Outrage as ARVs expire in government stores

Ugandan HIV/AIDS activists are outraged after antiretroviral (ARV) drugs worth an estimated US$500,000 recently expired in government stores while people have been dying of AIDS-linked illnesses.

"For drugs to expire in stores when we have only 80,000 HIV-positive Ugandans enrolled on ARVs is inexcusable," Beatrice Were, of the anti-poverty group, ActionAid International, told IRIN/PlusNews. "It shows that the health ministry is incompetent to manage HIV." Between 150,000 and 200,000 Ugandans need the life-prolonging medication.

According Uganda's New Vision newspaper, the director-general of health services, Sam Zaramba, said ARVs worth between $400,000 and $500,000 had expired at the national medical stores in Entebbe, some 40km from the capital, Kampala.

"Once treatment is interrupted, we will have problems like resistance, for example to tuberculosis treatment, and this can be grave for people living with HIV/AIDS," said Were, a prominent HIV-positive activist.

Her organisation had received reports of stocks running out in a number of centres, but when they raised this with the authorities "they were denying that there was ... cause for alarm ... now it is coming out".

The authorities insist that the situation has been brought under control.

"An emergency plan has been able to address the issue, though there are other problems still prevalent," said David Bogonza, general manager of Uganda National Medical Stores. "ARVs have a short shelf-life of between 18 to 24 months, so by the time these were put in place, some of the drugs that were meant to run for about two months expired."

Uganda has expanded its treatment programme from 26 sites in 2004 to 210 currently. "The problem was further compounded by the unprecedented scale-up of treatment sites," Bagonza added.

New stocks were now available for distribution to all accredited centres.

Zaramba said, "We're in the final stages of our investigation into this matter. Appropriate action is to be taken against those responsible for failing to follow the basic principle of distributing the stock that come in earliest."

The expiry of the drugs is the latest in a string of scandals involving the Ugandan Ministry of Health. In 2004, a widely used government-subsidised brand of condoms, 'Engabu', had to be recalled because of a "bad odour", leading to a condom shortage in the country.

In August 2005, the Global Fund to Fight AIDS, Tuberculosis and Malaria temporarily suspended grants amounting to more than $200 million, citing "serious mismanagement", but lifted the suspension in November 2005 after assurances by the government that it would look into the matter.

A commission of inquiry earlier this year implicated senior government officials, including three health ministers who have since been replaced.

Despite calls for criminal charges to be brought, no one has as yet been prosecuted.

"We need a total review of the health ministry," Were said. "Is the problem human resources, is it corruption or is it lack of political commitment to manage the pandemic? We need more action and less rhetoric around HIV."