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<p class="western" style="margin-bottom:0in;line-height:100%"><font size="1"><b>By
Denis Bukenya (PHM Uganda)</b></font></p><p class="western" style="margin-bottom:0in;line-height:100%"></p>
<p class="western" style="margin-bottom:0in;line-height:100%">
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font><b>1.
The Special Rapportuer’s Agenda excerpts<br></b></font></p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>In
his capacity as the Special Rapportuer, Mr.
Anand Grover, by his mandate from the Human Rights Council is due to
produce a report on Access to Medicines by March 2013. He is on a
private visit to Uganda to conduct a research in this
capacity on the challenges to Access to Medicines. Uganda being one
of the countries with a manufacturing plant for generic drugs made it
of priority for him to get information first hand from the
stakeholders. To achieve this, he met with civil
society, Government relevant ministries and the
pharmaceutical companies that produce the drugs to get
information firsthand about their achievements, challenges and the
experiences. </font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font></font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font><b>2.
Organizers and the Opening Remarks.</b></font></p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>The
Center for Health, Human Rights and Development took center stage in this meeting. An introduction was made
by the Executive Director Mr. Moses Mulumba who welcomed Anand. <br></font></p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font></font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>3.
<b>The Panel Discussions</b></font></p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font><b>Mr.
Kibira Denis </b></font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>(I)
On the theme of Medicine systems/communicable and non-communicable
diseases the following concerns were raised:</font></p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>a)
The government of Uganda through NMS has devised means of circulating
the drugs to the different parts of the country through a system
known as the 'push system' which has caused a great challenge since the
drugs that are circulated may not represent the needs of the area
requesting these drugs hence affecting access. He proposed a need
for the government to relax this rigid policy and may be include the
'pull system' as a solution. </font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>b)
He also looked at the capacity of the national drug authority to
control the issue of counterfeits in the country. There is sometimes flooding of markets with poor quality drugs due to the
fact that the people who do the control have no expertise to do it. </font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>c)
Mr. Kibira also spoke of the health care budget which is insufficient to curb the preventable
non-communicable diseases yet they are causing the most deaths in the
country. </font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%">
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font><b>Mr.
Leonard Okello</b> </font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>On
challenges of Access to Medicines by persons living with T.B and HIV
(<b>Executive Director</b> <b>Community Health Alliance Uganda</b>) </font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>a)
He expressed his concern of the referral process where
the patients are affected by the transport and the distances that
they have to cover for the treatment and yet in some instances these
referral places do not have the prescribed medicines for treatment.
This is psychological torture to the patients and may cause them to
abandon treatment hence the risk of resistance and spread of the
disease.</font></p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>b)
Some of the essential medicines are accessed at a time when the
patients have passed on due to the persistent stockouts.</font></p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>c)
The need to address the issue of under-staffing in the public
hospitals who cannot satisfy the needs of all the patients</font></p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>d)
He insisted that treatment is a good prevention strategy. </font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font></font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font><b>Ms.
Tinah Ntulo from Basic Needs Uganda</b></font></p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>The
essential drug should include Mental Health drugs. The government has
tried to include mental health drugs on the essential medicines drug
list. This has been affected by the push system where the
requisitions for the needed drugs are dictated by the government. </font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font></font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font><b>Mr.
Mulumba Moses </b></font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>Access
to a sustained supply of good-quality medicines is a critical part of
addressing both the current infectious disease epidemics and the
long-term quality of life and productivity of people. Good health also is a human
right. Reaching the people with the least access to resources and who
are affected by the conditions of poverty and are disproportionately
vulnerable to a wide array of diseases and chronic illnesses is the
challenge before us. The government of Uganda continues to allocate
inadequate funds to address these difficult
issues. The international community can do no less. As an example in
the financial year 2011/12, government allocated 12% of the entire
budget to ministry of health, this financial year 2012/13 that
ministry budget was cut by almost 5%. Aside from the government
cutting health funds, we have seen the donor community consistently
pull out of financing the health ministry due to misappropriated use
of funds by government officials and yet for years, we have failed to
see these officials brought to account for their misdeeds.</font></p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font></font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font><b>4.
Anand Grover’s Speech. </b></font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>Mr.
Anand stated that he cherishes interaction with communities and civil
society. He informed participants of the purpose to his visit in
Uganda. He categorically stated that he is on a private visit in
Uganda to do research on the situation of access to medicines. Uganda
being one of the countries with a pharmaceutical manufacturing plant
for generic medicines (Quality Chemicals) made it of priority for him
to visit and get information first hand from the stakeholders. He
expressed interest in the issues of generic drug use in Africa a
campaign he has been part of as a health right activist. </font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font></font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>He
emphasised on issues of his country visits/missions
</font><font>mandate </font><font>stating that every year he is meant to produce a report to the human
rights council. He explained to the members present that there are
many rapporteurs who deal with other Human Rights themes, but his is
specifically looking at the Right to Health and that it is important
that we interact with him on the Health Rights issues mainly on
Access to Medicines. Anand Grover encouraged people to write
complaints to his office so that they can formally be addressed. He
took people through the complaint procedure with the intention that, if there
are pressing issues, they could use the platform as a mechanism for
redress with the United Nations. </font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font></font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font><b>5.
