By Fred Ouma
AROUND the world, more than 6,800 people become infected with HIV every day, and more than 5,700 die from AIDS daily mostly because of inadequate access to HIV prevention and treatment services.
The joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organisation (WHO) 2007 report estimates that 33.2 million people around the world are living with HIV. Of these, about 2.5 million people were infected in 2007.
According to the report, the total number of people living with HIV continues to increase because the world’s population is increasing and people with HIV are living longer.
However, the number of people newly- infected with HIV has dropped significantly in recent years around the world, especially in sub-Saharan Africa, the report shows.
Experts suggest the decline reflects not only the result of HIV prevention campaigns, but the natural course of epidemics. “Epidemics have got curves. After making it to the peak, the decline is next,” said Wilford Kirungi, a senior epidemiologist with the Ministry of Health at the launch of the report in November 2007.
“We are seeing the beginnings of this epidemic turning around and showing an impact from all the investments that have been made,” Paul De Lay, the director of evidence, monitoring and policy for UNAIDS,” the report noted.
The most significant reason for the decline in new infections in the hardest-hit areas in sub-Saharan Africa was the increase in fidelity — more people were being faithful to one partner.
“Clearly, a reduction in the number of partners is a big factor in most of these countries,” said De Lay. Other factors, the report showed, were the consistent use of condoms among high-risk groups, such as sexworkers; and the treatment of other sexually- transmitted diseases, which can be a gateway for HIV to enter the body.
The report also cited studies showing the effectiveness of circumcision as a protective measure. “Circumcision definitely impacts the gender ratios, with the greater prevalence of HIV infections in younger women,” the report noted. In Africa, there were about 1.7 million new HIV infections in the sub-Saharan region in 2007.
This is is significantly lower than the 2001 estimate. Nonetheless, the region is still severely affected and is home to about 22.5 million people infected with HIV, representing 68% of the total global number.
About three-quarters of the deaths this year will occur in sub-Saharan Africa, the report said. In Uganda, as in other East Africa countries, adult HIV prevalence is either stable or has started to decline. While the latter trend is most evident in Kenya, in Uganda the trend slightly went up by 0.3% to 7.1% today, from 6.7 in 2005.
The rate had declined from 18% in 1992 to 6.8% in 2005. In comparison, Kenya’s prevalence has decreased from about 14% in the mid-1990s to 5% in 2006. The downward trend is also noticed in Tanzania, from 9.6% in 2001-2002 to 8.7% in 2003-2004 among women using antenatal service.
In Tanzania, a national population-based HIV survey in 2003-2004 found adult HIV prevalence of 7% in 2003-2004. The report notes that besides behavioural change, death of people infected with HIV several years ago has also contributed to the declines in prevalence.
Specialists hailed the drop as a possible historic shift brought about by increased investment in programmes designed to prevent the spread of the deadly disease.
The Uganda AIDS Commission director, Dr. Apuuli Kihumuro, urgues while the figures appear to be improving, there is an urgent need for action and funds to ensure access to HIV prevention, treatment, care and support. Uganda was the first country in sub-Saharan Africa to register a drop in national HIV prevalence.
This article was published in The New Vision on Monday June 1st 2008
Saturday, 7 June 2008
Opinion: What next after HIV Implementers meet in Uganda?
By Raymond Baguma. The writer is a journalist
Note: This blog brought you uncensored updates from the HIV Implementers Meeting in Kampala between June 3rd and 7th. Now here is my opinion about the meet. Read on...
THE HIV Implementers meeting that ended this afternoon, Saturday, in Kampala had all the trappings that come with big money: rich donors like U.S. government, the Global Fund, and the World, 1,700 participants, media from around the world, the luxurious surroundings of two of Kampala’s most expensive hotels and a stunning menu of well-funded research on every imaginable aspect of the HIV/AIDS. Yet one conclusion was inescapable: we are not winning the war against HIV.
Some prominent speakers acknowledged that more money as yet has not brought a positive answer to that basic question. “Many of our most trusted interventions … are at best unproven, at worst disproven,” noted David Wilson from the World Bank’s Global AIDS Team.
