Uganda's COVID-19 fight: Defying the odds to contain a global pandemic

Apr 30, 2020

With the majority of Uganda’s population living below the poverty line, Uganda cannot afford a widescale Covid-19 outbreak. Uganda’s Office of the Prime Minister has embarked on a controlled, centralized food & essentials distribution program targeting the vulnerable.

COVID-19 

By Kenneth Muhangi

This article looks at Uganda's response to Covid-19 and the successes registered as the world battles with the effects of the Pandemic.

The famous American paleontologist and evolutionary biologist, Stephen Jay Gould in his book the Mismeasure of Man wrote,

‘We pass through this world but once. Few tragedies can be more extensive than the stunting of life, few injustices deeper than the denial of an opportunity to strive or even to hope, by a limit imposed from without, but falsely identified as lying within.'

Gould's averments were in support of his proposition that statistics and numbers do not always tell the truth as even the best of scientists may be influenced by assumptions and reality. However, in Uganda's case, the statistics/evidence are unequivocal; Uganda's response to Covid-19 is working.

On 19th March, 21st, 2020, Uganda confirmed her first case of COVID-19[2]. As at 22nd April 2020, out of 14,761cummulative tests, Uganda has confirmed sixty-one (61) cases, forty-one (41) recoveries out of the 61 confirmed cases of COVID-19, and no recorded deaths.[3]

As per Uganda's Minister for Health, Dr. Jane Aceng in a press statement on 18th April 2020[4], out of the sixty-one cases, thirty (30) of Uganda's cases were identified in quarantine,  five (5) directly from the Airport, twelve (12) from returnees in self-isolation, eight (8) from contacts of returnees and six (6) from truck drivers carrying cargo from neighboring East African countries.

MAP OF UGANDA SHOWING DISTRICTS WITH CONFIRMED CASES



Source, MoH Uganda: COVID-19 Information Portal

Uganda introduced its first set of measures meant to curb COVID-19 in an address from Uganda's president, H.E. Yoweri Museveni, on 18th March, 2020[5].

The President announced 13 measures to wit; the closure of all educational Institutions which accounted for 15 million Ugandans, suspension of communal prayers in mosques, churches or in stadia and other open-air venues, stoppage of all public political rallies, cultural gatherings or conferences, banning Ugandans from moving to or through category one (I) countries that had had a large number of Coronavirus cases at the time, returning Ugandans were required to undergo mandatory quarantine, for 14 days at locations identified by Uganda's Ministry for Health.

Non-agricultural gathering points such as factories, hotels, large plantations, markets, taxi-parks, etc were allowed to do business but with strict Standard Operating Procedures (SOPs) put out by the Ministry of Health. Large weddings were discouraged and burials were limited to only immediate family. Monthly/weekly cattle auction and food markets were suspended,  public transport consisting of buses, mini-buses, taxis, and boda-bodas at the time remained accessible but with clear SOPs. Night Clubs, bars, sports, music shows, cinemas, and concerts were all suspended.

President Museveni also emphasized nutrition to strengthen the body's immune system and cautioned against spitting, coughing or sneezing in public, regular washing of hands with soap and water/sanitizers, regularly disinfecting surfaces such as tables, door handles, etc. and desisting from touching eyes, nose or mouth with contaminated and unwashed hands.

In a bid to further decongest public areas, and promote social distancing as the main weapon against the spread of Covid-19, on 25th March 2020, Uganda's President stopped all passengers coming into Uganda by air, land or water; this affected in-coming planes, buses, taxis or boat and also prohibited from entry pedestrians trekking on foot from Uganda's neighbors in East Africa.

On 21st March 2020, all public passenger transport was suspended, non-food stuff vending in public markets were closed to the general public save for food vendors who were cautioned against making unnecessary trips to and from home.  Private vehicles were allowed to move but with a restriction for them to carry a maximum of 3 people per vehicle including the driver.

