Uganda adopted policy of providing septrin for HIV-infected people in 2005 and the government has always budgeted for its procurement, directly from the suppliers.
Following recent media reports that have referred to septrine (cotrimoxazole) as a vital HIV Drug, after its stock out, the ministry of health has released a statement clarifying that septrine is not an HIV drug.
“Septrin is an age old antibacterial (antibiotic) that is used to treat a range of bacterial infections. Because of those properties, evidence indicated that it could also be used to treat and prevent a number of opportunistic infections among HIV infected patients,” says Charles Olaro, the director General Health Services at the ministry of health.
Uganda adopted policy of providing septrin for HIV-infected individuals in 2005 based on recommendations from World Health Organization (WHO) and UNAIDS and the government has always budgeted for its procurement, directly from the suppliers, who cited challenges resulting into delay.
“There were challenges with the lead time from manufacture to delivery that has resulted in stock out of septrin in the country,” Olaro says.
He adds that the manufacturers say that the deliveries of septrin are anticipated to be made in the next one month. Consequently, HIV positive patients are advised to obtain septrin from alternative sources.
According to Paulson Luttamaguzi (Nakaseke South), the shortage of septrine has caused some doctors to sell the drug to patients while others advised them to put it on the black market.
Jude Bigirwenkya of Advocacy for Better Health (ABH) says the continued stock-out of Septrin in health facilities is a big blow to the efforts to curb HIV/AIDS. He says while the ARVs are in stock, Septrin is one of those wonder drugs that helps contain opportunistic infections.
“These opportunistic infections often cause more problems than HIV itself. If we are going to ask people to buy Septrin, we will have many who will not be able to afford it and their health could deteriorate,” she says.
Early last week, Sarah Opendi, a state minister for health told Parliament that the Global Fund with headquarters in Geneva, Switzerland had stepped in to boost the supply of the drug, by providing sh14.4b.
“From July we shall have the funds and the drugs available,” Opendi said.
Nevertheless, Olaro notes that the ministry of health is reviewing the evidence for continued need for septrin for all HIV positive patients in the era of test and treat.
“There is scientific data indicating that for categories of patients who have been on Antiretroviral (ARV) treatment are virally suppressed and therefore categorised as stable and may not require continued use of septrin,” he says.
Once this policy review is concluded, the Ministry of Health may consider prioritising patients such as pregnant women, children and those new on ARV treatment to ensure rational use of resources. It is estimated that about 1.3 million Ugandans are living with HIV/AIDS. Of these, about one million are enrolled on ARVs.