NAIROBI, 22 May 2009 (IRIN) - Ugandan HIV activists have expressed concern over a recommendation by parliament's budget committee that the allocation for antiretroviral (ARV) drugs be cut.

The national budget for 2008/09 allocated 76 billion shillings (US$38 million) to purchasing ARVs, the first such allocation in the country's history, but this week the house standing committee recommended that the amount be cut to 40 billion shillings in the 2009/2010 budget.

"We recognise that HIV is a serious disease but it is not the only disease affecting Ugandans," Rose Akol Okullo, chair of the committee, told IRIN/PlusNews. "Cancer and diseases afflicting women need equal attention if we are to meet the MDG [UN Millennium Development Goal] on health."

More than 300,000 HIV-positive people in Uganda need ARVs. AIDS activists argue that the committee's recommendation will allow the government to shirk its responsibility to provide drugs to them.

"Government is the key duty bearer tasked with keeping Ugandans alive, which means ensuring that people on ARVs are able to continue on their medication, and people who are newly diagnosed are able to access treatment," said Beatrice Were, a prominent HIV-positive AIDS activist. "Parliament should not even be debating this issue."

Uganda's ARV programme is still 95 percent donor-funded; the two main contributors are the United States President's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Were argued that the government could not simply push its obligations on to donors.

"Other diseases, such as diabetes and cancer, are critical, but HIV/AIDS is a unique disease with unique ramifications," she told IRIN/PlusNews. "The consequences of treatment interruption as a result of drug shortages would be large numbers of people developing resistance, making treatment even more expensive and risking death on a large scale."

Okullo said her committee's recommendation was based on information that only about half the ARV allocation in 2008/09 had actually been spent on the drugs. The committee had originally recommended that ARVs be bought from Quality Chemicals Limited (QCIL), a new local manufacturer, but "The information we have received tells us that Quality Chemicals cannot produce drugs worth 76 billion," she said. "So we suggest that the government uses the 40 billion to purchase what Quality can make, and then imports the rest."

However, George Baguma, QCIL's marketing director, told IRIN/PlusNews: "We have the capacity to produce drugs for several countries in this region; they must be misinformed."

Beatrice Rwakimari, chair of the house committee on HIV and related matters, said her committee was disappointed by the recommendation and would meet with Okullo to discuss it. "We do not agree with the presentations made by the chair of the budget committee; in fact, what we need is more money for ARVs, in order to ensure that people who cannot access them now are able to do so in the future," she told IRIN/PlusNews. 

A test of political will? 

Were questioned why parliament could find money for "huge" ministry of defence budgets, but not for ARVs. "We have an inflated cabinet, and officials cruise around in large, expensive vehicles; parliamentarians can even cut their own allowances," she suggested. "If there is political commitment to save lives, then this can happen."

Activists are also calling for greater accountability. Uganda's AIDS fight has been dogged by corruption scandals - the Global Fund temporarily suspended grants worth $367 million in August 2005, citing "serious mismanagement". It lifted the suspension in November 2005 after assurances by government that it would look into the matter.

Last week, David Apuuli Kihumuro, director-general of the Uganda AIDS Commission, told parliament's Public Accounts Committee that the country had run out of HIV testing kits and drugs for sexually transmitted infections.

"As a country we have turned ourselves into beggars," the Daily Monitor newspaper quoted him as saying. "The government should provide funds for HIV instead of relying on handouts from donors."

Okullo said the government would consider her committee's recommendations before drawing up the national budget for approval by parliament; any new budgetary allocations would only be finalised in September.

"This is a test of the government's political will to ensure treatment for life," Were said. "Let us wait and see how it responds to these recommendations."

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