UNAIDS HIV Drug Access Initiative: Providing Wider Access to HIV-related Drugs in Developing Countries, Pilot Phase

THE PILOT SITES

Uganda
With a population of 21 million, Uganda had an estimated HIV-positive
population of 930,000 at the end of 1997.
The Drug Access Initiative is now in its first phases of drug provision in the
country:
* Six mid-level centres outside Kampala have been assessed for the
provision of more sophisticated treatments for opportunistic infections and
AIDS-related cancers.
* A full training plan has been approved by the Advisory Board, which
includes continuous updates and training of health personnel as new
clinics are brought into the Initiative.
* A total of 183 physicians and health care workers have attended clinical
training sessions on the use of ARVs, and nearly every medical officer in
Uganda has undergone a comprehensive training programme on
HIV/AIDS under this Initiative.
* Five clinics in Kampala now prescribe ARV therapy.
Advisory Board
A 15-member advisory board was appointed in June 1998, and has met
monthly ever since. The board reports to the Health Ministry, with a
representative of the Ministry present at every meeting. Also on the board
are the Minister of Finance, a UNAIDS-funded in-country manager of the
Initiative, the head of the non-profit company, and a number of prominent
Ugandan HIV/AIDS experts, including researchers, clinicians, a pharmacist,
and NGOs representing persons living with HIV.
Three sub-committees of the advisory board have been formed: drug policy
and pricing, vertical transmission, and care and practice. The advisory board
and the subcommittees meet regularly and follow strict procedures.
Non-Profit Company
A non-profit company, Medical Access Uganda Ltd, has been established,
with one full-time manager, a pharmacist (who sits on the advisory board) and
a part-time administrative assistant. The company receives orders and cash
payments directly from the health centres, then places orders and pays the
companies on a long-term credit basis. The manager of Medical Access is in
direct contact with the referral centres and the prescribers and has helped
them substantially in the needs estimates and stock management. This has
improved the dialogue between the parties and the accuracy of the purchase
orders.

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