Community outreach

 Health Policy Advocacy

Counseling & Complaints  Desk

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HEPS LAUNCHES UGANDA HIV/AIDS FUNDING REPORT

Reveals big gaps in funding HIV/AIDS activities.

Despite a lot  of donor funds flowing into the country works towards scaling up its interventions to improve accessibility to HIV/AIDS treatment and other Interventions. It is of great concern however, that as more and more resources are channeled into the fight against HIV/AIDS, the impact of such resources are not visible because value for money is not yet visible. Health spending is largely still shouldered privately since the government contributes only USD 5 out of the USD 14 per capita spent on healthcare. The government’s commitment to funding the HIV/AIDS fight needs to be evaluated basing among other factors, on reducing inequalities in accessing treatment, long periods of medicine stock-out and having a clear strategy for long term sustainability for funding.

The study  entitled “Funding the Promise; Monitoring Uganda’s Health Sector Financing from an HIV/AIDS Perspective,” was commissioned Last year by HEPS Uganda, with support from Action Aid International Uganda with the objective to establish the level of government commitment in meeting its Obligation of ensuring access to healthcare for all, assessing the degree of prioritization accorded to different components of HIV/AIDS interventions and to establish whether HIV/AIDS resources reach people who need them most.

The study findings of the report  show that access to basic health services in the country is still low; drug supply at the health facilities has remained inadequate compared to the demand. Although half of the PHC funds are allocated for drugs, it is not enough. Uganda has a big financial gap in the health sector. It is estimated that the immediate shortfall is about Ug. Shs 200 billion (US$110 million). Further, the infrastructure, both physical and human, is still lacking. Evidence from the districts visited reveals that there is no contribution from district budgets for HIV/AIDS activities.

The commonly cited reason is lack of revenue following the abolition of graduated tax (G.tax). Consequently, the health sector entirely depends on public health care (PHC) funds from the centre and donor support. Since districts operate balanced budgets allocations for drugs and other requirements are made by ,simply apportioning available funds. Although with the pull system districts have an opportunity to demand for what they want , the money they get is inadequate for all their needs.  this is made worse by the delays in the delivery of drugs by National Medical Stores (NMS) , worsening the stock -out problem. Out of an estimated 1.1 million people living with HIV/AIDS in Uganda, about 150,000, are in need of anti-retroviral treatment (ART), but only about 67,000 were being served by the end of fiscal year 2004/5. Precisely, about 83,000 people living with HIV/AIDS (PHAS) in urgent need of ARVs are not accessing them.

We at HEPS believe that health and other resources should reach the intended beneficiaries and should be evidenced and reflected by reality at grass root level. We therefore recommend.

• There is need for greater commitment of public funds to health and HIV/AIDS services, in particular as an essential ingredient to the longevity of scaled –up Programmes, especially treatment.

• Government and all stakeholders in the fight against HIV/AIDS should dialogue on ways to ensure uninterrupted access to ARVS and other drugs for treating opportunistic infections (OIs).

• Advocacy is required to build about reforms so that districts change from operating

a balanced budget with inadequate resources and ensure greater transparency in allocations, for and actual spending on , HIV/AIDS.

• Given that external funding agencies open and close their projects, central and local Governments and civil society actors need to work in close partnership, to identify ways of sustaining major support initiatives in order to ensure health for all.

The report was officially launched on 19th Sept 2006 by the Permanent Secretary Ministry of Health  during the National social forum at Namboole stadium. 

                                                                                                      HealthFinancing Report

C&C officer Presenting the Project Plan at HEPS  strategic workshop

C&C officer explains the objective of the study to Mengo Doctors

HEPS Staff at the launch of the survey at Mengo Hospital

Health Rights Counseling and Complaints survey kicks off at Mengo.

The long awaited counseling and complaints (C&C) desk finally went underway as a pilot study at Mengo Hospital on 7^th June , 2006 after a lengthy preparatory process

HEPS Uganda staff , spearheaded by C&C officer Mr. Robert Peters ( VSO volunteer) , worked with HEPS volunteers  Mr. Richard Mugisha  and Abraham Mutumba Zahura both of whom were recruited to specifically help carry out the  study. They were also joined by HEPS information officer Mr. Muhinda Aaron to launch what is meant to culminate into a mechanism to address violation of health rights in Uganda.

The main objective of the study is to institute a redress mechanism and to provide counseling services for health consumers whose health rights are violated. Also focus was put on the available services at the hospital  and sort of complaints that health consumers currently have.

According to Uganda Human Rights Commission (UHRC) the rights abused most include the right to;-          Access to drug ,food  ( including drinking water), Prompt treatment ( except in private health facilities , treatment with or without pay, Treatment in emergency situation ,Optimal care/holistic treatment, Treatment in emergency situation

However, the biggest obstacle to realization of health rights is rampant absence of drugs, especially in public health facilities. Where the drugs are available (mostly private health facilities), the prices are beyond the reach of most patients.

The Violation of these rights is not properly addresses in Uganda. ,UHRC acknowledged that the situation has hitherto been made worse by the absence of a feedback mechanism between health consumers, health providers and policy makers.  Also lacking has been a redress mechanism between health providers and consumers.

 Mr. Peters says with the C&C Desk , health consumers will be able to voice their complaints and /or suggest feedback mechanism to start a dislodge with central government , policymakers and health providers to improve healthcare.

HEPS Strategic Meeting

HEPS Uganda carried out its 4th annual strategizing and planning meeting at Lweza Training and Conference Centre near Kampala between February 16-17, 2006.

Like the preceding ones, the meeting was aimed at evaluating the work programmes of the Uganda Coalition for Access to Essential Medicines (UCAEM) and planning for activities for 2006/7.

As the ‘Lead’ agency for the coalition since it was formed in 2002, HEPS-Uganda, again, took the responsibility of organizing the meeting and mobilizing the other members of the Coalition. Participants included civil society organizations, community-based organizations, professional associations and individual members.

The meeting was also aimed at reviewing the work structures (working groups) of the Coalition as well as electing new office bearers (Chairpersons of working groups).

Unlike the previous meetings, the 2006 convention was attended by several new members and focused more on the viability and justification of the coalition’s current structure and ability to meet its objectives. This arose from the reality that the Coalition’s work was disproportionately allocated, with the biggest workload on HEPS-Uganda.

A special presentation was made at the meeting that focused on how coalitions work and examples were discussed as a way of sharing best practices and ideas to inform the process of shaping a new UCAEM. The meeting resolved to carryout consultations amongst members with a view to seeking consensus on the best form the coalition should take. The process, to be spearheaded by HAG and HEPS-Uganda, would take three months.

Consequently, new office bearers were not elected to the working groups. The process was suspended until the consultation process is completed. The traditional working groups (PAPA and Information and Research) would continue in operation in the interim period.

At the end of the meeting, new work (issue-driven) programmes were approved aimed completion of unfinished business and ensuring readiness to emerging issues as well as emergencies. The areas include:

• Rapid response to emerging issues

• Pricing of medicines

• Health financing in relation to essential medicines

• Implementation of HIV/AIDS policy in relation to essential medicines

• Coalition management

The meeting was organized with support from Health Action International (HAI-Africa Region). It was attended by the HAI Africa Coordinator, Mr. Patrick Mubangizi and the HEPS-Uganda, Chairperson, Reveland Dr. Mable Katatwire.

Summary presentations during the Strategic Meeting:

Coalitions and how they are run

Health financing from HIV

Medicines Procurement in Uganda

Outcomes Hong Kong WTO Ministrial

Presentation on Health Human Rights by  Rosette Mutambi