By Apio Dinah
On 20th September, 2016, all roads led to Parliament for the different Civil Society Organizations in the HIV response. Led by their umbrella organization, Uganda Network of AIDS Service Organizations (UNASO), the advocacy team met with the Parliamentary Committee on HIV/AIDS seeking clarification and responses to the myriad of challenges surrounding HIV services in the Country. The meeting intended to resolve issues of; ARV pricing, stewardship and leadership crisis at Uganda AIDS Commission (UAC) and MOH, operationalization of the AIDS Trust Fund (ATF), roll out of test and start as well as increased domestic funding to HIV/AIDS programs.
Through the committee Chairperson, Ms. Judith Alyek, Key stakeholders; UAC, MoH, National Medical Stores (NMS) and CIPLA Quality Chemicals were summoned to this meeting. Each stake holder committed to their roles which will be closely followed up by the CSOs to ensure they are delivered upon in the most prudent manner.
In response to the key CSO concerns MOH committed to rolling out test and start program by 1st January, 2017 as stated by state Minister for Primary Health Care, Sarah Opendi who also mentioned the program’s deficit of about 6M USD. The minister further clarified on status of ATF that it will be managed by MOH, seconded by Parliament, as opposed to earlier suggestion that UAC takes lead. Accordingly cabinet is to pass it by October, 2016. One contentious issue surrounded Hepatitis B management to which the minister reported having rolled out testing program covering 14 districts in North Eastern so far and that additional 220bn is required to cover the country extensively. The next targeted region will be western Uganda with 26 districts in focus and central region with less prevalence will be targeted last. The country has 10% of the population affected with 30%, about 1 million people living with chronic Hepatitis B.
Equally significant were responses by National Medical Stores represented by Dr. Kamabare who requested for submission of lists of persons legible for Hepatitis B treatment by different districts, a point which needed further clarity as it attracted critics from a section of the MPs present. Relatedly, Mr. Katongole of Quality Chemical the leading manufacturer of ARV in the country, defended his pricing basing his argument on the economic gains the company offers to the country. One wonders however, how much of this benefit is ploughed back into the health sector. Perhaps this could be the next advocacy issue that such monies from investors are directly contributing to health financing.
The quick win from this engagement is that there is a consensus on increased domestic financing for HIV control and prevention. Specifically CSOs called for an increase of the national budget to ART from 100bn to 150 bn USHS come next FY 2017/18. There is also hope that ARV pricing will be lowered with consistent campaign by CSOs.
The civil society can achieve more with consistent high level advocacy such as this that brought together key individuals and institutions whose work directly impacts the HIV prevention and control. It thus remains imperative for CSOs to play the complementary role by unearthing with evidence such issues that tend to bog down health services in general and HIV response in particular and forward them to the relevant powers.