The frequent occurrences of stock outs of HIV commodities in Ghana jeopardizes all the efforts that have been made so far in stabilizing the epidemic and keeping hope alive for those infected and affected by the disease. As at June 2012, almost 73,000 Ghanaians have been initiated on antiretroviral therapy since 2003 out of which about 67,000 adults and children are alive and continuing medications. Below is a matrix showing the rate of growth of entry into the HIV treatment program. As you may be aware of, ART does not cure HIV infection but rather a lifelong therapy which increases the quality and quantity of life of people infected with HIV. It also has demonstrated efficacy and effectiveness in preventing mother to child transmission of HIV and in recent times empirical evidence has it that ART has been shown to provide a massive prevention bonus when early treatment is initiated among those infected. These benefits of antiretroviral therapy will however, be eroded when adherence is not more that 95 percent. Adherence to therapy in Ghana has generally been very good. The treatment program in Ghana has demonstrated robustness in scaling up and is predicated on a strong coordination unit called the National HIV and STI Program under the Ghana Health Service which is backed by a pool of experts in HIV medicine and research (the ART Technical Working Group). This think tank has provided support in the adoption of new guidelines for the country and provides oversight for performance reviews of the HIV program generally. The treatment program in Ghana has largely been supported by the Global Fund with PEPFAR and WHO providing technical assistance in health systems strengthening. In spite of all these, the frequent shortages of HIV communities like HIV test kits, reagents and antiretroviral drugs has led to a lot of questions being asked by concerned citizens, Development Partners and most especially Persons Living with HIV as to what is happening to HIV commodity security in Ghana? Unfortunately, anytime there are stock outs, a lot of guesses a thrown about and there is no formal communication as to what the true situation is. As to whether this is a deliberate act or not nobody knows. Lack of information then leads to fueling of speculations and the news is all over the media and the Internet and suddenly the information goes viral "Ghana has run out of ARVs". Telephone and mobile phones start belling and if you are lucky you get a response which is mostly inadequate (Example of a typical response: there are no shortages per se, our stock levels have gone down and we have a strategy in place to move drugs from low volume areas to high consumption areas and also rationing the drugs to forestall the shortfalls we are experiencing so that everybody will get limited stocks until we restock). In most cases the phones of the key personnel suddenly goes off and out of coverage area. At this very moment, there are reports that ARVs and HIV test kits have run out of stock and some patients have gone on "drug holidays" while others have been receiving rationing stocks of about a week or two instead of the usual three to six month stocks. We also here that, we have just received triple fixed dosed combinations of ARVs for 56,000 patients which will last for about three to fourth months. He reality is that, stock-out whether perceived or real rebates lots on anxiety and fear among person living with HIV and on treatment. This is because they have been advised by health counselors about the risk associated with drug default which includes having resistant viruses which does not respond any longer to therapy and the ultimate is treatment failure and probably death. This is why it strikes fear in the HIV community. It also becomes a good excuse for people not to test because after all the drugs are not even available. The question is: How does Ghana manage its HIV commodity security? Do we have Early warning systems? Whose responsibility is it to ensure that there are no stock outs? What governance arrangements exists to ensure that there are no stock-outs? How is information on HIV commodities shared and by whom? The first ever HIV commodity security plan was developed in 2005 and it expired in 2010. The reality is that, the plan appeared not to have been implemented as it lacked the needed financial muscle and for that matter lacked ownership and was not also coordinated. The question again is: How did we manage our stocks between 2005-2010 when the plan wasn't implemented? Could it be that our problems with stock outs could have been traced to our ineffective implementation of the commodity security plan? Now, the number of people on ART is growing rapidly. How are we going to ensure that health products and pharmaceuticals are available at the right time, the right quantities, the right doses at the right places of need? With the help of Deliver JSI through PEPFAR, a new security plan has been drafted for 2011-2015. Learning from history, there is need to give this plan life so that it can work for its intended purpose. There is need for leadership from the Minister of Health to ensure that capacity is built in the country for forecasting and quantification of HIV commodities. Furthermore, people needs to be held accountable for delays in procurement of health products realizing that stock outs of HIV commodities strikes fear of death to those infected and as such cannot be treated as business as usual. The decisions on procurement of HIV communities must be transparent, prompt and timely. There is the need for the Minister to take personal interest in this since the system appears to be failing. This is because any time there are stock outs, it means the system has failed. Ghana cannot achieve universal access to prevention, treatment, care and support services for all HIV persons who need if our commodity security cannot be assured. There is the need to revive the HIV commodity security committee which should become the platform for coordinating the new HIV community security plan and most importantly for information sharing and tracking of commodity pipelines and stock-levels. Our over reliance on the Global Fund is a threat to our HIV treatment program. The Global Fund has helped immensely to strengthen country systems and kept Ghanaians alive. The current global economic crises now means we need to diversify our funding sources and increase government input. Government has shown commitment to support the National Strategic Plan 2011-2015. We therefore need effective, efficient and sustainable approaches to ensure that our HIV treatment program and the national HIV response as a whole are optimized and delivering on results.