Condom Shortage in Uganda

There is yet another condom shortage in Uganda but people are not necessarily having too much sex.

Instead, health officials say there is increased use of condoms after serious social behavioral campaigns, awareness in the media about the HIV prevalence going up and vigorous public education among the most at risk populations.
Usage of condoms is between 8 to 10 million per month but estimates of condoms needed to cover all risky sex acts has grown from 192 million in 2007 to 208 million in 2010. 

“We need a condoms or contraceptives only warehousing facility and a contracted exclusive distributor for these commodities, said Mrs. Vastha Kibirige the head of the condom monitoring unit in the Ministry of Health.

Officials at National Medical Stores (NMS), a drug procurement, distribution and storage body, said the condoms are bulky and take up a lot of space, which makes them warehouse unfriendly, as such NMS, can only store stock levels of 4-6 months. Previous stock levels were up to 6 months. 

“The procurement process is very long and the delivery is not at regular intervals so sometimes we under estimate their arrival,” said Mrs. Kibirige.

Currently, condom shortages have been recorded in most of the districts around the country including the capital, Kampala, and this could lead to spread of sexually transmitted diseases including HIV and increased unwanted pregnancies.

It is estimated that the shortage could go on for a month until the next consignments arrive, the earliest by end of next month. At least 5 million condoms are expected from Britain, as announced by Andrew Mitchell, the DFID secretary of State.

They are part of the contraceptives supplies package announced from DFID last month that could avert 75,000 abortions and 250,000 unwanted pregnancies.

Another 15 million condoms are expected from USAID at the end of July this year, while 45 million condoms are expected later this year and early 2011. 96 million branded condoms from the Global Fund will also be available but their arrival is unknown.

But what should Ugandans do in the meantime as the scarcity bites for a whole month? Experts have advised that in line with the ABC strategy that Uganda uses, people should take on the other option. 

“For this one month, during the shortage we would advise Ugandans to abstain from sex,” said an official from the Ministry of Health.

Those who can afford, can buy them from the private sector, the cheapest cost Ush 500 ($0.2) to 5,000 ($2) per pack of three condoms.

“ We have not increased the price and hopefully we shall not. The demand has not increased or maybe I have not noticed it,” said Paul Lukwago at one of the Pharmacies in Kampala.

Condoms procurement mainly supported by development partners are procured for both disease prevention and contraception.But while contraceptives are distributed through health units, condoms for disease prevention are mainly distributed through channels like lodges, community based sites, village health teams, self-dispensers.     

Uganda has made considerable progress to ensure that sexually active people have access to condoms - mostly the male brands.

From the policy of quiet promotion in the early 1990s, the country has since developed and disseminated policy guidelines on distribution, use and quality control of condoms.

Now with the prevalence going up from the average 6.4 percent, the most at risk are being targeted. The most at risk populations which are mostly responsible for the new infections, 163,000 per year, are prisoners, the military and army, men who have sex with men (MSM), new born babies and migrant populations like fishermen. The HIV prevalence rate among fishermen is one of the highest at 28 percent.

The other alternative to shortages would be the use of female condoms, which have become acceptable, a fact proven by an operation research done in four districts of Gulu, Pader, Kitgum and Kampala. 

“Uptake of female condoms is good with less complaints and demand is well above what we have in stick. We also need donors to fund them,” said Mrs. Kibirige.