NCD Alliance launches new COVID-19 response fund

"When my leg started swelling, I thought I had been bewitched. I tried using local herbs to treat the condition in vain," 50-year-old Regina Nanju, a resident of Kyadembe village in Watuba sub-county, Kyankwanzi district, says.

When the herbs failed, she visited a number of witchdoctors for treatment to no avail.

"I used all sorts of herbs, but my leg continued rotting. I even clashed with my neighbours thinking they were after my life," she adds.

Her suspicion of witchcraft intensified when she started feeling thirsty, hungry and urinated frequently.

The situation worsened with recurrent headache, amnesia and loss of sight. She struggled with bad health for three years until she visited a health facility where she was diagnosed with diabetes.

Just like Nanju, 21-year-old John Kyabasinga of Lwamata in Kiboga, has a nerve-wracking story.

"In 2007, I started falling sick frequently with bouts of fever. I always tested for malaria and HIV, but the results were always negative," he says.

 The father of one says he got so worried that he wrote a Will in anticipation of death.

"Not even painkillers would relieve me of headache; I was always thirsty and hungry; the toilet became my second living room as I visited it almost every 15 minutes to urinate," he says.

Kyabasinga says when he fell sick, diabetes was not anywhere on the list of diseases he suspected he had.

"Before I discovered that I was diabetic, I made many wrong decisions regarding my health," Kyabasinga, who has been receiving insulin injections since 2017, says.

Kyabasinga says before he went to the clinic, he used to spend sh30,000 on treatment.

Diabetes is one the non-communicable diseases that have claimed the lives of Ugandan.

According to David Mulabi, the chief executive officer for East African Non-Communicable Diseases (NCD), when a household has just one person living with NCD, the whole household is affected, not just the patient.

He said the NDCs also affects people's income and their assets like land or livestock are sold in order to pay for medical bills for diseases that can be easily prevented. 

It is estimated that 100 million people are pushed into extreme poverty due to health-related expenditures, mainly NCDs.

COVID-19, a nightmare for people living with NCDs

The emergence of COVID-19 has had an overshadowing effect on long-standing health issues like NCDs.

"NCDs combined kill 97,600 people in Uganda per year while 41 million people globally die annually because of NCDs and the main cause of the deaths are lack of comprehensive data on NCDs, and globally the NCDs pushes 100 million people into poverty," he said.

"Their income and assets are gone, people sell land, cows and their livelihood to pay for medical bills," he added.

NCDs, including heart disease, stroke, cancer, diabetes and chronic lung disease, are collectively responsible for almost 70% of all deaths worldwide.

Mulabi says diabetes is one of the leading NCDs that kill people in Uganda.

Challenges of NCDs in COVID-19 pandemic

 Mulabi says NCDs pose the greatest health and development challenges, including bankrupting not only poor households that have people have a people living with non-communicable diseases (PLWNCDs) but also have the capacity to bankrupt entire health systems.

A call for NDCs integration into COVID-19 response 

"In a twisted sort of fate within this tragedy, COVID-19 has done in three months is what NCD advocates have been saying for over a decade that there is need for a systemic restructuring and strengthening of national health systems using a whole-of-society and whole-of-government approach.

"We have seen with COVID-19 whereby the response needed action outside health to prevent trade-related drivers of the disease, NCDs also require such approach since many of the risk factors are outside health. And we have been saying these things for years with limited success," he says.

A hope for UHC

These intersections will help us to do solidarity advocacy and awareness with COVID-19 so that we can broaden the overall health advocacy agenda under the Universal Health Coverage Umbrella (UHC).

UHC helps to develop safety nets for the poor such that they do not suffer the shocks as they do now, according to Malabi.

The COVID-19 related travel bans have made politicians to realise they cannot go abroad for treatment and are now stuck with only local options.

"We hope this will also contribute to increased health financing in Africa to build robust health systems and make it universal for all.

"So we can then see an advocacy silver lining on COVID-19 that gives us an opportunity to undertake a more formidable broader health reform advocacy under the UHC framework. We hope this will contribute to changing the perceptions around NCDs, as a national health and development issue that needs urgent national responses, and not am an individual problem," Mulabi says.
 
Uganda to benefit from the grant

Mulabi says the grant is a God-send that will enhance and increase solidarity advocacy towards achieving an increase in health financing in line with the Abuja Declaration, which Uganda signed on to and committed to spending 15% of the budget on health.

He says cardiovascular diseases such as heart attack and stroke, cancer, chronic respiratory diseases such as chronic obstructed pulmonary disease and asthma and diabetes, may become history in Uganda with such funding.

The funding

Civil society alliances from Africa, Asia, Europe, Eastern Mediterranean and Latin America will be awarded grants to accelerate the response to the coronavirus pandemic through the first Civil Society Solidarity Fund on NCDs and COVID-19.
 
Todd Harper, President of the NCD Alliance, says, the coronavirus pandemic shows many intersections between COVID-19 and NCDs. People living with NCDs are more vulnerable to COVID-19, with a substantially higher risk of becoming severely ill or dying from the virus.

The fund totaling $300,000 will competitively award grants of up to $15,000 to national and regional NCD alliances to support them in addressing the critical needs of people living with NCDs during COVID-19 through advocacy and communication activities that will support stronger organisational stability and resilience.

Activities will include advocacy and communication efforts for the continuity of essential NCD health services and inclusion of NCDs in national COVID-19 response and recovery plans and community-led awareness-raising campaigns on the linkages between NCDs and COVID-19.

Katie Dain, the CEO of NCD Alliance, says this is a first-of-its-kind fund to support NCD civil society organisations (CSOs) responding respond to COVID-19.

Dain says given the vulnerabilities of COVID-19 to people living with NCDs, it is key to ensure a vibrant and strong NCD civil society that can elevate the voices of communities and people living with NCDs, advocate for health policy reform and hold governments and other stakeholders to account.

Communities the most affected

The pandemic is also impacting the poorest communities around the world and the most vulnerable people in every country.

The civil society solidarity fund was born out of the need to tackle NCDs as fundamental to health security and to prevent a reversal of gains made in NCD prevention and control around the world.

Who is at risk?

Dr Diana Atwine, the health ministry permanent secretary, says risk factors for developing NDCs include obesity, high cholesterol, high blood pressure and physical inactivity.

"The risk of developing diabetes also increases as people grow older. People who are above the age of 40 and overweight are more likely to develop diabetes," she says.

The health minister, Dr Jane Ruth Aceng, says she is worried of the high rate at which Ugandans were consuming alcohol, smoking and eating fast and processed foods, all of which predispose them to diabetes.

"Alcohol, tobacco, cigarettes and eating fast foods are dangerous to one's life. Such risky behaviour increases the chances of one being diabetic. I want to appeal to you to adopt a better lifestyle and embrace good eating habits with food that is nutritious to the body," she says.