Is Museveni receiving briefings on non-COVID-19 diseases?

OPINION  HEALTH  COVID-19

 

 

Even before the COVID-19 pandemic, Uganda made significant achievements in key health outcomes over the 3 decades of President Museveni's regime. The life expectancy at birth is now above 60 years, up from below 45 years due to the wrath of HIV/AIDS; maternal deaths have reduced from above 500 to less than 350 per 100,000 live births, which is still unacceptably high; and there has been simultaneous reductions in child mortality and Malaria in the recent past.

 

Conquering epidemics is not new to President Museveni, and Uganda's medals range from victory over the deadly "kill-me-quick" Ebola to the chronic HIV/AIDS that we have positively learned to live with. Uganda has done relatively well in the COVID-19 fight. Currently, Uganda is outshining its East African neighbors having maintained a significantly lower burden of COVID19 despite a higher per capita testing. Thus far, of the estimated 40,000 tests we have detected only 100 cases of COVID19 and over 50% have recovered from supportive treatment in Uganda.

 

The key success factors in Uganda's fight against COVID-19 have been unassuming yet focused leadership from the top, community mobilization and cooperation, substantial monetary investment, trusting professionals in science and above all raising awareness about SARS-CoV-2. In all this, the heroic proletariat of professionals in medical care: nurses, doctors and midwives; the media and the armed forces have been leading at the frontline. That Mr. Museveni has provided clear direction, our Minister of Health Dr. Aceng has followed through hinged on a scientific approach and Rt. Hon. Kadaga appropriated the money timely, is no mean feat in Uganda's leadership resolve to conquer COVID19. True, lately the 10 billion shillings allocation by Parliamentarians soiled the trust in our leaders; they still remain steadfast.

 

Every policy intervention creates new policy problems. What are our blind spots? Are we covering all our bases in this COVID-19 fight? What has happened to the killer diseases prevalent before March 18th when Mr. Museveni declared 13 measures against COVID-19? A quick review of Uganda's annual health sector performance report showed that severe malaria, severe pneumonia and severe anemia claimed over 10,000 lives in the 2018/2019 report. Further, there were 1,135 maternal deaths during this period. Noteworthy, all these are premature and preventable deaths of Ugandans that were reported at the health facility level. Mortality could be higher if Ugandans who die in the community are captured in our district health information systems. 

 

The trillion-shilling question is, are there excess deaths from severe malaria, severe pneumonia, severe anemia or pregnant mothers ever since we turned all our attention and resources to COVID-19? In all his 13 state of the nation addresses, Mr. Museveni has been keen to point out each COVID-19 patient in such detail that Medical Ethicists would raise eyebrows; and with satisfaction concludes, "Uganda's COVID-19 curve is flat!" While no system is perfect, is the President receiving daily briefings on the non-COVID19 curve?

 

Our Permanent Secretary, Dr Atwine has often challenged the medical fraternity to provide solutions, beyond merely complaining. Defining the non-COVID-19 diseases problem is the port of entry in providing for alternative and comprehensive COVID-19 interventions. As context is everything, we were at day 34 of lockdown or community quarantine by the last Presidential address on 4th May 2020. How does this community quarantine affect the burden of non-COVID-19 deaths? How does this burden compare to the same period of March to May last year, 2019? We celebrate Sr. Okudinia, the nurse who wheeled a patient in need of emergency medical care for three kilometers from Ediofe Health Centre III to Arua Regional Hospital, soon after the lockdown was instituted. Such are the undesired events of the total lockdown. And what about the RDC who has to give permission to pregnant mothers to go and deliver? Does this introduce another point of delay to access quality medical care?

 

Again, a quick review of the same 2018/19 Ministry of Health report suggests that we lose an average of 12.3 Ugandans per day from malaria, 7.8 from pneumonia, 6.1 from anemia and 3.1 pregnant mothers during childbirth. Estimating this by day 34 of lockdown, we have 418 deaths from severe malaria, 265 from severe pneumonia and 207 from severe anemia alone totalling 890. Two issues arise from this 890 deaths figure; first that these Ugandans would have died anyway with or without COVID-19. The COVID19 Scientific Advisory Committee can easily settle this question by reviewing the Ministries health management information systems monthly reports of 2020. Secondly, is the moral and ethical question whether these deaths are any less important than the COVID-19 deaths of which Uganda has reported none! It is this last matter that Mr. Museveni and his team ought to address if indeed all Ugandan lives matter! The solutions, therefore, lie in the hands of our leaders to whom we have entrusted our national treasury.