Antiretroviral drugs stolen and resold on the black market. More than 40 million dollars taken from the Global Fund for HIV and turned into private accounts. Despite the efforts of the country, the fight against AIDS in Uganda is lagging behind. While, in general chaos, to benefit are the pharmaceutical companies.
The arrest of an officer of the Organization for Security, Teddy Ssez Cheeye, has further obscured the truth about the scandal concerning the misuse of funding from the Global Fund in Uganda: funds that would help the population in the fight against HIV / AIDS . Although Uganda is considered among the African countries that have responded better to the emergency, the figures remain alarming. There are at least 300 000, approximately 6.5% of the population, the Ugandans who need anti-retroviral drugs (ARVs), but only 106 thousand are able to obtain them. For the Ministry of Health (MoH) and UNAIDS, there are about 110 000 children living with HIV and 25 thousand are born with HIV each year. More than 50 thousand have immediate need of ARVs, but less than one in five receives the medication.
In this scenario, you add corruption. Teddy Cheeye was accused of embezzlement and forgery of documents. Besides him, there are at least 11 suspects identified in a two-year investigation. "Our lawyers have an excellent case against the defendants. We are ready for them." So in November Sydney Asubo, director of the legal department to the General Inspectorate of Government, expressed in the Daily Monitor, the local newspaper.
Promises not kept
It all began in 2006 when Jim Muhwezi, former Minister of Health, and assistants Mike Mukula, Alex Kamugisha and Alice Kaboyo, were fired and arrested for embezzling funds from the Global Fund for a total of about one million dollars transferred in their personal accounts. But the situation remains unclear. The accused stated to the press that he had operated under the aegis of authority more powerful than they are, including the president and first lady, calling himself "scapegoats". At the moment all the defendants are accused of mishandling $ 43 million in loans from the Global Fund.
Although President Yoweri Museveni has repeatedly insisted that light was thrown on this matter as soon as possible, the process seems to have stuck. "We have lost many lives because the Ministry of Health, and we continue to lose them," says Alice Bomeng, 40-year old suffering from HIV. "They put us on the list of their program, they tell us to take the drugs, then do not give them. A friend of mine, tired of the behavior of the government, he said 'enough, I go back to my village to die.'" When Alice discovered she was HIV positive, was inserted into the program MoH. All went well until the doctor told her that the ARVs, which was supposed to receive free, they were finished and had to buy them at the pharmacy. Alice managed to get the list of patients treated by the NGO Samaritan Comboni, who through the Catholic Relief Service, American humanitarian organization, receives medications PEPFAR. The controversial PEPFAR, Emergency Plan for AIDS aid, approved it in 2003, the former U.S. President, George W. Bush. The program began with 15 billion dollars to spend in 5 years, and was renewed in May 2008 with $ 48 billion for another five years.
Aid hairy
The PEPFAR serves not only to cure AIDS, but also malaria and tuberculosis. Provides information, technical courses and strengthens the local health system. Thanks to these funds, humanitarian agencies have lined up a number of patients receiving ARVs for free. Out of 106 thousand, 50 thousand Ugandans who receive aid from PEPFAR. But not all gold that glitters. In his book "Genocide denial by" the notorious Ugandan physician Peter Mugyenyi, a pioneer in the fight against HIV / AIDS, shows that the pharmaceutical companies are the real beneficiaries of PEPFAR. The Arv, extremely expensive for the average salary of a Ugandan, are patented, approved by the American Administration of the food and Drug Administration (FDA) and sold at the same U.S. government at the request of humanitarian organizations.
Andrew Ocara, head of the program for the distribution of ARVs organization Numat (Northern Uganda Malaria AIDS and tuberculosis), explains: "Numat is funded by USAID humanitarian assistance, which in turn receives funding from PEPFAR. We have about 4,500 patients . Our task is to sort and distribute drugs in health centers scattered around the villages. We also work together with John Snow Inc., a research institute based in Boston. They control the distribution of ARVs, help us to keep the bills and write orders for the request of other drugs. " With this supervision throughout the U.S., the profits of U.S. pharmaceutical companies are enormous. According to the nonprofit organization Health gap, formed thanks to human rights activists, professors and doctors who fight the injustices perpetrated by the pharmaceutical companies, the PEPFAR was born with the ideal of abstinence with a religious background, instead of promoting a serious prevention and condom use; Furthermore, patenting its drugs, hampers the production of generic ARVs, much cheaper.
Interference between aid
Other criticisms leveled against the drug approval by the FDA only implemented without regard to the World Health Organisation, the UN body that would make the operation more impartial and would facilitate access to more patients. The Arv so yes come for free, but only to a small number of people.
Among other things, many families are divided in children under the MoH, and parents supported by PEPFAR. These parallel strategies that do not undermine the social structure of the country. "Almost half of our patients are from the MoH program," says Dr. Ocara. "Over the past three months, in the districts of Kitgum and Lira, hundreds were left without the ARV of the government, and this happens often."
According to a recent report by the International Coalition for the preparation of treatment (ITPC), storage of ARVs is a problem that is getting worse. "The press reports cases in which certain drugs disappear en route" states Aaron Muhinda, one of the authors. "In Soroti an individual's fake official district to take possession of a consignment of drugs and resell them at a pharmacy." In 2007, however, Arv worth almost a million dollars have expired under the gaze helplessly officers of the deposit for the National Escort Medicinal Products (NMS). "The system will ask for medicines NMS through the MoH is too bureaucratic and complex," says Martin Odong, deputy director of Lacor hospital. "The clinics operate mostly in remote villages, where they often lack power and equipment. Even send us a fax or an email is a problem."
Alice Bomeng admits that there are also gaps in the modus operandi of humanitarian organizations: "You are creating a parallel market. Since there is not much coordination between the NGOs, there are many cases in which people with HIV are registered with different programs and sell medicines that have more. Emergence HIV in Uganda is very difficult to manage if you seriously want to do. " And he concludes: "It's like being in front of a sinking ship carrying thousands of people, and have only a few tens of lifeboats."
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