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Fighting epidemics is Uganda's top health export

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Added 29th April 2020 08:22 AM

Uganda seems to be using the experience it gained fighting HIV/Aids, Marburg, Ebola and measles to keep the COVID-19curve flat. 

Fighting epidemics is Uganda's top health export

Peter Mwayi

Uganda seems to be using the experience it gained fighting HIV/Aids, Marburg, Ebola and measles to keep the COVID-19curve flat. 

ANALYSIS EBOLA HIV/AIDS

By Peter Mwayi

 
By April 23, Uganda had 63 confirmed COVID-19 cases. The first case, a male traveller arriving in the country from Dubai in the United Arab Emirates, was tested and confirmed on March 21. 


However, the first global case is traced back to Wuhan in China on November 17, last year. Weeks later, the Chinese government declared an outbreak after discovering over 260 people had contracted the virus. 

In the US, which by April 23 had recorded 47,974 deaths out of 849,092 infections and the highest number of people dying on a single day from COVID-19 related complications, the first case was discovered on February 15. 

Closer to home, Kenya declared the first COVID-19 case on March 13 and by April 23, the country had crossed the 300 mark, with 303 infections across the country. While Tanzania had recorded 284 cases on April 23, one month and eight days since its first case was recorded on March 16. 

When Uganda recorded its first case, President Yoweri Museveni closed all borders, stopping international passenger flights into and out of the country on March 23. President Museveni noted that the Government was two days late since the first case had already made its way into the country past the strict check points that had been setup. 

The other infections that were discovered also turned out to be international travellers or people they had come in contact with, except for two cases that still remain a mystery.

Museveni has since March 23 taken to media, teaching Ugandans the basics of how to avoid contracting the virus. 

None of what the President has declared is unique to the country although his message seems to have gained the attention of not just the Ugandan citizens who wait in anticipation every time the President is scheduled to speak, but also citizens of neighbouring Kenya who have since taken to social media in praise of the Ugandan government's swift and firm response to the outbreak, which many say accounts for the hitherto low infection rate. 

In one of his addresses to the nation, Mr Museveni, a bush war hero, noted that the control of the outbreak in Uganda was a war and, therefore, declared that Ugandans support the Government in taking a military approach to fighting the virus. 

"We don't want to make your life difficult, but this is a matter of life and death. We are not talking about convenience, we are talking about survival," Museveni told Ugandans on April 3, adding that he was confident the country would win the war against the virus. 

HISTORY OF ‘WARS'

It is not the first time Uganda is adopting a military approach in fighting a scourge. In the early 1990s, when AIDS hit Uganda hard, President Museveni's approach to stemming the spread became an area of envy for other governments around the region and Africa as a whole.

In his book: Kizza Besigye - Uganda's Unfinished Revolution, journalist Daniel Kalinaki states: "After coming to power, President Museveni had impressed many by publicly acknowledging that HIV/Aids posed a serious public health challenge to Uganda, at a time when most African governments refused to acknowledged the presence of the disease." 

Kalinaki explains that the disease had had a toll on the country, seen in graves littered across the country thus the urgency in the need to address the outbreak. 

"HIV had first been confirmed in Uganda in 1981 in Kasensero, a small fishing village in Rakai district. The disease was initially attributed to witchcraft, with the ignorance and fear sparking stigma and discrimination that saw many people who contracted the disease abandoned to die, alone and helpless in their homes," Kalinaki writes.

He adds: "Entire villages had been decimated and children, some as young as five, found themselves taking care of their fellow orphaned siblings." 
 
According to the journalist, Mr Museveni had also been hit by a hard scientific reality when he sent his soldiers to Cuba for training and most of them were discovered to be infected. 

"Museveni's openness on the issue helped make Uganda a success story in the fight against the epidemic. As care for the sick improved, so did the willingness to test, seek treatment and change behaviour," Kalinaki further notes. 

