2019/2020 Budget: Dwindling funds for palliative care hurts patients

By Carol Natukunda

The majority of adults in need of palliative care have chronic diseases such as cardiovascular diseases, cancer, chronic respiratory diseases, and AIDS.

Kasaijapic703422 350x210

Joseph Egolet was diagnosed with cancer of the rectum. He is receiving treatment at the Uganda Cancer Institute, hundreds of miles away from in his home district of Pallisa.
He has undergone colostomy, a surgical procedure that creates an opening on the large intestine (colon) and abdominal wall. Egolet’s condition requires a daily supply of colostomy bags to collect waste from the body.
However, such essential bags are not available back in his hometown. 
“It is very costly to live with my condition. It is not only medicines that are expensive. It was only after reaching Hospice Africa Uganda that I was able to access free colostomy bags. I appeal to the government to ensure that such essential supplies,” he says.
Egolet was one of the palliative care activists that recently petitioned the deputy Speaker of Parliament Jacob Oulanyah over what they described as dwindling funding to the sector.
Health ministry statistics show that non-communicable diseases account for 33% of all deaths in Uganda. On particularly cancer, there were 32,617 new cancer cases and 21,829 cancer deaths recorded in 2018.
These conditions require palliative care, an approach that, among other things, provides pain relief and offers a support system for terminally ill patients.
However, statistics further show that only 11% of Ugandans who need pain control and palliative care access. The country’s Health Sector Development Plan 2015/16 - 2019/20, shows that palliative care services are being offered in only 4.8% of the public hospitals.
Even worse, as the cancer patients rise, the funds allocated to the sector are dwindling.  In fact, palliative care has no direct funding or vote in the current national budget.
In the Budget Framework Paper for the 2019/20 financial year, the Uganda Cancer Institute (UCI) budget is projected to decrease from over sh91billion in FY 2018/19 to only about sh61billion in the next financial year.
“These are significant budget cuts that touch the provision of palliative care,” said Allana Kembabazi, one of the petitioners from the Initiative for Social and Economic Rights.
“This retrogression in funding is unjustified in a state that is faced with lack of essential medicines, medical equipment and human resource to tackle the growing cancer cases,” she added.
Rose Kiwanuka, the Country Director of the Palliative Care Association of Uganda stressed that  Palliative Care is a component of the definition of universal health coverage which has a central place in achieving the Sustainable Development Goals (SDGs) by 2030.
According to the World Health Organization, Palliative Care is an approach that improves the quality of life of patients and their families facing the problems associated with a life-threatening illness. 
It can be through the prevention and relief of suffering by means of early identification and thorough assessment and treatment of pain and other problems, “The diseases that require palliative care for adults and children to include; cancer, cardiovascular/heart, HIV/AIDS and liver, and kidney diseases, among others. 
The majority of adults in need of palliative care have chronic diseases such as cardiovascular diseases (38.5%), cancer (34%), chronic respiratory diseases (10.3%), AIDS (5.7%) and diabetes (4.6%),” explained Kiwanuka, in reference to the WHO classification.
Parliament's Role
Responding to the concerns,  the Deputy Speaker of Parliament Jacob Oulanyah said that parliament was committed to discussing such real-life issues, which he said touch the core of humanity.
He advised the palliative care fraternity to prepare for engagements in the budgeting process for the next financial year and pledged support to this effect.