The health ministry has phased out Septrin for people living with HIV and AIDS in Uganda. Septrin (Cotrimoxazole) is a complementary drug that fights opportunistic infections, such as pneumonia, malaria and diarrhoea. According to the guidelines, people that could take or continue with Septrin are HIV-positive people newly enrolled on treatment, pregnant women and infected children below 15 years, but those above 15, not pregnant and have been on ARVs for many years, virally suppressed, have been stopped.
Dr Joshua Musinguzi, the head of the HIV and AIDS control programme at the health ministry, said the guidelines followed recent research by scientists from both the ministry and the Uganda Virus Research Institute, which came up with evidence that the drug is useless among people whose viral load has been suppressed and stable on drugs.
The new guidelines were approved in September. Musinguzi added that the first category of people living with HIV do not need Septrin because they are started on antiretroviral drugs (ARVs) the moment they are diagnosed with HIV, meaning their immunity is kept strong against virusrelated opportunistic infections.
“By withdrawing Septrin, the Government is expected toreduce its expenditure on purchasing Septrin by sh7.5b from the previous sh30bannually, which will reduce the funding gap,” said Musinguzi.
In 2005, Uganda adopted the policy of providing Septrin for all people living with HIV that is six weeks old on recommendations from World Health Organisation and UNAIDS, though the programme has often faced rampant stock-outs of Septrin, which affected the beneficiaries.
The withdraw of Septrin has not met the approbation of some people living with HIV who have been taking ARVs alongside Septrin, saying taking them off Septrin has made them develop skin rash and headache, among other infections. The 36-year-old Edward Kirumira, a resident of Kamuli, said he had been taking ARVs alongside Septrin since 2010, but since he stopped (a few months ago), he has had side effects, such as nausea, headache and general body weakness. He, however, says his viral load is undetectable.
However, some people, including those living with HIV, have hailed the ministry’s move, saying it was timely to withdraw the drug (Septrin).
“Septrin or no Septrin,I am healthy and okay. In fact, I have not taken Septrin for the last sixyears, but I am adhering to my ARVs. Amazingly, my viral load is suppressed,”Lillian Mworeko, the regional co-ordinator of the International Community ofWomen Living with HIV Eastern Afric, said.
Mworeko is supported by Dr Stephen Watiti, a medical consultant on HIV and AIDS at Mildmay-Uganda, who said the withdrawal of Septrin is a welcome move, which should be embraced by everyone since it reduced the pill burden. Stella Kentutsi, the exucitive director of the National Forum of People Living with HIV/AIDS Networks in Uganda, says the health ministry ought to have sensitised people living with HIV on the new Septrin policy