Reactions, Questions and Points of information from the Civil Society
Members Present. </b></font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font></font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font><b style="color:rgb(51,51,255)">PHM
Uganda through </b><span style="color:rgb(51,51,255)">Mr. Bukenya Denis working with the Center For
Health, Human Rights and Development presented a statement on behalf
of the movement on the call to action that was reached by the
People’s Health Assembly in South Africa (Cape Town). He stated
that the Movement reaffirms its commitment to the people’s charter
for Health and the (Cuenca Declaration) which are fundamental
documents to the call for action</span><b><span style="color:rgb(51,51,255)">.</span> By and large, </b>he expressed
concern on the issue of Global Health stating that health is<b>
</b>threatened by the crisis of capitalism, manifested in food,
ecological, financial, economic and political crises. These crises
underpin the global health inequities within and between countries
and that there is also a growing health crisis. He touched the
issues of: </font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>-The
relegation of women’s health to maternity and family planning
on the one hand and the concerted attack on women’s reproductive
and sexual rights on the other is violating women’s autonomy, dignity and Human Rights, on top of it limiting their
access to medicines due to their lack of information. </font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>-Also,
the emerging global trade and investment regime (driven by
multilateral, and bilateral trade and investments
agreements) is seriously undermining universal social entitlements and
the powers of states to regulate activities of corporations and
private financial institutions hence posing a danger to access of
essential medicines</font></p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>Another
issue he raised was that of the government of Uganda shifting
responsibility to non-state actors in the spirit of investors who provide substandard services as in the example sited of the government contractors
that build health centers and do
shoddy work which does not even last for six months and yet they were
handed over to the accounting authority. The government, he thought,
should be advised to supervise such work by themselves so as to make
the people contracted accountable. </font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%">
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>On
the call to action welcoming the recent upsurge of interest
in the concept of universal health coverage, he alluded to what was
stated that there was a need to oppose the idea that this be achieved
through the promotion of a minimalistic insurance model that would
operate within a market system of health care or, worse still, be
used as an excuse to dismantle or undermine public
hospitals and to promote corporate interest in health care delivery.
This was intended to sound a warning that Universal health coverage
must be achieved through organized and accountable systems of high
quality public provision. This has not been included in the health
system of Uganda, but is receiving great attention in Uganda. He asked Mr.
Anand to advice on the modes of counteracting the government in the
event they are corrupted by multinational corporations. </font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font></font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>Other
issues discussed included: the issue of the Anti-Homosexuality Bill, how he could
intervene on behalf of civil society on the 'stop stock out
campaign', issues of quality of the medicines and their accessibility
citing the example that, even though we have a manufacturing plant in
the country, they are enjoying a monopoly that ends up defeating the
purpose of reducing the cost of these drugs. Their drugs are twice as
expensive as any other imported one or even more. </font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%">
</p>
<p class="western" style="margin-bottom:0in;line-height:100%">
<font><b>Anand Reactions </b></font>
</p>
<p class="western" style="margin-bottom:0in;line-height:100%"><font>Discussing
the issue of the Anti -Homosexual Bill, he stated that he had already
made an effort by approaching the government diplomatically on the Human
Rights implication of the Bill. He noted that, to date, the Bill has
been withheld. He also said that he has been engaged with the
government on many other issues to do with health and Human Rights
which are making headway in his opinion. On the issues of
petitioning the government on the stop stock out campaign, the
quality of the medicines, their accessibility, judicial training for
the judiciary, issues of access by sexual minorities, quality of
syrups used by people living with HIV/AIDS, access and use of the
female condoms which has been neglected by the government
indiscriminately fundraising only for condoms, procurement being
government business, etc, he referred the people to the complaint
mechanism that will officially alert his office so that they can make
the necessary investigations and thence advise the government. He
further responded by saying that it is our responsibility to demand
for information from government "you must push the government to
action" - " Never give up on speaking out for what concerns
you". This, he said over and over again. He also said that the
situation of quality of medicines has improved, but substandard
medicines & those not of quality cannot be tolerated in our
market. He urged us all to learn to communicate to communities this
message as they help in pushing the government to action. All issues of Quality must be addressed. He also
pledged support for the process of pushing government to revise
proposed laws that affect access to medicines. If they don't do this
and multi-nationals come over to start claiming rights, he'll be at
the forefront to fight them. And he hopes we'll support him in this. </font></p>
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