Wilson said the “best preventive intervention in the history of the epidemic, male circumcision, is barely advancing,” and even though reducing the number of sexual partners has been the major contributor to reducing HIV transmission, except for in Uganda early in the epidemic, that has happened “despite, not because of formal programs.”
Wilson spoke against a backdrop of steadily rising HIV/AIDS funding. Under the US Presidential Emergency Plan for AIDS Relief (PEPFAR), funding has shot to US$6 billion in 2008 compared to the US $2.3 billion in 2004, according to Dr. Thomas Kenyon, from PEPFAR. In Uganda, PEPFAR’s pledge for this year is US$283 million this year, compared to US$236 million in 2007. Also, the six-year-old Global Fund to fight AIDS, TB and Malaria has committed more than US$11b in 136 AIDS-affected countries in the developing world, with sixty percent of its funding going to African countries.
Ironically, progress was more dramatic 25 years ago when there was little funding. The UNAIDS boss, Dr. Peter Piot said with every two people on treatment worldwide, five people are becoming infected with HIV daily.
First Lady Janet Museveni wonders whether all the new money has been a good thing. “In the late 1980s and the early 90s, there was a sense of urgency to stop AIDS and we had many volunteers,” she says. “At that time, there was no money and expected no financial rewards. Then money started coming in, and we lost volunteers when we institutionalised recruitment.” Today, the rate of new infections in Uganda is rising by as much as 2% in some areas.
Various explanations have been offered for why the dramatic rise in spending has brought a less than dramatic reduction in the rates of HIV-infections. Some say the easy battles have all been won. Others blame changing morals or complacency. But others ask whether the huge establishment created by HIV spending is losing sight of simple things that make a difference.
As Wilson put it, “We must understand, but not overcomplicate.” That may be hard because the HIV/AIDS sector has become a massive industry, sometimes concerned with perpetuating itself. In fact, conference sponsors already were thinking about the next big HIV/AIDS gathering.
During last week’s meeting, they refused to release research papers and presentations to the media because the same presentations will be made at the International AIDS Conference to take place from 3 rd to 8th August in Mexico City. Apparently, they did not want the Kampala meeting to pre-empt the Mexico agenda.
Meanwhile, the HIV/AIDS sector’s size has brought duplication of services, donor programmes and poor coordination of AIDS activities at different country levels. The donor market dedicated to combating HIV/AIDS is crowded and donor agencies have begun fighting for attention and space, observed the UNAIDS deputy executive director, Michel Sidibe. “We are trying to deal with the magnitude of the epidemic. But on many occasions, we have been doing it in an uncoordinated manner,” Sidibe said, “We need to simplify and coordinate the aid money. We need to improve the performance of national systems.” The World Bank’s Operations Advisor Jonathan Brown acknowledges that duplication and competition of donor activities is alive but perhaps a natural thing to occur.
In line with the theme, Sidibe said that partnerships and coordination of HIV/AIDS response programmes is important to the long-term response to the epidemic.
In the competition for funds, some anti-HIV activists feel squeezed out. Phillip Mitchell who is a director of Hope Clinic Lukuli in Kampala said that the implementers meeting did not encourage networks and explain how small NGOs can access funding. “To scale up, you have to bring in more people. They are large multi-country companies that have PEPFAR money. But they are not bringing in new organisations. Donors should make it easier for new implementers to get into the system. They have created a barrier for us to access funds,” said Mitchell.
These problems are not limited to Uganda. In Rwanda, Agnes Binagwaho, the executive secretary of the National AIDS Control Commission said lack of coordination has led to fragmentation of donor programmes run by World Bank, Global Fund and UN. “Aid is lost in overhead, and aid funding is unpredictable and comes late,” she said.
The anti-HIV effort also suffers because donors sometimes do not have the same priorities as beneficiaries. Several African countries have weak, non-functional health systems and keep requesting for technical support to infrastructure development – to increase capacity and systems of storage for donated drugs, for instance.
Uganda’s state minister for primary health care Emmanuel Otaala said, “Donors cannot allow us to put up infrastructure, or train human resource. In the end, we only distribute drugs but lack human resource. But we have initiated a move to build evidence that we need to strengthen our health systems.” While health officials deal with such questions, there are ominous signs that the HIV epidemic could grow worse.
