HAU produces oral liquid morphine to supply all of Uganda’s needs through a Public Private Partnership with the Government. The Morphine Production Unit (MPU) at Hospice Africa Uganda is a model facility for low and middle-income countries with populations of more than 15 million interested in reconstituting their own oral morphine for pain relief.
When HAU was founded in 1993, Uganda’s population was much lower than today at around 23 million, and oral morphine for HAU patients was made on site by hand using a bucket and sink. This is known as the “kitchen sink method” and proved to be very simple and effective for 17 years. This is an easy method for making small quantities of morphine, even in local pharmacies.
However, as Uganda’s population grew (todays population is approaching 50 million), and to meet good manufacturing practice requirements, HAU moved from the “kitchen sink method” to making oral morphine at a small production facility. With the support of the American Cancer Society’s Treat the Pain programme, HAU acquired manufacturing equipment and modified a part of its premises to ensure the production of high-quality morphine that meets proper safety standards for all patients in Uganda who require this opioid medication for the management of moderate to severe pain.
The upgrades at the MPU resulted in an 8-fold increase in production capacity, allowing HAU to meet growing demand for oral morphine due to a growing population. Oral liquid morphine is a free medication in Uganda for all those that need it. Our gratitude goes to the Government of Uganda that allocates funds for availability of this medication.
HAU
As well as being used for patients at end-of-life with cancer, HIV and non-communicable diseases the oral morphine can also be used in earlier stages of diseases and other painful conditions in children and adults. The oral liquid morphine is packed in two different strengths: 5mg / 5mls (green colour) and 50mg / 5mls (red colour). The green morphine is in two volumes 250mls and 500mls, while the red morphine is available in 250mls only. The morphine is supplied through the National Medical Stores (NMS), which is the Government of Uganda main medicines management entity. NMS receives orders from the pharmacists in various public health facilities in Uganda. The private not-for- profit health facilities receive morphine from the Joint Medical Stores who import the morphine powder used to make the oral liquid morphine.
Oral liquid morphine is a free medication in Uganda for all those prescribed by a registered prescriber. This is thanks to the Government of Uganda which has been funding this medication since 2003 in a public private parentship with the Ministry of Health.
This partnership was agreed in 2003 thanks to work by a committee headed by Dr Jack Jagwe, the first chair of the then newly formed National Drugs Authority (NDA) Board. A Government statute allowing midwives to prescribe pethidine for women in labour was extended to also allow the prescription of morphine by nurses trained by HAU in assessment of those in need of morphine.