NMS blames drug abuse on HIV-positive persons

The National Medical Stores (NMS) has said persons living with HIV/Aids are likely diverting antiretroviral drugs given to them for free to treat and fatten livestock and poultry, particularly pigs and chicken.

Officials from the agency, which is mandated to buy, store and distribute essential drugs to health facilities in the country, made the allegation yesterday when appearing before Members of Parliament (MPs) on the Committee on HIV/Aids who pressed for answers on how farmers access ARVs for misuse.

Mr Paul Okware, the chief stores and operations officer at NMS, said they only supply medicines and health commodities to health facilities, not individuals or other entities.

Declining to comment on whether the HIV drugs served to animals and birds were expired ones, Mr Okware submitted to lawmakers that it was more likely individuals enlisted on ARV treatment either directly using or transferring stocks to unauthorised persons for illegal use.

“We … believe that some farmers are HIV [positive] and, therefore, would be getting these medicines [from health facilities] as any other patients. If then they prioritise their pigs and poultry instead of their health, [then] that should worry all of us,” he said.

The comments came a day after officials of National Drug Authority (NDA), the statutory drug regulator, stunned parliamentarians that they knew about the misuse of ARVs to treat and feed pigs and chicken, but concealed the information for fear of alarming the public or hurting the economy.

In a press statement yesterday, the entity attempted to walk back comments its Senior Inspector for Drugs, Mr Amos Atumanya, made to MPs that they through their “pharmacovigilance system” received information about abuse of Aids drugs way back in 2013, a decade ago.

NDA said the drugs were being used to treat African Swine Fever, also known as Ebola fever, in pigs and New Castle Disease in chicken.

“We have known about them (cases of ARV abuse), we are trying to do something about it, but there are some concerns that if we blow it out of proportion, what does it mean for the economy if you are going to export food?” Mr Atumanya said in his submission to lawmakers. He added: “It is in that context that you find that whereas we have known about this issue [Aids drugs misuse] for some time, we are taking some measures without necessarily having to alarm the whole country.”

In yesterday’s statement issued by spokesman Abiaz Rwamiri, NDA noted that the reportage by the media on the House proceedings when its officials appeared on Wednesday were “incomplete”.

The regulator, he noted, in its investigations determined that the amounts of reported usage of ARV in pigs and chicken were “very low to cause unnecessary public alarm”, adding that they have been vigilant and arrested some abusers of the drugs.

It has emerged that seven people have so far been taken into custody over the practice.

Although NDA’s Rwamiri did not state the ARV misuse threshold which would have prompted it to notify Ugandans, the revelation about apparent conspiracy of information concealment surprised lawmakers because, at Shs150b, the government annually contributes less than donors to buy the life-saving medicines, yet citizens complain of access handicaps due to stock-outs.

A team of academics and researchers at Makerere University College of Health Sciences, led by pharmacy lecturer Dr Hussein Oria, earlier reported finding notable quantities of ARV drugs in particularly pork and chicken consumed in Wakiso and Kampala.

A group of scientists appeared to appraise the legislators on the discoveries, although we were unable to verify if it was Dr Oria’s team or another one. 

Back at Parliament, NMS officials yesterday said they only learnt of the misuse of Aids drugs through the media, with Mr Okware submitting that “misuse of drugs is potentially harmful and medicines should only be used for the indications or purposes that have been approved by the NDA”.

MP Polycarp Ogwari (Agule, Ind) said the government agencies were either complicit or not well coordinated in delivering ARVs to the last mile, leading to leaks and misuse. 

“I believe you have a system [for] checks [to] find out; are these drugs being delivered [to the right recipient]? If it isn’t there, then it is a pity,” he said, accusing NMS of doing less-than-satisfactory job in stemming abuse of the life-saving drugs.

As a stop-gap measure, MP Jeniffer Nalukwago (Kalaki Woman, NRM) proposed that the government develops a centralised, digitalised system to nationally coordinate and monitor the delivery and uptake of drugs.

“We need [to] digitalise … capturing of data [on ARV recipients] because they tell us some of the drugs are from patients that passed on … We would curb the problem of not giving drugs to dead people,” she said. The MP added: “If NMS would work hand in hand with NDA … and have this data captured, it would avoid doubling of drugs [requests] …”