According to Dr. Peter Piot AIDS is remains the first cause of death after malaria and respiratory tract infections. Today, 3 million people living in the developing world are on ARV treatment and another 6 million people need ARV treatment. But health experts forecast that by the year 2010, the number of people in need of ARV treatment will be 10 million worldwide. Still, universal access to ARVs cannot be achieved by 2010, given that twenty percent of people worldwide today, know their HIV status, which is prerequisite to accessing treatment. While there are clear and ambitious targets for ARV treatment, there are no clear targets on prevention, as Piot points out. “We need combination treatment and combination prevention. With this, millions of lives would be saved,” Piot said.
Note: This blog brought you uncensored updates from the HIV Implementers Meeting in Kampala between June 3rd and 7th. Now here is my opinion about the meet. Read on...
THE HIV Implementers meeting that ended this afternoon, Saturday, in Kampala had all the trappings that come with big money: rich donors like U.S. government, the Global Fund, and the World, 1,700 participants, media from around the world, the luxurious surroundings of two of Kampala’s most expensive hotels and a stunning menu of well-funded research on every imaginable aspect of the HIV/AIDS. Yet one conclusion was inescapable: we are not winning the war against HIV.
Some prominent speakers acknowledged that more money as yet has not brought a positive answer to that basic question. “Many of our most trusted interventions … are at best unproven, at worst disproven,” noted David Wilson from the World Bank’s Global AIDS Team.
Wilson said the “best preventive intervention in the history of the epidemic, male circumcision, is barely advancing,” and even though reducing the number of sexual partners has been the major contributor to reducing HIV transmission, except for in Uganda early in the epidemic, that has happened “despite, not because of formal programs.”
Wilson spoke against a backdrop of steadily rising HIV/AIDS funding. Under the US Presidential Emergency Plan for AIDS Relief (PEPFAR), funding has shot to US$6 billion in 2008 compared to the US $2.3 billion in 2004, according to Dr. Thomas Kenyon, from PEPFAR. In Uganda, PEPFAR’s pledge for this year is US$283 million this year, compared to US$236 million in 2007. Also, the six-year-old Global Fund to fight AIDS, TB and Malaria has committed more than US$11b in 136 AIDS-affected countries in the developing world, with sixty percent of its funding going to African countries.
Ironically, progress was more dramatic 25 years ago when there was little funding. The UNAIDS boss, Dr. Peter Piot said with every two people on treatment worldwide, five people are becoming infected with HIV daily.
First Lady Janet Museveni wonders whether all the new money has been a good thing. “In the late 1980s and the early 90s, there was a sense of urgency to stop AIDS and we had many volunteers,” she says. “At that time, there was no money and expected no financial rewards. Then money started coming in, and we lost volunteers when we institutionalised recruitment.” Today, the rate of new infections in Uganda is rising by as much as 2% in some areas.
Various explanations have been offered for why the dramatic rise in spending has brought a less than dramatic reduction in the rates of HIV-infections. Some say the easy battles have all been won. Others blame changing morals or complacency. But others ask whether the huge establishment created by HIV spending is losing sight of simple things that make a difference.
As Wilson put it, “We must understand, but not overcomplicate.” That may be hard because the HIV/AIDS sector has become a massive industry, sometimes concerned with perpetuating itself. In fact, conference sponsors already were thinking about the next big HIV/AIDS gathering.
During last week’s meeting, they refused to release research papers and presentations to the media because the same presentations will be made at the International AIDS Conference to take place from 3 rd to 8th August in Mexico City. Apparently, they did not want the Kampala meeting to pre-empt the Mexico agenda.
Meanwhile, the HIV/AIDS sector’s size has brought duplication of services, donor programmes and poor coordination of AIDS activities at different country levels. The donor market dedicated to combating HIV/AIDS is crowded and donor agencies have begun fighting for attention and space, observed the UNAIDS deputy executive director, Michel Sidibe. “We are trying to deal with the magnitude of the epidemic. But on many occasions, we have been doing it in an uncoordinated manner,” Sidibe said, “We need to simplify and coordinate the aid money. We need to improve the performance of national systems.” The World Bank’s Operations Advisor Jonathan Brown acknowledges that duplication and competition of donor activities is alive but perhaps a natural thing to occur.
