In Uganda, EGPAF Addresses Potential Challenges to Implementing WHO’s New Guidelines

A patient at an EGPAF-support clinic holds a box of antiretroviral drugs. Throughout sub-Saharan Africa, countries face shortages of necessary drugs and testing kits.

Jon Hrusa

The World Health Organization (WHO)’s new consolidated HIV/AIDS treatment and prevention guidelines promise to radically shift the antiretroviral therapy (ART) paradigm, allowing HIV-positive pregnant and breastfeeding women to start lifelong treatment sooner. 

But frequent supply shortages throughout sub-Saharan Africa, especially in Uganda, threaten the region’s ability to successfully provide prevention of mother-to-child transmission (PMTCT) care and treatment services. For example, over the past few months, some clinics in Uganda have been facing supply shortages of HIV test kits, disposable male circumcision kits, and ARVs.
Makaria Reynolds, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF)’s  Country Officer for Uganda, said she thinks the new guidelines will make drug shortages more common because in many countries, the health systems aren’t robust enough to deal with the increased demand.

Health facilities order drugs from the district level, which are then compiled and sent to the national level, and supplies are transported from the district office to individual facilities. During a shortage, drugs are sometimes transferred between clinics with an oversupply to those with a stock out. But this constant shuffling of supplies is merely a temporary fix. Depending on the scale, it can take days or weeks to receive supplies from the national central stores to local clinics – frequently leaving mothers and children without the treatment they need and many clinics without HIV testing kits or medications.

Many sub-Saharan countries lack computerized methods of tracking supplies, and instead rely on a paper trail. To address this challenge, EGPAF works with health ministries to strengthen health systems and supply-chain logistics.

Since 2010, the USAID-funded STAR-SW project in Uganda has worked with local health offices to provide PMTCT services in 13 southwestern districts. STAR-SW helps mitigate drug shortages at EGPAF-supported sites by maintaining buffer stocks, improving drug ordering systems, and transporting supplies throughout the region.

Reynolds said EGPAF staff is currently investigating the benefits of using mobile apps to allow health officials to track stock quantities through cell phones to help mitigate supply shortages.

To learn more about ways you can get involved in the fight to end pediatric HIV, click here.
To read more about EGPAF’s work in Uganda, click here.

Chelsea Bailey is EGPAF’s Communications Assistant based in Washington, DC.