Reports Leo Odera Omolo

UGANDA will find it increasingly difficult to provide antiretroviral treatment to people living with HIV/AIDS, the Director General of the Uganda AIDS Commission, Dr. Kihumuro Apuuli, has said.

He said Uganda was getting new HIV infections yet the people on the ARVs live longer and continue to be many.

He said by the end of 2009, a total of 1.2 million Ugandans were living with HIV, with 124,000 new infections reported.

“In terms of halting new infections, we are not doing enough.

I think the availability of drugs has changed people’s perception and their (sexual) behaviour becomes worse and worse,” Kihumuro said.

He said Uganda’s HIV prevalence had stagnated among adults aged between 15 and 49 years.

Kihumuro noted that 540,000 adults and children in Uganda are in need of ARVs, but only 237,800 have access to them.

“The lifetime cost of someone on ARVs in Uganda today is sh25 million, while to monitor people on ARVs today for life costs over sh5 trillion. Sustainability is going to be a problem,” Kihumuro added.

He was addressing journalists yesterday ahead of World AIDS Day today.

In Uganda, the national commemoration of the day will take place at Kitebi Primary School playground in Kampala. The celebrations will begin with a parade from Katwe, a Kampala suburb.

Dr. Stephen Watiti of Mildmay Centre, which provides paediatric HIV services, said many people living with HIV in Uganda were not able to access treatment.

“It is a black mark on our country,” he said in a telephone interview.

Many of the HIV-infected Ugandans, he added were not sick-looking. However, they contribute to the infections because they are sexually active. People, he said, should be encouraged to go for testing to know their sero-status.

He said in rural areas, most health centre IVs are not well-equipped to operate as ART centres.

A guardian to an HIV-positive orphan from Masindi said drugs were available at The AIDS Support Organisation (TASO) only on appointment. Otherwise the patients are referred to the major hospitals.

“When there are no drugs in the hospital, we are advised to buy, yet sometimes money is not readily available,” Birungi said.

Watiti said at Mildmay, it costs sh70,000 to treat a child admitted at the centre, with sh30,000 going towards the purchase of ARVs.

Kihumuro’s concerns are echoed by the American Institute of Health on Africa, which released a report on Monday.

The report showed that the number of people infected with HIV/AIDS in sub-Saharan Africa is projected to outstrip available resources for treatment by 2020.

This will force African nations to make difficult choices about how to allocate inadequate supplies of lifesaving antiretroviral drugs, the report read.

It called for renewed emphasis on reducing the rate of new infections, promoting more efficient models of care, and encouraging shared responsibility between African nations and the US for treatment and prevention efforts, which could greatly improve prospects for 2020 and beyond.

Prof. David Serwadda, the co-chairman of the US-Africa committee on Envisioning a Strategy to Prepare for the Long-Term Burden of HIV/AIDS, said: “Already in Uganda and a few other nations, we don’t have enough health care workers or ARVs to meet demand. Health centres are increasingly turning away patients who need drugs to survive.”

Serwadda added that there was an urgent need for African countries and the US to share responsibility and initiate systematic planning for the future.

“If we don’t act to prevent new infections, we will witness an exponential increase in deaths and orphaned children in sub-Saharan Africa in just a couple of decades,” he said.

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