On 30th March 2020, after authorities unearthed that unregulated private car owners were using their cars to ferry passengers at exorbitant rates, Uganda announced a lockdown for 14 days starting 01st April 2020 and prohibited all people to people movement, prohibited gatherings of more than five (5) people and closed all shopping malls, arcades, and shops selling non-food items.

Only factories, farms, supermarkets, food stores, stores selling agricultural products, veterinary products, detergents, and pharmaceuticals were allowed to remain open but with clear SOPs mandating social distancing.  E-commerce and home deliveries for essentials were also encouraged.

Factories and construction sites were also allowed to continue but with restricted movement as all workers had to be encamped at their places of work for the period of the lockdown.

Uganda also recognized essential services as being, medical & veterinary, telecom & internet service providers, couriers & door-to-door delivery, banks, private security companies, cleaning services, garbage collection, fire-brigade, petrol stations, water departments and key government offices such as Uganda Revenue Authority and Uganda National Roads Authority.

With the exception of cargo transport by road or air within Uganda that has remained relatively unabated save for prohibition from carrying passengers, Uganda also announced a countrywide curfew starting1900 hours and ending 0600 hours every day.

Uganda also recognized that a disadvantaged section of its population would still require access to certain services. Consequently, individuals with pre-existing medical conditions, pregnant women requiring antenatal visits, mothers with newborn babies, and the sick are allowed to access health centers but with permission from Resident District Commissioners and District Health Officers.

Additionally, the government announced that it would collect any government vehicles that do not belong to Uganda's security forces and Uganda Wildlife Authority and temporarily allocate the vehicles to District Health Officers.

On 14th April, 2020 Uganda announced an extension of the lockdown for an additional 21 days[6]. During the lockdown, Uganda's Ministry of Health has been able to increase surveillance, testing and screening and Government Scientists have prepared over 30 protocols for Covid-19 related research.

The Ugandan government also recognized the impact Covid-19 will have on the economy and has stopped landlords from evicting tenants during the lockdown period. On April 6th, 2020, the Central Bank of Uganda, reduced the Central Bank Rate (CBR) to its lowest ever  8% down from 9%. Bank of Uganda also announced measures to be complied with by the banking sector that included loan holidays for affected customers, reduction of the Central Banking Rate from to 8%. today,

Uganda has also promoted local manufacturing with local industries encouraged to adapt and meet the demand for personal protective equipment, sanitizers, face masks, and even bicycles.

President Museveni has with each address reiterated in detail the importance of hygiene and has employed humor and satire in his addresses to perhaps boost the morale of Ugandans in lockdown.

On 9th April 2020, Uganda's President Yoweri Museveni released a video of his home workout routine in a bid to encourage Ugandans to stay indoors during the country's coronavirus lockdown. The 75-year-old is shown jogging barefoot around his office before completing 30 press-ups. Museveni banned public exercise on Wednesday to limit the spread of the virus.[7]

#STAYSAFEWORKFROMHOME

Uganda's lockdown like in many other countries has disrupted Uganda's imagined social order. As companies and employers adopt remote working and social distancing, Uganda through its agencies like Uganda Communications Commission (UCC), the National Information Technology Authority, Uganda (NITA-U) and the Ministry of ICT have embarked on campaigns to combat fake news, promote data protection and cybersecurity vigilance.

The use of trusted sources, such as the Uganda government-sanctioned,  https://covid19.gou.go.ug website have been key for Ugandans accessing up-to-date, fact-based information on COVID-19.

The Data Protection Act 2019, Electronic Transactions Act 2011(ETA), the Computer Misuse Act & the Electronic Signatures Act, 2011(ESA), have also given credence to the success of the #STAYSAFEWORKFROMHOME initiative.  

In particular, The Electronic Transactions Act, 2011 essentially provides for the use, security, facilitation, and regulation of electronic communications and online transactions. The Act (together with the Electronic Signatures Act, 2011) also significantly provides for the legal recognition of electronic transactions, records & signatures; which guarantees effective enforcement of the rights of consumers, if infringed.

