By Dr Nelson Musoba
The Uganda AIDS Commission has received several complaints relating to access to HIV services in health facilities by people living with HIV in view of the lockdown. A number of People Living with HIV/AIDS have reached out to us requesting that existing restrictions on movement be revised in their interest to enable them to access vital treatment and services.
As the Uganda AIDS Commission, we are cognizant of the challenges that People Living with HIV/AIDS face because of our long-existing partnership. We understand the challenges that come with failure to adhere to the regular medical guidelines that include dosage, diet, and others. We are also aware that the recent national directives and guidelines by President Yoweri Museveni and the Ministry of Health will inconvenience some of our people who are on treatment.
I want to make it clear to all stakeholders in the national HIV/AIDS response that we are all being guided by the existing directives on movement and access to special services as issued by President Museveni in his regular updates and the Ministry of Health. For People Living with HIV/AIDS, there are even greater benefits in following strict social distancing routines against getting infected with COVID-19. Remember that People Living with HIV/AIDS and people with other pre-existing conditions have poorer outcomes once infected with COVID-19 given the already weakened immunity.
Therefore, all the existing guidelines on social distancing and sanitation should always be a priority under any circumstances. I want to call upon leaders in the HIV response to look within the existing guidelines for solutions to the challenges being faced and ensure that we all remain law-abiding citizens during this brief period of inconvenience.
Uganda AIDS Commission has reviewed the various guidelines provided by the President and the Ministry of Health and found that if correctly interpreted and well implemented, there will be a minimum interruption of access to services by people living with HIV. Two critical areas that the guidelines address include getting permission to travel to health facilities and access to public transport at the local government level. The guidance from the Ministry of Health is that people living with HIV should be allowed to go and access the health services that they need. They should liaise with local government authorities for the implementation of this guideline.
This Uganda AIDS Commission advisory is intended to emphasise the importance of adherence to the guidance provided by the President and the Ministry of Health by everyone with the aim of minimising interruption and optimising access to essential services required by people living with HIV. All leaders and enforcement officers should support the people living with HIV when approached during the implementation of the Presidential directive.
As Uganda deals with the coronavirus pandemic, we must support our communities to stay healthy. The Ministry of Health has advised all the regional implementing partners, leaders of People Living with HIV/AIDS to work with the districts to ensure that critical HIV services are not interrupted. District health officers and in-charges of anti-retroviral therapy (ART) clinics will ensure that staff is available at facilities to attend to the clients seeking HIV and TB services in the ART clinics, record details of clients served, quantify ARVs and other drug supplies and place emergency orders. The districts with support from the implementing partners should adopt the use of telephones and internet platforms to communicate to facilities and other stakeholders, including conduct training and mentorships.
In the spirit of ensuring that we keep everyone safe and free from COVID-19, the Ministry of Health issued guidance and there are some services that have been suspended until when it is safe to resume. For example, the peer support staff at HIV service points such as expert clients, young peer leaders, linkage facilitators, peer/mentor mother, etc. All non-essential peers and health service providers can work from home using phones to follow-up clients: remind them of appointments, drug pickups and linkage to nearest community ART services points.
Finally, even before the COVID-19 outbreak, communities of People Living with HIV, especially in hard to reach areas, were already using creative approaches to ensure that they do not miss out on their drugs. They would organise themselves into groups and select one leader who would travel to the health facility to pick drugs for the rest. These journeys were done on a rotational basis for the purposes of ensuring that everyone gets an opportunity to monitor their viral load. This approach is part of the Ministry of Health guidance known as a differentiated service delivery model (DSDM) meaning every client only comes to the health facility, when absolutely necessary.
Such best practices can be employed under the current circumstances to ensure that we remain compliant. Let us all abide by the existing guidelines and play out part in ensuring that Uganda succeeds in its efforts against COVID-19. Detailed guidelines on accessing HIV services have been sent out to all districts.
The writer is the Director-General, Uganda AIDS Commission