A new report of audit by Global Fund indicates that new HIV infections in Uganda have been decreasing since 2010.
According to the report, the new infections have decreased from 140,000 in 2010 to less than 100,000 in 2014, with the number of people receiving anti-retroviral treatment for HIV going up from 21% in 2010 to 50% in 2014.
Uganda has received US$623 million since 2002, but according to the GF audit, there are a series of problems which range from pervasive stock outs of key medicines; unexplained stock differences; funds that cannot not be accounted for; lapses in services provided to patients and poor oversight by the Ministry of Health.
This matter has now been forwarded to Office of the Inspector General (OIG), Global Fund.
‘The OIG auditors identified stock-outs of key medicines; particularly those to treat HIV, in 70% of 50 health facilities visited which could result in treatment disruption for patients. Furthermore, 54% of the health facilities visited had accumulated expired medicines’ the report.
Further, the report states that twelve per cent out of the 50 facilities visited were testing for HIV using expired test kits and, contrary to national guidelines and 14% of facilities visited did not perform confirmatory tests on clients diagnosed as HIV positive.
‘Uganda has aligned its anti-retroviral therapy policies to the latest guidelines from the World Health Organization and UNAIDS. This has not only increased the number of people qualifying for HIV treatment (estimated to be 260,000 in 2016) but has also resulted in a funding gap of US$92 million for HIV and 9 million for tuberculosis. If unaddressed, this funding gap will result in treatment disruption in the future,’ the report indicates.
According to the report, despite the under-funding, the authorities also have difficulties in using the money that they receive.
‘The OIG noted that only 46% of funds disbursed to the Ministry of Finance between January 2013 and June 2015 had been spent at the time of the audit. This low absorption rate is attributed to protracted procurement and recruitment processes,’ the report adds.
It adds: ‘The Ministry of Finance is a pass-through Principal Recipient and has delegated most of its role to the Ministry of Health. The OIG noted lapses in Principal Recipient oversight and inadequate financial management by the Ministry of Health. Financial transactions are recorded using basic software which is prone to human error and not secure. The current financial management system has also been unable to effectively support processes such and tracking of value-added taxes paid with grant funds’.