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Govt pilots sale of ARVs in pharmacies

ARVs for the patients

ARVs for the patients

The Community Retail Drug Distribution Points (CRDDP), a government initiative piloted in Kampala to distribute antiretrovirals to patients through nearby pharmacies, has brought medical services closer to people.

Sarah Magara, an HIV/AIDS patient and resident of Najjanankumbi, said that previously, ARVs were primarily distributed through specialized health centers and hospitals but, however, now, they are also available in some pharmacies, which has helped much especially in rural areas where people have been underserved in accessing medication.

“It is much convenient and easier to access medication with the program. It has also helped us to save transport, time and avoid long queues at health facilities. The medication is also free,” she said.

“An individual is able to timely access his/her medication from a select nearby pharmacy or clinic because most pharmacies and clinics operate Monday to Sunday unlike the health facilities that operate from Monday to Friday, leaving out weekends,” she added.

Dr John Vianney Kigongo, a pharmacist at The AIDS Support Organization (TASO) Mulago, Kampala said this government initiative aims at several targets including, but not limited to, decongesting health facilities and extending health services closer to people.

“The initiative also enables people to timely get medication because most pharmacies operate 24/7 while a facility like ours operates from 8 am to 5 pm on Monday to Thursday, 8 am to mid-day on Friday and does not work over the weekends,” he said.

He also noted that TASO partners with select pharmacies especially where most people living with HIV/ AIDs (recipients of care) stay and
also sets standards which the select pharmacies or clinics must meet such as having a license, computers and access to internet, among others.

An example of such a pharmacy is Tanid Pharmacy-limited located in Kawempe trading centre (Nabukalu zone) that partners with TASO Mulago.

“Under this initiative, a retail community pharmacy is linked to only one specific health facility in the district that refers patients to the pharmacy. However, a health facility can be linked to several community retail pharmacies depending on the number of patients. TASO works with implementing partners such as Reachout Mbuya for Kampala Central, IDI for Wakiso and Mityana districts (Central Uganda), and Baylor Uganda for Eastern Uganda which provide support in the fight against HIV/AIDs,” he explained.

Dr Emmanuel of Allied Clinic in Najjanankumbi said extending ARVs to some pharmacies is a crucial step in fighting against HIV/AIDS. “It will also help prevent stigma amongst patients especially those who don’t want to be seen at health facilities.”, he said.

Dr Emmanuel also noted that it’s important to note that patients are referred back to the health facility especially if they fail to adhere to the guidelines of the program such as if one gets pregnant, when the virus in the body is high, among others.

However, Sarah Magara noted that some people in their communities got to know the select pharmacies and clinics and thus they lack privacy, leading to stigmatization. She also highlighted unprofessionalism amongst some medical personnel who discuss their statuses unlike their mother health facilities.

“We are given counselling sessions at our mother facilities unlike in some clinics and pharmacies. This is because these clinics and pharmacies have other clients who have other diseases and they have to attend to them,” she added.

According to ministry of Health, the initiative is convenient, free, quick, flexible and it reduces one’s clinic visits to the health facility. It’s a voluntary and free community-based drug distribution program which allows one to collect one’s medicines at a nearby selected local clinic.

For registration, an individual is supposed to contact his facility’s health worker. The program is accessible to adults aged 20 years and above, who are not pregnant or breastfeeding, doing well on their current treatment, not having tuberculosis or any major illness at the moment, those who have been on medication for a year and those whose virus load in the body is currently low (suppressed).

It is part of the differentiated service delivery (DSD), a client-centered approach that simplifies and adapts HIV services in communities grouped into four categories namely; health care worker-managed groups, client-managed groups, facility-based individual models and out-of-facility individual models.

According to the Community Retail Drug Distribution Points Implementation toolkit (2021) of the AIDS Control Programme of Uganda, the service is a voluntary, free community-based drug distribution approach that acts as an alternative ARV pick-up point for selected patients.

According to AIDS Control Program Uganda, AIDs cases in Uganda were first recognized in 1983, with about 900 cases reported by 1986, rising to 6,000 cases by 1988. By the early 1990s, Uganda was among the countries worst hit by HIV/AIDS epidemic. In 2022, Uganda was globally ranked 5th of those countries with the highest HIV burden.

However, Uganda has responded by taking an open stance to the epidemic and was among the first African countries to establish a national AIDS Control Program (ACP) and the National Committee for the Prevention of AIDS (NCPA).

According to the Uganda AIDS Commission (2023) fact check, there has been a drastic reduction in the number of HIV infections in Uganda from 30% in the 1990s to 5.1% in 2022. The numbers have equally declined by 25% from 2010 to 2022.

Subsequently, it is among the eight countries in the world that had fully achieved the 90-90-90 targets by the end of the 2020—others being Botswana, Malawi, Qatar, Slovenia, Es- watin, Switzerland and Rwanda.

The Uganda Population-Based HIV Impact Assessment (UPHIA) of 2016-2017 shows that the prevalence of HIV among adults aged 15 to 64 in Uganda is at 6.2%, 7.6% among females and 4.7% among males corresponding to about 1.2 million people aged 15 to 64 living with HIV in Uganda while the ministry of Health estimates (2020) show that the prevalence of HIV among adults (15 to 49 years) in Uganda is 5.4% with 6.8% in females and 3.9% in males.

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