Data protection revolves around several principles encapsulated by notions that a data controller/processor should be accountable to the data subject for data collected, processed, held or used; data should be collected in a lawful and fair manner; it should be adequate, minimal and not excessive, accurate, not misleading & up-to-date, collected transparently, shouldn't be kept longer than necessary, should be secure and overall should only be used for the purpose for which It is collected.

Uganda Ministry of ICT has also issued a call for Ugandan innovators to come up with solutions geared at fighting Covid-19 whilst aiding the work at the home campaign.

The cashless lockdown

COVID-19 has increased the reliance/need for digital money and e-commerce. E-Commerce is in general parlance any activity that relates to the purchase and sale of goods and services over the Internet.

Studies have shown that Africa is the "mobile phone continent" of the world as more than half of the population owns a mobile phone. It was predicted that at the end of 2014 nearly 600 million Africans owned a mobile phone, and it's this mobile phone generation who are causing a surge in entrepreneurship. [8]

Ugandans in lockdown have embraced online banking, mobile money and by advertence e-Commerce platforms have grown in popularity as cheaper, cashless solutions for online shopping.

E-commerce will be key during the lockdown and after. For key sectors like transport and logistics, ride-hailing being a more organized industry, maybe preferred and even wholly embraced by the different demographics; considering that in 2000, just one percent (1%) of the African population owned a mobile phone and in 2014, 92 percent (92%) of adult Tanzanians sent a least one text. 

Regulatory sandboxes and the 4IR

A regulatory sandbox is a framework set up by a regulator to allow small scale, live testing of innovations by private firms in a controlled environment (operating under a special exemption, allowance, or other limited, time-bound exception) under the regulator's supervision.

The concept of regulatory sandboxes was developed in a time of rapid technological innovation and attempts to address the frictions between regulators desire to encourage and enable innovation and the emphasis on regulation.

Regulatory sandboxes are being applied in Africa's financial sector to foster innovation in many African countries. For example, In May 2019, Kenya's Capital Markets Authority approved the, Regulatory Sandbox Policy Guidance Note that allows Digital Finance Services (DFS) players to deploy and conduct live-tests of their innovative products, solutions, and service for a maximum period of 12 months.

Furthermore, in early 2018, Sierra Leone in collaboration with United Nations Capital Development Fund (UNCDF) and Financial Sector Deepening Africa (FSDA), introduced a regulatory sandbox framework, The Sierra Leone FinTech Initiative.

Such regulatory sandboxes, as pre-existing efforts will be key as Uganda considers the possibility of utilizing unmanned propulsion systems (drones) to fight Covid-19.

Drones have in the past few year, gained notoriety as a cheaper, more efficient mode of transport. In the less developed world where the transport ecosystem is in most cases worse for wear, drones have been deployed to deliver medicines, blood and lifesaving supplies to hard to reach areas.

In 2019, the Ugandan government-approved, as safe for use, medical drones procured by Infectious Disease Institute (IDI) to deliver essential medical supplies to hard-to-reach places. The project by IDI will see ‘medical drones' deliver the ARVs to Kalangala District, an island usually only accessible by boats and ferry. Another organization, Uganda Flying Labs, deploys drones for mapping, and data analytics.

Access to Medicines and a Case for Intellectual Property

Despite the lack of a cure or vaccine, several treatments for COVID-19 have been identified that have been effective in the treatment of the virus in Uganda. Some of these drugs include hydroxychloroquine and antiretroviral drugs, amongst others.

Uganda has had a history of pandemics with diseases such as Malaria, HIV-AIDS, and Ebola indiscriminately killing many, young and old. The management of past pandemics may be credited to Uganda's access to essential medicines credited to the domestication of The Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). TRIPS is an international legal agreement between all the member nations of the World Trade Organization (WTO). It sets down minimum standards for the regulation by national governments of many forms of intellectual property (IP) as applied to nationals of other WTO member nations.

