Uganda wants stronger partnership to tackle NCDs

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Kigali, Rwanda

Uganda’s health ministry permanent secretary, Dr Diana Atwine, has called for stronger partnerships in addressing the growing burden of non-communicable diseases (NCDs).

The call was made during the Fourth Global NCD Alliance Forum in Kigali last week.

She says co-ordinated efforts and synergy among stakeholders will ensure tangible results in tackling NCDs, which are on the rise across the continent.

Atwine expressed her gratitude to the organisers of the Global NCD Alliance and commended Health Heart Africa, AstraZeneca and other allied organisations for their unwavering commitment to fighting NCDs in Uganda and beyond.

"It is important that we define the roles of the partnerships. We need to agree together that when we come together and discuss the issues of partnerships, we look at the host countries and what they are doing so that it’s not standalone silos," she said.

The Fourth Global NCD Alliance Forum in Kigali. (Credit: John Musenze)

The importance of synergy 

Atwine highlighted the critical need for synergy in partnerships, as isolated and unco-ordinated efforts often fail to bring sustainable results.

She pointed out that Uganda has made significant strides in integrating community-based interventions to enhance early detection of NCDs.

"Synergy is what will bring results. Synergy is what will help us improve performance and get the results we desire," Dr Atwine stressed.

She underscored that early detection is the cornerstone of effective NCD management. Without it, many individuals only seek medical attention when complications have already set in, such as chronic kidney failure or heart disease, making treatment far more expensive and difficult.

"The whole mainstay of dealing with NCDs is early detection. That’s why we are here. If we are not putting emphasis on early detection, then we will not overcome the NCD burden," she emphasised.

Community-based approach 

Atwine shared Uganda’s innovative approach to tackling NCDs through the empowerment of community health extension workers. This is through community extension workers who were equipped with bicycles, glucometers, blood pressure machines, and mobile tablets for data collection.

These health workers conduct house-to-house screenings, enabling early detection and prompt intervention for conditions such as diabetes and hypertension. Atwine emphasized that community-led health programs provide the most effective avenue for detecting and addressing NCDs before they progress to life-threatening stages.

"Many of our people in the communities do not take it as a routine to do check-ups. They will only show up in our hospitals when they have complications, and at that time, you cannot say we are trying to prevent NCDs; we are simply trying to treat the end stage," she noted.

Role of data 

Another key highlight of Atwine’s address was the importance of data in shaping effective health interventions. She called for innovative ways to gather community-level data, ensuring that local leaders and policymakers have the necessary evidence to allocate resources effectively.

"Evidence is extremely important. You cannot know the burden; you cannot plan for the burden; you cannot budget for the burden if you do not know what it is. We must find an innovative way to get to the community and gather this information," she said.

She noted that local leaders play a crucial role in budgeting for healthcare services, and by having concrete data on disease prevalence, they can make informed decisions that prioritize NCD management within their districts.

Partnerships and resource optimisation

Atwine called for greater co-ordination among stakeholders to avoid fragmented efforts that do not yield meaningful impact. She cautioned against entities operating in silos, stressing that integration is key to optimising resources and maximising results.

"If one entity comes to my country and starts doing something, and then the Government is doing something else, it does not build synergy and does not optimise resources. At this time, we need to talk about how we optimise our resources in the midst of different increasing priorities," she said.

The permanent secretary also pointed out that as life expectancy increases across Africa—from an average of 45 years in the past to now reaching the 60s and 70s—the prevalence of NCDs is becoming an even greater challenge. Therefore, governments, non-governmental organizations, and development partners must shift their approach towards preventive measures rather than just treatment.

Growing NCD burden 

Uganda, like many other African nations, faces an escalating burden of NCDs, including hypertension, diabetes, and cardiovascular diseases. A significant number of cases remain undiagnosed until they reach advanced and costly stages of treatment.

Data from the health ministry highlights NCDs contributed to 37% of all deaths in Uganda in 2023.

Recent health reports also indicate that over 39% of Ugandans suffer from high blood pressure, with many unaware of their condition. Diabetes and other metabolic disorders are also on the rise, with lifestyle changes and urbanisation contributing to increased risk factors.

"If we do not look for these diseases in the community, we will always be at the end, treating complications rather than preventing them. We need to change our approach and shift the focus to early detection at the household level," Atwine said.