In line with the theme, Sidibe said that partnerships and coordination of HIV/AIDS response programmes is important to the long-term response to the epidemic.
In the competition for funds, some anti-HIV activists feel squeezed out. Phillip Mitchell who is a director of Hope Clinic Lukuli in Kampala said that the implementers meeting did not encourage networks and explain how small NGOs can access funding. “To scale up, you have to bring in more people. They are large multi-country companies that have PEPFAR money. But they are not bringing in new organisations. Donors should make it easier for new implementers to get into the system. They have created a barrier for us to access funds,” said Mitchell.
These problems are not limited to Uganda. In Rwanda, Agnes Binagwaho, the executive secretary of the National AIDS Control Commission said lack of coordination has led to fragmentation of donor programmes run by World Bank, Global Fund and UN. “Aid is lost in overhead, and aid funding is unpredictable and comes late,” she said.
The anti-HIV effort also suffers because donors sometimes do not have the same priorities as beneficiaries. Several African countries have weak, non-functional health systems and keep requesting for technical support to infrastructure development – to increase capacity and systems of storage for donated drugs, for instance.
Uganda’s state minister for primary health care Emmanuel Otaala said, “Donors cannot allow us to put up infrastructure, or train human resource. In the end, we only distribute drugs but lack human resource. But we have initiated a move to build evidence that we need to strengthen our health systems.” While health officials deal with such questions, there are ominous signs that the HIV epidemic could grow worse.
According to Dr. Peter Piot AIDS is remains the first cause of death after malaria and respiratory tract infections. Today, 3 million people living in the developing world are on ARV treatment and another 6 million people need ARV treatment. But health experts forecast that by the year 2010, the number of people in need of ARV treatment will be 10 million worldwide. Still, universal access to ARVs cannot be achieved by 2010, given that twenty percent of people worldwide today, know their HIV status, which is prerequisite to accessing treatment. While there are clear and ambitious targets for ARV treatment, there are no clear targets on prevention, as Piot points out. “We need combination treatment and combination prevention. With this, millions of lives would be saved,” Piot said.
Uganda: Donors could buy ARVs from country
By Raymond Baguma
THE Global Fund (GF) will consider buying ARVs manufactured in Uganda if they are affordable and meet approved standards.
The executive director of the Global Fund Against AIDS, TB and Malaria, Michel Kazatchkline, said: “As a donor, what I am ready to fund is the cheapest drug available, which is of quality. It is okay if Uganda produces its own ARVs.
The drug should be of approved quality and cheap. Otherwise, I will ask the Uganda government to buy drugs elsewhere.”
He was addressing journalists at the global meeting for HIV/aids implementers in Kampala. The five-day conference at Imperial Royale Hotel attracted over 1,700 participants from Africa, Europe, Asia and Latin America.
During the opening ceremony, President Yoweri Museveni criticised donors for setting stringent regulations to guide recipient countries during the procurement of antiretroviral (ARV) drugs. Museveni said Uganda has constructed an ARV manufacturing factory, which will also manufacture malaria drugs and other antibiotics.
However, donor regulations provide that their funds should be used to buy drugs manufactured by foreign countries. Kazatchkline said the Global Fund had committed more than US$11b to 136 countries during its six years in existence and that 60% of the funding benefits African countries, the main recipients.
Kazatchkline said he met President Museveni, who made a commitment to completing all investigations into the Global Fund scandal and the recovery of the embezzled funds. Dr. Thomas Kenyon, the Chief Medical Officer of the US Presidential Emergency Plan For AIDS Relief, said there were no strings attached to donor aid.
Rather, he added, donors only fund what the aid recipient countries need. “Country ownership is the basic principle by which we work. what we link to our funds is accountability. The landscape is now moving out of the concept of donor-beneficiaries and moving to the concept of partners,” Kenyon explained.
This article was published in The New Vision on Saturday June 7th 2008
THE Global Fund (GF) will consider buying ARVs manufactured in Uganda if they are affordable and meet approved standards.
The executive director of the Global Fund Against AIDS, TB and Malaria, Michel Kazatchkline, said: “As a donor, what I am ready to fund is the cheapest drug available, which is of quality. It is okay if Uganda produces its own ARVs.
