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Archive for June 14th, 2013

HIV test kits – shortage in Uganda because demand outpaces supply

Posted by African Press International on June 14, 2013

Demand outpaces supply (file photo)

KAMPALA, – Uganda has run out of most antiretroviral drugs (ARVs), HIV testing kits, drugs to treat opportunistic infections and several crucial diagnostic tools for HIV care, according to a recent Ministry of Health stock status report.

The report, posted by the ministry on 27 May, listed the status of medical supplies as of 1 May. It reported that central stocks of a number of first- and second-line ARVs, paediatric ARV formulations and HIV test kits were either out or below the minimum stock levels in country’s three government warehouses – National Medical Stores (NMS), Joint Medical Stores (JMS) and Medical Access Uganda Limited (MAUL).

The report noted that the antifungal drug Fluconazole, used to fight opportunistic infections in people living with HIV, was out of stock at all three warehouses, while laboratory commodities for haematology, clinical chemistry and assessing CD4 counts – a measure of immune strength – were also running dangerously low. In addition, stocks of “nearly all first-line TB [tuberculosis] drugs” were low.

The ministry noted that a number for of requests had been sent to partners – including the US President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to fight AIDS, Tuberculosis and Malaria, and pharmaceutical giant Pfizer – to boost stocks.

Ruth Aceng, the director general of health services at the Ministry of Health, told IRIN the countrywide ARV shortage was result of government’s move to increase the number of ARV-accredited sites, on national, district and county level, to improve access to HIV treatment. The government has recently expanded its prevention of mother-to-child HIV transmission programme, and it is also running a voluntary medical male circumcision programme and a provider-initiated HIV testing programme, all of which have contributed to increases in the demand for tests and treatment.

Demand outpacing supply

As of 2012, some 62 percent of those needing HIV treatment in Uganda were on ARVs, up from 50 percent in 2010; that figure is expected to rise again in 2013.

“It’s true we have an ARV shortage in the country. We made a deliberate effort to get everybody who was eligible for ARVs to be enrolled. The deliberate, ambitious expansion and the scale-up has brought the current stock-outs we are experiencing,” Aceng, told IRIN. “Instead of enrolling 100,000 people annually, we decided to put all 190,000 who were eligible for treatment this year. This was a little ambitious plan for us.”

“We are working around the clock with our partners to normalize the situation. We expect the drugs to arrive in the country in the next two weeks or so,” she added.

Civil Society Organizations (CSOs) working to increase access to ARVs, TB drugs and other essential medicines said in an 11 June statement that 24 districts had reported stock-outs of HIV test kits. Health officials now fear the stock-outs will lead to drug resistance, illness and death.

“We call upon the members of the country coordinating mechanism to help expedite the process of procurement of the testing kits and other essential commodities through the Global Fund HIV Grant,” the CSOs said. “We also urgently call upon the Ministry of Health, NMS, relevant offices in the local governments and [officials] in charge of the affected health facilities to ensure that clients obtain drugs and testing services.”

“A big number of patients in the district have been affected [by] the current ARVs stock-outs. The patients can’t refill their monthly stock because the drugs are not there. This is going to cause adherence issue[s] and create drug resistance, which is very dangerous,” Janet Oola, health officer for northern Uganda’s Nwoya District, told IRIN.

Persistent supply-chain issues

John Anguzu, health officer for the northeastern district of Nakapiripirit, said he had been forced to borrow drugs from neighbouring Moroto District to fill his patients’ ARV prescriptions.

“This crisis is particularly concerning given Uganda’s rising rates of HIV incidence, unique among East and Southern African countries,” said the CSOs’ statement.

Uganda’s HIV prevalence rose from 6.4 percent in 2005 to 7.3 percent in 2012, a sign that the country’s once-successful HIV prevention programme is faltering.

The current shortage is only the latest in a list of supply-chain problems that have caused similar stock-outs of drugs and condoms in the past. Activists say continued mismanagement of the distribution chain is harming the country’s HIV response.

“The Ministry of Health exactly knows the number of people on ARVs. I wonder what is difficult with them to focus and make the right quantifications of the drugs,” Oola said. “The ministry should also have buffer stock for emergencies.”

