ARVs when the person in charge of distributing them went on leave and those left to assist also went absent.
What’s more, people are going for treatment but there are very few personnel available that have knowledge about the new and changing requirements of treating people living with HIV.
There are also no sustainable government plans for ARV supplies, which are only left to donors to provide. If a donor is providing ARV for five years what will then happen after this time is up? The government is not stepping in to provide a budget support plan to continue with the provision of ARVs to the thousands of people living with HIV. The good news regarding the availability of ARVs is that less and less people are now dying of AIDS related illnesses but there are no sustainability plans from government.
Dr. Watiti urged people to register to know their HIV status so that an adequate and appropriate plan of action to tackle HIV can be successful.