The high rates of HIV infections created demand for testing and counselling services. As such, a group of organisations, including The Aids Support Organisation, Uganda Redcross Society, Nsambya Home Care, the National Blood Bank and the Uganda Virus Research Institute together with Ministry of Health established the Aids Information Centre, the first voluntary testing and counselling centre in Africa in 1990. 

In the same year, the Government of Uganda opened the Joint Clinical Research Centre, a collaboration of the Ministries of Health, Defence and Makerere University School of Public Health. 

Since then the centre has conducted research on HIV, Tuberculosis and Malaria with support from the World Health Organisation, United States Aid Agency and others that have made it a centre of excellence on research and innovation in the fight against HIV. 

Uganda has also since started manufacturing antiretroviral drugs under a public-private partnership at Quality Chemicals Industry in Luzira, Kampala. 

Uganda has since 1990 approached the HIV/Aids scourge as more than a health issue. The Uganda Aids Commission devised a national HIV/Aids policy that spells out approaches ranging from promoting condom use, preaching abstinence and faithfulness to promotion of the prevention/elimination of mother to child transmission policies (PMTCT). 

According to the World Health Organisation, 41,000 women received PMTCT services in 2001.

With strong political leadership, a vibrant civil society and an open multi-sectoral approach, Uganda's response in the fight against HIV/Aids is arguably the most effective national response to the pandemic in sub-Saharan Africa, according to Wikipedia.

Although received with mixed reactions, the directives by government that outlined 34 measures in a partial lockdown on the country, seem like the government has its best foot forward in stopping the spread of COVID-19, the other foot would be to test the readiness of the country's heavily criticised health care system to manage a fast-spreading virus. 

David Segawa Mukasa, a Ugandan living in the UK where COVID-19 has killed more than 18,000 people, says the position by government is the safest bet in combatting a pandemic that has surprised the developed world. 

"No leader, whether of a developed country or a less developed one wants to see the devastation on his people. COVID-19 is a disaster and the best way of stopping it from destroying you is lockdown," Segawa says. He adds that other effects of a lockdown can be dealt with. "Nothing is worth the lives that are at stake," Segawa says. 

Critics of the response plan to the COVID-19 approach argue on mainly two fronts. One line of argument is that the shutdown lacks a long term economic response plan. They say that the shutdown will have long term effects on the activities of Ugandans and, therefore, the Government should devise means to absorb the shock that the pandemic will leave on the economy.

On the medical front, critics argue that the measures put in place will have a negative impact on the health sector because while saving people from COVID-19, the Government is ignoring and exposing Ugandans to death from other illnesses that have existed in the past.

The former president of the Uganda Medical Association, Dr Ekwaro Obuku, warns against lockdown, saying Ugandans suffering from other illnesses as well as expectant mothers still need to access health care which the lockdown supresses. 

Dr Obuku notes that more than 4,000 Ugandans died from Malaria in 2019 and 11,000 mothers died in maternity, on top of thousands of others that have died from other preventable illnesses. He, therefore, argues that the solution could cause more devastation than the problem. 

EBOLA CHECKPOINT

In October 2000, Uganda recorded an outbreak of Ebola in the northern district of Gulu that lasted up to January 2001 with 425 cases out of which 224 died. Uganda was pronounced Ebola-free on February 27, 2001, 42 days after the last case had been reported. 

Since then a few cases have been reported but no major outbreak has occurred. Most of the cases have been imported from neighbouring DR Congo where the disease has until today continued to kill people in their hundreds. 

Since November 2018, Uganda has, as part of the preparedness activities, vaccinated 4,699 health and frontline workers from 165 health facilities in areas at risk of the outbreak. 

The ministry has set up several Ebola Treatment Units in districts bordering DR Congo to handle cases if they come. 

The government of Uganda, guided by the World Health Organisation has avoided travel and trade restrictions from DR Congo into Uganda. The WHO continues to monitor travel and trade activities between the two nations. 

Mwayi is the media affairs manager Uganda National Chamber of Trade and Investment

 

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