The drug should be of approved quality and cheap. Otherwise, I will ask the Uganda government to buy drugs elsewhere.”
He was addressing journalists at the global meeting for HIV/aids implementers in Kampala. The five-day conference at Imperial Royale Hotel attracted over 1,700 participants from Africa, Europe, Asia and Latin America.
During the opening ceremony, President Yoweri Museveni criticised donors for setting stringent regulations to guide recipient countries during the procurement of antiretroviral (ARV) drugs. Museveni said Uganda has constructed an ARV manufacturing factory, which will also manufacture malaria drugs and other antibiotics.
However, donor regulations provide that their funds should be used to buy drugs manufactured by foreign countries. Kazatchkline said the Global Fund had committed more than US$11b to 136 countries during its six years in existence and that 60% of the funding benefits African countries, the main recipients.
Kazatchkline said he met President Museveni, who made a commitment to completing all investigations into the Global Fund scandal and the recovery of the embezzled funds. Dr. Thomas Kenyon, the Chief Medical Officer of the US Presidential Emergency Plan For AIDS Relief, said there were no strings attached to donor aid.
Rather, he added, donors only fund what the aid recipient countries need. “Country ownership is the basic principle by which we work. what we link to our funds is accountability. The landscape is now moving out of the concept of donor-beneficiaries and moving to the concept of partners,” Kenyon explained.
This article was published in The New Vision on Saturday June 7th 2008
Uganda: UNAIDS official pleads for homosexuals
By Raymond Baguma
A SENIOR HIV/AIDS expert has urged the Government to release three gay activists arrested by security operatives during the HIV Implementers meeting in Kampala.
Dr. Michel Sidibe, the deputy executive director of UNAIDS, said the incident might overshadow Uganda’s HIV/AIDS achievements. “We have received information that some people were arrested. We are looking forward to their safe and imminent release,” Sidibe told participants attending a plenary session at Imperial Royale Hotel on Thursday.
“I do not know if they were gay. But if they were not registered for the meeting and wanted to be part of the movement fighting against AIDS……Uganda is known as a country of openness. I do not want this incident to overshadow the national efforts,” Sidibe, who is also a former UNICEF representative to Uganda, told Saturday Vision.
Security operatives on Wednesday arrested a woman and two men who sneaked into the meeting, carrying placards and a 67-page document soliciting for funding for their activities.
The placards and document were advocating consideration of homosexuals in HIV/AIDS programmes. The Police identified the trio as Pepe Juliana Onzema, who said she was a freelance journalist, Usaam Mukwaya and Valantini Katende.
They were detained at Jinja Road Police Station on Thursday night. Homosexuality is a crime in Uganda, punishable by life imprisonment under the “unnatural offences” in section 140 of the penal code.
In his presentation during same the plenary session, renowned Ugandan AIDS activist, the Rev. Canon Gideon Byamugisha, said that some governments were using AIDS to control people rather than using people to control the disease.
Byamugisha, representing people living with HIV/AIDS said: “implementation is in chaos. we seem to have different agenda. To say that you cannot give me treatment because I have sex differently is beside the point. We are in implementation to save lives. Are we going to put conditions on who will survive and who will die?”
This article was published on Saturday June 7th 2008
A SENIOR HIV/AIDS expert has urged the Government to release three gay activists arrested by security operatives during the HIV Implementers meeting in Kampala.
Dr. Michel Sidibe, the deputy executive director of UNAIDS, said the incident might overshadow Uganda’s HIV/AIDS achievements. “We have received information that some people were arrested. We are looking forward to their safe and imminent release,” Sidibe told participants attending a plenary session at Imperial Royale Hotel on Thursday.
“I do not know if they were gay. But if they were not registered for the meeting and wanted to be part of the movement fighting against AIDS……Uganda is known as a country of openness. I do not want this incident to overshadow the national efforts,” Sidibe, who is also a former UNICEF representative to Uganda, told Saturday Vision.
Security operatives on Wednesday arrested a woman and two men who sneaked into the meeting, carrying placards and a 67-page document soliciting for funding for their activities.
