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Applying human rights to advocacy campaigns for access to essential medicines in Uganda
- 1. Applying Human Rights to Advocacy Campaigns for Access to Essential Medicines in Uganda Lessons from AGHA Sandra Kiapi Executive Director, Action Group for Health, Human Rights and HIV/AIDS (AGHA) Uganda
Notas do Editor
- The concept of minimum healthcare package has been used as a means of setting priorities for national health budgets. The aim is to identify a set of health services for which the Government can afford free access: this is intended to assist with resource allocation in the face of huge health
- This year, AGHA launched its innovative “Stock Out Survey.” The survey, which took place in three new districts in rural Southwestern Uganda, collected data on the supply of essential malaria and anti-biotic medicines and staffing levels at selected health facilities. The objective of this study was to assess the trends of drug availability in health facilities in three districts, while also exploring the challenges faced by health workers in getting drugs at the health facility level.
- This study found that the drugs being tracked were often out of stock in the facilities visited. Availability of Malaria Medicine : CoArtem, the Ministry of Health mandated first line treatment for malaria was often unavailable in health clinics in all three districts. In Ibanda, 10-30% of clinics experiences CoArtem stock outs over the course of 5 visits. In Isingiro, all clinics had CoArtem at 3 of the 6 data collection visits; the other 3 visits found 10-40% of clinics had no CoArtem in stock. In Lyantonde, CoArtem stock out rates ranges from 10% to 50% at one visit, meaning half of all clinics visited that day did not have the first line treatment for malaria—the leading killer in Uganda. Availability of Antibiotics : The study found high levels of stock outs in antibiotics at health centers in all three districts. For example, for the first month of the study, 60-80% of clinics in Ibanda had no access to the 4 major antibiotics traced by this study. In Isingiro district, access to any of the four antibiotics traced differed significantly, from less than 20% to 85% in stock, but never reached 100% coverage for any medicines during the survey time.
- In September, AGHA held a meeting for members of parliament, ministry of health officials, health professionals, and civil society organizations to launch the results of the survey and to present policy recommendations. These policy recommendations included: Addressing Budget Gaps by scaling up spending to meet the 15% target from the Abuja Declaration and loosening any macroeconomic structures which prevent increased health spending Reforming drug purchasing and distribution by creating more flexible drug purchasing systems and financing mechanisms Improving the monitoring and evaluation of the drug procurement and distribution system Address human resources for health issues by meeting staffing targets, training staff on drug forecasting, and providing incentives for workers to join new districts Build better communication systems between districts, health facilities, and central bodies such as the NMS and the Ministry of Health. AGHA is currently planning follow-up meetings in the districts that participated in this study to continue putting pressure on policy makers to address these issues.