“We are tired of this preventable crisis. It’s time for [the] government to guarantee that stock-outs will be a thing of the past,” said Margaret Happy, the advocacy manager for the National Forum of People Living with HIV/AIDS Networks in Uganda (NAFOPHANU).

so/kr/rz  source


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Rising Muslim-Buddhist tensions

Posted by African Press International on June 14, 2013

COLOMBO,  – An increasing number of Muslim Sri Lankans, who make up around 9 percent of the population, are feeling uneasy amid fears of growing sectarian tensions, say local people and observers.

“We just don’t feel we belong here any more,” Fadhil Ahamed, who works in a food store in Colombo, told IRIN. “I had a shop where I sold halal food, but several Buddhist monks who were aligned with a government politician told me not to sell halal food as this was a Sinhalese Buddhist country.”

There is increasing fear within Sri Lanka’s minority Muslim community, the 54-year-old said, and many feel they are being targeted by ultra-nationalist Buddhist groups because of their faith.

“Tensions are clearly on the rise. There is a lot the government and especially the police can do to handle this situation. It does not look like this is happening, and thus tensions are on a high as we speak,” said Ahamed Lebbe, a former school teacher and community activist in Batticaloa.

In recent months, groups led by Buddhist monks have spread allegations that Muslims have been dominating businesses, while at the same time claiming they are trying to take over the country by increasing their birthrate, local media reports say.

Sinhalese-Buddhists comprise almost 75 percent of the country’s 20 million people, according to the Department of Statistics and Census.


In May, Azard Sally, an outspoken Muslim politician and a former deputy mayor of Colombo, was arrested under the Prevention of Terrorist Act, for “instigating communalism”, according to police sources.

Sally is an outspoken critic of a new hardline Sinhalese Buddhist group Bodu Bala Sena (Buddhist Strength Force), which since February 2013 has reportedly attacked a number of Muslim-owned commercial establishments, and agitated against certain religious practices, including the halal system of slaughtering animals for Muslims.

Sally is also a vocal critic of the government of Sri Lankan President Mahinda Rajapakse and blames the authorities for allowing an anti-Muslim campaign that culminated in an arson attack on two Muslim-owned businesses in March.

Though released on 10 May, his arrest underscores growing anxiety among many Sri Lankan Muslims.

“It seems as if they [the government] pervert the law to arrest anybody who stands to protect the Muslim community,” said Fatima Mira, a university student from Colombo.

“When Sinhalese extremists attack Muslims, the government watches as spectators, while when Muslim politicians stand up for their community, they are arrested and painted as terrorists,” the 32-year-old said – a sentiment echoed by others.

“There is no peace for Muslims this year in Sri Lanka,” said 46-year-old Muslim Colombo resident Hazeel Segu, a local community leader.

Polarized society

According to Jehan Perera, who heads the National Peace Council in Colombo, Sri Lanka continues to be a polarized and fragmented society at various levels – economic, social, religious and political, more than four years after the country’s 26-year civil war officially came to an end. This has led to a lack of communication and acute mistrust between parties on different sides of various divides, including Buddhists and Muslims.

“There is a sense of exclusion among communities, who feel they are not being included in national decision-making and in enjoying the fruits of development,” Perera said.

Since 18 May 2009, when government forces declared victory over the Tamil Tigers (LTTE), who had been fighting for an independent Tamil homeland for more than 25 years, the country has failed to make a successful transition to a sustainable peace, said Dayan Jayatilleka, former Sri Lankan ambassador (2007-2009) to the UN in Geneva.

“The blocked transition is due to the unwillingness of both major communities [Sinhalese and Tamil] to be self-critical and to reach out to one another in order to forge a new social contract,” he told IRIN.

Moreover, the recent upsurge of anti-Muslim rhetoric from Sinhala Buddhist extremist groups like Bodhu Bala Sena and Sinhala Ravaya has rekindled fears of an inter-communal conflict, said Jayatilleka.

Call for more inclusive government

Meanwhile, Rajiva Wijesinha, a ruling party MP and Sri Lanka’s former secretary to the Ministry of Disaster Management and Human Rights, described recent agitation by certain groups as “counterproductive”, and has called on the government to do more to mitigate racial and religious tensions.

“What [the] government must do is be much more inclusive and have more discussion between all parties and make it very clear that the government rejects extremisms in all its forms,” Wijesinha said.

“While we understand that there are fears of certain groups, we cannot allow fears to dominate the discourse. Driving concepts should be concepts of national unity and sympathy for others. One very simple thing that government can do is to arrest people who are engaged in violence and it is disgraceful that this has not been done. The fact that Azard Sally was arrested for a comment shows a complete bias.”

contributor/ds/cb source


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