The placards and document were advocating consideration of homosexuals in HIV/AIDS programmes. The Police identified the trio as Pepe Juliana Onzema, who said she was a freelance journalist, Usaam Mukwaya and Valantini Katende.
They were detained at Jinja Road Police Station on Thursday night. Homosexuality is a crime in Uganda, punishable by life imprisonment under the “unnatural offences” in section 140 of the penal code.
In his presentation during same the plenary session, renowned Ugandan AIDS activist, the Rev. Canon Gideon Byamugisha, said that some governments were using AIDS to control people rather than using people to control the disease.
Byamugisha, representing people living with HIV/AIDS said: “implementation is in chaos. we seem to have different agenda. To say that you cannot give me treatment because I have sex differently is beside the point. We are in implementation to save lives. Are we going to put conditions on who will survive and who will die?”
This article was published on Saturday June 7th 2008
Uganda: AIDS drug made for rural women
By Raymond Baguma
THE US Centres for Disease Control has developed a home-delivery package of Nevirapine to boost chances of safe birth for pregnant HIV-positive women in rural areas.
The pilot programme carried out in Tororo district aims at increasing the chances of safe delivery and reducing mother-to-child transmission of HIV. Dr. Julius Kalamya, a specialist, said less than 30% of pregnant women deliver in health facilities in Uganda.
“We found a good number of mothers, who delivered at home because they stayed far away from health facilities. They also lacked transport. One way to look at safety was to pack Nevirapine for them.”
The take-home Nevirapine syrup is packed in an aluminum foil and is given to the expectant mothers. Findings of the pilot project done between October 2005 and December 2007 indicate that 982 pregnant women tested HIV-positive at Tororo Hospital.
Of these, 807 were given the Nevirapine tablet, while 744 were given the syrup pack. The beneficiaries and midwives said it was easy to carry, store and administer.
Kalamya noted that current health guidelines do not recommend giving the syrup to mothers during their antenatal care visit. He urged the health ministry to consider including the provision of the Nevirapine syrup to HIV-infected mothers in its national programmes.
Kalamya presented the findings at the ongoing HIV/AIDS implementers’ meeting in Kampala.
This article was published in The New Vision on Thursday June 5, 2008
THE US Centres for Disease Control has developed a home-delivery package of Nevirapine to boost chances of safe birth for pregnant HIV-positive women in rural areas.
The pilot programme carried out in Tororo district aims at increasing the chances of safe delivery and reducing mother-to-child transmission of HIV. Dr. Julius Kalamya, a specialist, said less than 30% of pregnant women deliver in health facilities in Uganda.
“We found a good number of mothers, who delivered at home because they stayed far away from health facilities. They also lacked transport. One way to look at safety was to pack Nevirapine for them.”
The take-home Nevirapine syrup is packed in an aluminum foil and is given to the expectant mothers. Findings of the pilot project done between October 2005 and December 2007 indicate that 982 pregnant women tested HIV-positive at Tororo Hospital.
Of these, 807 were given the Nevirapine tablet, while 744 were given the syrup pack. The beneficiaries and midwives said it was easy to carry, store and administer.
Kalamya noted that current health guidelines do not recommend giving the syrup to mothers during their antenatal care visit. He urged the health ministry to consider including the provision of the Nevirapine syrup to HIV-infected mothers in its national programmes.
Kalamya presented the findings at the ongoing HIV/AIDS implementers’ meeting in Kampala.
This article was published in The New Vision on Thursday June 5, 2008
Uganda: President hails donors in fighting HIV/AIDS
By Raymond Baguma and Anthony Bugembe
PRESIDENT Yoweri Museveni has appreciated the support given to Uganda by global partners in fighting the HIV/AIDS pandemic. “Without your support, we would not have reached where we are today.”
He specifically thanked the UN agencies and the Global Fund for AIDS, Tuberculosis and Malaria.
The President, who was on Tuesday addressing the ongoing Global HIV/AIDS implementers’ meeting in Kampala, also paid glowing tribute to the US government, especially President George Bush. He cited Bush’s support through the President’s Emergency Plan for AIDS Relief and increasing aid to Uganda by the US from $236m (sh386) to $283m (sh463b).
