Uganda

The problems posed by the struggle to ensure that patients in Uganda take appropriate, affordable, safe medicines when they are needed were summed up by Dr S. Zaramba, Director General of Health Services, at an international MeTA meeting in London in May 2008:

Inadequate availability of essential medicines
High prices in retail outlets and from dispensing doctors
Public mistrust of the quality of generics
Low level of consumer empowerment.

Dr Zaramba outlined planned activities to remedy this as

Continued monitoring of prices and availability of medicines
Monitoring of quality (reassurance for the public on generics)
Improved availability of drugs in health facilities
More rational use of medicines (by both prescribers and consumers).

On availability, an international MeTA document cited a survey which found that among 28 medicines included on Uganda’s essential medicines list only just over half could be found in health facilities where treatment was offered for free.

On quality, the Ugandan Minister of Health announced last year that as many as half of all medicines bought for use in the public health system were being siphoned off by health workers and resold to private clinics or pharmacies.

But problems have solutions, and Douglas Alexander, the UK’s International Development Minister, gave an example of the MeTA approach in a speech at the launch of the Alliance in London in 2008:

“Once citizens, government regulators, healthcare workers and companies have access to information, they can challenge corrupt practice, challenge excessive pricing, and identify the problems of inefficiency and waste.

“In Uganda a health consumers group found that orders were failing to meet demand at one rural health centre. So they encouraged the district health officer to involve community members in the planning process to create a better understanding of what medicines were actually needed. As the supply of the right medicines increased, so too did confidence in the healthcare system with attendance of patients doubling at that self-same health centre.”

Partly because of its experience and initiatives in dealing with HIV and AIDS, the country has a diverse range of non-governmental organisations, and they are expected to make a strong contribution to MeTA Uganda as it gets down to work in April 2009.