ARVs will never run out of stock
Jul 11, 2006
I wish to refer to recent newspaper articles in regard to firstly, the alleged imminent stock out of anti-retroviral (ARV) drugs and the much hyped loss of Global Funds for Malaria because of the failure to procure long lasting insecticide treated nets (LLINS).
By Keith Muhakanizi
I wish to refer to recent newspaper articles in regard to firstly, the alleged imminent stock out of anti-retroviral (ARV) drugs and the much hyped loss of Global Funds for Malaria because of the failure to procure long lasting insecticide treated nets (LLINS).
Many Ugandans are aware that the Global Fund programmes were suspended in August 2005 on account of mismanagement by the then Project Management Unit (PMU). Even though the suspension was in force, the Government of Uganda and the Global Fund agreed that emergency procurement of ARVS and other life saving treatments would continue. Consequently, ARVs, anti-malarials and Tuberculosis treatment drugs have continued to be purchased.
Drugs worth $38.2m have been purchased since the suspension of which US $3.1m are for ARVs, $30.7m for anti-malarials (including $28m for the new anti-malarial treatment (Coartem) and $1.3m for drugs treating Tuberculosis. This does not include the drugs and other health products such as condoms (76 million), HIV test kits, drugs for opportunistic infections, etc, that are being supplied under contracts signed before the suspension.
The Daily Monitor also alleges that a recent provision for purchase of ARVs worth $9m has been reduced to $1m. This is an obvious misrepresentation. The Aids Control Programme prepared an emergency request in May 2006 for $9m to cover six months. Following the three-month rule I will shortly describe Government opted to buy ARVs that would stock out in three months and commence normal procurement procedures for the rest of the drugs as per workplans that had recently been approved.
What has led to this perception?
At no time has there been a stock-out of ARVs in health centres. Indeed quick assessments made by Ministry of Finance officials in some clinics in Kampala confirm that ARVs are being issued from central stores regularly and are available for people who require treatment.
Stock-outs at the National Medical Stores are prevented because of the employment of trigger mechanism that allows emergency purchases to be made the moment stocks reach a level of three months. In other words the Ministry of Finance makes every effort, including buying ARVS off shelves in pharmacies in Kampala, to ensure that drug stock-outs do not happen. Indeed, there is even a ‘Plan B’ in that in the event we cannot purchase any ARVs in-country, Government can airlift drugs from neighbouring countries that have an excess stock, though this option has never been required.
This seemingly unplanned approach has been used because organised regular purchase of ARVs can only happen when there are work and procurement plans approved by the Global Fund in Geneva. The suspension of the Global Funds in August last year halted implementation of all these plans, which required that the process of review be undertaken after the suspension had been lifted. It is only in the May–June period that this exercise has been completed which will allow larger, more orderly purchases to be made. We envisage this process to commence in the next couple of months.
The story relating to Long Lasting Insecticide treated nets (LLINs) is a bit similar. The requirement that Government reviews previous work and procurement plans meant that previous plans that had been formulated were no longer tenable. In other words it is not correct for the Daily Monitor to allege that the Ministry of Finance has been trying to purchase for over two years and has failed to undertake this simple task. This process only began after the completion of the review of work plans in May 2006 and will be completed before the grants expire. I expect all the 1.8 million nets to be available in the country sooner rather than later.
The writer is the Deputy Secretary to the Treasury
I wish to refer to recent newspaper articles in regard to firstly, the alleged imminent stock out of anti-retroviral (ARV) drugs and the much hyped loss of Global Funds for Malaria because of the failure to procure long lasting insecticide treated nets (LLINS).
Many Ugandans are aware that the Global Fund programmes were suspended in August 2005 on account of mismanagement by the then Project Management Unit (PMU). Even though the suspension was in force, the Government of Uganda and the Global Fund agreed that emergency procurement of ARVS and other life saving treatments would continue. Consequently, ARVs, anti-malarials and Tuberculosis treatment drugs have continued to be purchased.
Drugs worth $38.2m have been purchased since the suspension of which US $3.1m are for ARVs, $30.7m for anti-malarials (including $28m for the new anti-malarial treatment (Coartem) and $1.3m for drugs treating Tuberculosis. This does not include the drugs and other health products such as condoms (76 million), HIV test kits, drugs for opportunistic infections, etc, that are being supplied under contracts signed before the suspension.
The Daily Monitor also alleges that a recent provision for purchase of ARVs worth $9m has been reduced to $1m. This is an obvious misrepresentation. The Aids Control Programme prepared an emergency request in May 2006 for $9m to cover six months. Following the three-month rule I will shortly describe Government opted to buy ARVs that would stock out in three months and commence normal procurement procedures for the rest of the drugs as per workplans that had recently been approved.
What has led to this perception?
At no time has there been a stock-out of ARVs in health centres. Indeed quick assessments made by Ministry of Finance officials in some clinics in Kampala confirm that ARVs are being issued from central stores regularly and are available for people who require treatment.
Stock-outs at the National Medical Stores are prevented because of the employment of trigger mechanism that allows emergency purchases to be made the moment stocks reach a level of three months. In other words the Ministry of Finance makes every effort, including buying ARVS off shelves in pharmacies in Kampala, to ensure that drug stock-outs do not happen. Indeed, there is even a ‘Plan B’ in that in the event we cannot purchase any ARVs in-country, Government can airlift drugs from neighbouring countries that have an excess stock, though this option has never been required.
This seemingly unplanned approach has been used because organised regular purchase of ARVs can only happen when there are work and procurement plans approved by the Global Fund in Geneva. The suspension of the Global Funds in August last year halted implementation of all these plans, which required that the process of review be undertaken after the suspension had been lifted. It is only in the May–June period that this exercise has been completed which will allow larger, more orderly purchases to be made. We envisage this process to commence in the next couple of months.
The story relating to Long Lasting Insecticide treated nets (LLINs) is a bit similar. The requirement that Government reviews previous work and procurement plans meant that previous plans that had been formulated were no longer tenable. In other words it is not correct for the Daily Monitor to allege that the Ministry of Finance has been trying to purchase for over two years and has failed to undertake this simple task. This process only began after the completion of the review of work plans in May 2006 and will be completed before the grants expire. I expect all the 1.8 million nets to be available in the country sooner rather than later.
The writer is the Deputy Secretary to the Treasury