Government Commitment To Provide Essential Medicines
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The Government of Uganda, through the Uganda National Minimum Health Care Package (UNMHCP), has committed to ensuring that the population has universal access to essential medicines at public health facilities. Uganda has an Essential Medicine and Health Supplies List (EMHSLU) classified by the level of care. The Annual Health Sector Performance Report 2013/14 indicates that the government has increased funding for medicines and health supplies (including antiretroviral drugs, Artemisinin Combination Therapies, Laboratory Commodities, Tuberculosis drugs and Vaccines) from 201.7 billion in 2010/2011 to 219.4 billion in 2013/2014. However, this funding level is still inadequate to guarantee universal access to essential medicines. The per capita government expenditure on EMHS in the FY 2013/14 was about US$ 2.4, significantly lower than the estimated requirement in the HSSIP of US$ 12. This leaves a funding gap which is financed by development partners and out of pocket expenditure. Despite some improvements over the years, the stock outs level of the indicator medicines in public health facilities is still high. The percentage of health units with no stock outs of any indicator medicines in the previous six months was 60% in 2013/14, increasing from 43% in 2010/11 (MOH, 2014). Besides funding, inadequate human resources; capital investment gaps; poor planning, prioritization and forecasting; inadequate data management and monitoring systems; non-supply of ordered items by National Medical Stores; poly pharmacy tendencies1 ; and abuse of the referral system2 (MOH, 2014; BMAU, 20153 ) are hindering the public sector mandate of providing medicines to meet the requirements for universal access.