Lack of HIV test kits in Uganda put unborn babies at risk

In Uganda health facilities are facing an ongoing crisis with a shortage of supplies which are putting unborn babies at risk of HIV and other infections.

In Uganda health facilities are facing an ongoing crisis with a shortage of supplies which are putting unborn babies at risk of HIV and other infections.

A Ugandan government official, who preferred not to be named, said: “HIV test kits have been in short supply ever since the withdrawal of partners in the supply of medical equipment. In some cases we have to issue health facilities with just a few kits and stern instructions that they be reserved for pregnant women. It is an emergency that we have chosen to handle this way.”

Proscovia Kagoya is an HIV counsellor living with HIV who is shocked by the ever diminishing number of kits at a time when they are needed most. She works at the Kyaligondo Health Centre in Luwero, central Uganda and runs a programme to prevent the transmission of HIV from mothers to their children, which is funded by ViiV Healthcare. She explains that test kits are vital for testing pregnant women and other clients to determine their HIV status so they can access treatment if needed.

HIV prevention and treatment

Recently in Uganda, the first lady Janet Kataha Museveni launched the World Health Organisation’s Option B+ which involves providing triple therapy antiretrovirals to all pregnant women with HIV and continuing for the rest of their lives. But the chances of it succeeding amid a shortage of HIV test kits is unlikely.

Kagoya said: “The shortage of test kits is unfortunate. In some cases there are only a few reserved for pregnant women and the men do not have any. Even mama kits are not available. Women need these but it is only once in a while that we have them.” Mama kits contain basic materials to facilitate clean and safe delivery and reduce the risk of infection to mothers and newborn babies.

There is huge interest by donors and the health community in preventing parent-to-child transmission of HIV as a strategy towards zero new HIV infections. Through the ‘networks model of intervention’ community members are trained to identify women who are pregnant and encourage them to go for HIV counselling and testing. When they find mothers who are HIV positive, they are referred to health facilities.

Political feuds affecting healthcare

Yet health facilities are clearly suffering because of feuds that are targeting millions of dollars in the Ministry of Health. It’s possible that as the government denies donors the space to procure and distribute medical equipment, donors may channel such money to the national resource pool, where funds can be easily accessed by local politicians. But we’ve already seen what can happen with this sector-wide approach to funding under the office of the prime minister of Uganda, with billions of shillings being swindled.

Jeniffer Gaberu, a team leader from Community Health Alliance Uganda who works on preventing mother-to-child transmission of HIV, said: “A number of the structural changes in procurement within the government affected delivery of mama kits. We have heard these complaints and they are genuine. But we are hoping that when our equipment is cleared, we can distribute to those in need.”

At the moment, Asuman Lukwago, permanent secretary in the Ministry of Health, is being investigated by the Uganda police for corruption. It is alleged he is being witch-hunted because he insists it is the technocrats at the Ministry of Health not politicians who should be in charge of all the vertical programmes carried out by the government. Since 2012 the Ugandan government’s allocation for health has hovered around 8% of the national budget – far below the recommendation of 15% that African governments made in Abuja for budget allocation to health – and having non-technical people in charge won’t help in using resources efficiently.

Struggles in the health ministry

The Ministry of Health has also faced a struggle with the office of the first lady of Uganda, who wanted changes in control of a $21m immunisation programme funded by the Global Alliance for Vaccines and Immunization.

Analysts believe the office of the first lady wanted supervision of activities to shift from the Uganda national expanded programme on immunisation (run by the Ministry of Health) to the National Medical Store, which is an autonomous government corporation where they can exert their influence more than they would with technocrats at the Ministry of Health. It is some of these factors that could have affected not only the availability of HIV test kits and other supplies, including antiretroviral drugs and blood.

When two elephants fight, it is the grass that suffers. With ongoing institutional power play over resources in Uganda, it is the people in need of antiretrovirals, mothers and HIV programmes, who are feeling the pinch.

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    I am impressed with this story, keep on doing a good job James likewise HIV test kits is an issue too in Malawi