A large supply of paediatric antiretroviral medication donated by the Clinton Foundation could expire in Ugandan medical stores because of low demand, a senior health official says.
"There are few children who are receiving the drugs; they are going to expire by March ," said Zainabu Akol, head of HIV programming in the Ministry of Health, told IRIN/PlusNews.
Fewer than a quarter of the 125,000 Ugandan children who need life-prolonging anti-retroviral treatment have access to it, mainly because of stigma and inadequate education of parents, say specialists.
"This is so worrying and disturbing; at least half the HIV-positive children should be on treatment," she added.
"Due to stigma, parents have failed to take their children for ART; they believe if their children start ART, they will be shunned by the community and pupils at school," said Goretti Nakabugo, from a local NGO, Strengthening HIV/AIDS Counsellor Training.
"People don't yet believe that HIV/AIDS is not transmitted through casual contact; a child with rashes is always shunned," she added.
Many parents cannot face the idea of telling their children they have a potentially life-threatening illness, and live in denial.
"It's very difficult for the parents to tell their infected children about their status... they keep postponing it," Akol said. "In the end, the children are not taken for treatment."
She added that the guardians of HIV-positive orphans were often too poor to properly care for them and ensure that they received treatment.
However, according to health workers, the government has not pushed the paediatric treatment agenda as aggressively as the adult programme; more than half of all adults who need ARVs have access to them.
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"The publicity about paediatric services and care in the country is too low; people are not aware there are centres that offer treatment for infected children," said Rose Seyinde, a health worker at the country's largest referral facility, Mulago Hospital.
"Messages on ARVs for adults are more pronounced that those for children; the trend needs to be changed," she added.
The ministry's Akol agreed that the government needed to step up its efforts to ensure more children received ARVs; she said most hospitals in the country were ill-equipped to deal with paediatric HIV.
"We have only six centres in the country where these tests for children are done," she said. "We have to collect blood samples from upcountry to be brought to Kampala for testing."
She noted that another major hindrance was a shortage of suitably qualified medical personnel.
"To change the trend, there is a need to educate the public about the available facilities, train more health workers and mobilize the community to advocate against stigma," Akol said.