Uganda domesticated and implemented the TRIPS flexibilities into its national law, the Industrial Properties Act, 2014. As a Least Developed Countries (LDCs), Uganda enjoys certain flexibilities that allow for the manufacture of already patented (generic) medicines. In the context of LDC's, generic is used to mean copies of patented drugs or drugs whose patents have expired.

Access to affordable generic medicines greatly aided the control of HIV in Uganda and has also allowed Uganda to cheaply manufacture generic medicines that have been instrumental in the recovery of COVID patients.

Article 31 of the TRIPS Agreement domesticated under sections 58, 60, and 61 of the Industrial Property Act, further allows Uganda the use of compulsory licenses. Compulsory licenses have made it possible for Uganda to access patentable medicines without the consent of the patent holder. For medicines that cannot be produced locally as per Paragraph 6 of the DOHA Declaration of the TRIPS Agreement, domesticated under Section 44 (e) of the Industrial Property Act Uganda recognizes that although LDCs can manufacture generic medicines, most LDCs do not possess the capital or expertise to manufacture such medicines.

Consequently, Uganda has been able to import from India generic medicines such as the aforementioned and now widely used Covid treatment medicine, Chloroquine.

Tomorrow's Uganda

With the majority of Uganda's population living below the poverty line, Uganda cannot afford a widescale Covid-19 outbreak. Uganda's Office of the Prime Minister has embarked on a controlled, centralized food & essentials distribution program targeting the vulnerable. The exercise is monitored by government authorities with individuals and companies prohibited from undertaking any distribution/donation drives except through authorized government channels that can be monitored with emphasis on hygiene and social distancing.

In a statement to the Public on 02nd April. 2020, the Minister for Health announced that Uganda has a total of 2,370 hospital beds to treat Covid. Uganda has also set up a temporary COVID-19 emergency Hospital with an additional capacity of 100 beds. The hospital also has a surgical section, oxygen, and amenities like air conditioning and washing machines [9].

As Professor Yuval postulated[10], ‘Every point in history is a crossroads. A single travelled road leads from the past to the present, but myriad paths fork into the future. Some of these paths are wider. Smoother and better marked, and are this more likely to be taken, but sometimes history or the people who make history- takes unexpected turns......In a few decades, people will look back and think that the answers to all of these questions were obvious.'

It may be too soon to tell if Uganda will remain on this path to normalcy. With Covid-19 as the worst pandemic of the last decade, road Uganda takes is undoubtedly one less traveled. Uganda may yet provide lessons for other LDCs dealing with pandemics albeit with limited resources.

The writer is a Partner with Technology, Media, Telecommunications, Intellectual Property-KTA Advocates, 41R Taskforce Member- World Economic Forum and World Bank, consultant

[1] S. J Gould, The mismeasure of man. (1981) (New York, Norton. p60.

[2] https://covid19.gou.go.ug

[3] Ibid 2

[4] https://www.newvision.co.ug/new_vision/news/1518038/-live-broad-update-ugandas-covid-19-response
[5] http://www.statehouse.go.ug/media/press-releases/2020/03/30/more-guidelines-covid19-preventive-measures-need-shut-down-president
[6] https://www.newvision.co.ug/new_vision/news/1517866/-live-coronavirus-situation-uganda
[7] https://www.theguardian.com/world/video/2020/apr/09/ugandan-president-makes-home-workout-video-encouraging-citizens-to-exercise-indoors-video
[8] https://www.virgin.com/entrepreneur/four-ways-mobile-phones-have-transformed-life-africa
[9] https://www.youtube.com/watch?v=9TXkE8OSZ04
[10] Harari, Yuval N. author. Sapiens : a Brief History of Humankind. New York :Harper, 2015.

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