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Posts Tagged ‘President’s Emergency Plan for AIDS Relief’

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 http://www.irinnews.org

 

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“The world won’t end AIDS without PEPFAR”

Posted by African Press International on June 8, 2013

“The world won’t end AIDS without PEPFAR”

ADDIS ABABA,  – Ten years ago, a shipping container was converted into Ethiopia’s first HIV treatment centre, in Addis Ababa, the capital. Created in response to a dramatic rise in new HIV infections and AIDS -related deaths, the centre offered the only hope for HIV-positive Ethiopians, who had to pay to access the life-prolonging antiretroviral therapy (ART).

When US Global AIDS Coordinator Ambassador Eric Goosby joined other US and Ethiopian officials at the centre on a recent trip, they found a state-of-the-art facility, where thousands of clients receive free, comprehensive HIV treatment. The centre, a wing at the Empress Zewditu Memorial Hospital, has just added an outpatient annex.

“At least 350 clients will be seen daily in this new facility, some of whom have not been able to receive the services they need and deserve elsewhere. I particularly applaud Zewditu for its tremendous effort to build the first site in Ethiopia that offers counselling and testing services for the deaf and blind,” Goosby said at the inauguration ceremony.

The centre is now one of 900 sites across the country where over 290,000 people are receiving ART. The new centre, like thousands across Africa, was funded by the US government-run President’s Emergency Plan for AIDS Relief (PEPFAR).

Established in 2003, PEPFAR was the product of a rare bipartisan deal between former US president George W. Bush and lawmakers spearheaded by the Congressional Black Caucus. It was first a commitment of US$15 billion in funding to fight the global HIV/AIDS pandemic; at the launch of the plan, only 50,000 Africans were accessing ART, according to Eric Goosby who heads PEPFAR.

In 2012, an estimated 8 million people were receiving treatment in low- and middle-income countries – of which PEPFAR directly supported 5.1 million. This was a 20-fold increase in treatment coverage since PEPFAR was created in 2003. In 2012 alone, the emergency plan helped carry out 46 million HIV tests, preventing 230,000 babies from being born HIV-positive, Goosby said in an interview with IRIN.

Funding cuts versus AIDS-free generation

But experts are concerned that consistent budget cuts in PEPFAR funding could make reaching the goal of an HIV-free generation difficult, if not impossible.

Chris Collins, a vice president and director of public policy at the Foundation for AIDS Research (amfAR), argues that despite impressive gains made in the AIDS response now is not the time for funding cuts.

“Funding for PEPFAR has fallen 12 percent since 2010 in the State Department HIV bilateral budget line. Last week, the White House proposed an additional $50 million cut for 2014. When the mandated sequestration cut is taken into account, the programme is now at its lowest funding level since 2007,” Collins noted in an April editorial.

“The honest truth is that the world won’t end AIDS without PEPFAR. Some will say: judge PEPFAR on its outcomes, not its funding. But when PEPFAR’s own Blueprint calls for rapid scale-up of effective services in order to show tangible gains, it’s hard to understand why now is the time to cut back,” Collins argued.

But Goosby explained the cuts are being made for three reasons. The first is because they are “getting better and smarter” in service delivery, such as procuring and shipping commodities like condoms and test kits at cheaper costs and favouring less expensive generic drugs over pricey brands.

“We also started a dialogue (this… was an attempt to try to make these services sustainable, not just dependent on one funder) with governments around what their contribution was now to these services and what they could be. And governments all heard this and [began] to pour… their own money into the service pot,” he told IRIN. “So, again, it would be additives, so we can build on what we have already started… with a donor-start but it is a government finish.”

The US is also looking to more cooperation with the Global Fund to Fight AIDS, Tuberculosis and Malaria to raise funds to pay for the HIV prevention and treatment programmes, according to Goosby, who says the US donates a third of the money that goes to the Global Fund.

“So we think of it as a shared responsibility… We see our ethical obligation to the patients that are using these services… We will not renege on that. But we also feel that in order to make sure these services continue, we need to diversify the fund portfolio so others are contributing.”

Chipping in

But whether poorer countries in the region will be able to take over the ongoing programmes is a concern for many.

According to the African Union commission, a number of countries have begun to implement innovative AIDS financing measures intended to reduce dependence on external funders such as PEPFAR.

“Zimbabwe and Kenya now earmark a portion of domestic tax revenues for an AIDS Trust Fund, while countries such as Benin, Congo, Madagascar, Mali, Mauritius, Niger, Rwanda and Uganda have established special HIV levies on mobile phone usage or airfares,” said the commission in a statement issued on May 26. “Taking a different approach, South Africa reduced its spending on antiretroviral medications by 53 percent by reforming its tender process to increase competition among suppliers.”

“Our continent is demonstrating strong political commitment and action by embracing transformative reforms to address AIDS, TB [tuberculosis] and malaria,” said the commission’s chairperson, Nkosazana Dlamini Zuma.

PEPFAR’s Goosby agrees it is not yet time to scale back the fight against HIV/AIDS. “If we pull back on what we are doing for HIV, it will come right back, without any doubt. We see that in just about every infectious disease, but HIV is notorious for this. So keeping this going becomes the challenge. That’s why we want to emphasize the shared responsibility.”

kta/kn/rz  source http://www.irinnews.org

 

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