Museveni, who was accompanied by his wife Janet, also thanked the Global Fund for resuming remissions to the country. He gave assurance that past mistakes, where resources from the body were mismanaged, would not be repeated because “mechanisms have been put in place to ensure proper use of the funds.”
Former health minister Maj. Gen. Muhwezi and his deputies then, Capt. Mike Mukula and Dr Alex Kamugisha, have been charged with embezzling the funds. The five-day meeting at the Imperial Royale Hotel in Kampala is running under the theme Scaling-up-Through Partnership: Overcoming Obstacles to Implementation.
It has attracted over 1,700 participants. Museveni observed that the theme was appropriate because it could help each country identify specific interventions that could lead to stemming the pandemic.
He pointed out that Uganda was able to reduce the rate of HIV/AIDS prevalence because the major mode of transmission (sexual intercourse) was identified and tackled head on.
The President, however, was dismayed by the stagnation of the prevalence rate at 6.4% today from 30% in 1986. Messages against the disease should warn the public, especially the youth, against reckless living, Museveni stressed.
“The (Uganda) AIDS Commission should repackage its message to young people that anti-retroviral drugs (ARVs) are a second choice. The first choice should be to remain healthy and don’t fall sick.”
He noted that the country had lost at least one million people to the scourge and two million children left orphaned, something which he said had slowed down development.
“Although our economy is one of the fastest growing in the world, it could have grown faster by one percent more every year if it was not for HIV/AIDS.”
The Government, he added, was emphasising behaviour change instead of condoms. “Our main method was behaviour change and it has worked. Many people are discouraging us, saying it is not possible.
This is absolute nonsense.” The UNAIDS executive director, Dr. Peter Piot, said most interventions were focusing on treatment, but paying less attention to prevention.
This article was published in The New Vision on June 4th 2008
PRESIDENT Yoweri Museveni has appreciated the support given to Uganda by global partners in fighting the HIV/AIDS pandemic. “Without your support, we would not have reached where we are today.”
He specifically thanked the UN agencies and the Global Fund for AIDS, Tuberculosis and Malaria.
The President, who was on Tuesday addressing the ongoing Global HIV/AIDS implementers’ meeting in Kampala, also paid glowing tribute to the US government, especially President George Bush. He cited Bush’s support through the President’s Emergency Plan for AIDS Relief and increasing aid to Uganda by the US from $236m (sh386) to $283m (sh463b).
Museveni, who was accompanied by his wife Janet, also thanked the Global Fund for resuming remissions to the country. He gave assurance that past mistakes, where resources from the body were mismanaged, would not be repeated because “mechanisms have been put in place to ensure proper use of the funds.”
Former health minister Maj. Gen. Muhwezi and his deputies then, Capt. Mike Mukula and Dr Alex Kamugisha, have been charged with embezzling the funds. The five-day meeting at the Imperial Royale Hotel in Kampala is running under the theme Scaling-up-Through Partnership: Overcoming Obstacles to Implementation.
It has attracted over 1,700 participants. Museveni observed that the theme was appropriate because it could help each country identify specific interventions that could lead to stemming the pandemic.
He pointed out that Uganda was able to reduce the rate of HIV/AIDS prevalence because the major mode of transmission (sexual intercourse) was identified and tackled head on.
The President, however, was dismayed by the stagnation of the prevalence rate at 6.4% today from 30% in 1986. Messages against the disease should warn the public, especially the youth, against reckless living, Museveni stressed.
“The (Uganda) AIDS Commission should repackage its message to young people that anti-retroviral drugs (ARVs) are a second choice. The first choice should be to remain healthy and don’t fall sick.”
He noted that the country had lost at least one million people to the scourge and two million children left orphaned, something which he said had slowed down development.
“Although our economy is one of the fastest growing in the world, it could have grown faster by one percent more every year if it was not for HIV/AIDS.”
The Government, he added, was emphasising behaviour change instead of condoms. “Our main method was behaviour change and it has worked. Many people are discouraging us, saying it is not possible.
This is absolute nonsense.” The UNAIDS executive director, Dr. Peter Piot, said most interventions were focusing on treatment, but paying less attention to prevention.
This article was published in The New Vision on June 4th 2008
Uganda: AIDS body chief roots for gays
By Raymond Baguma
THE gay community in the country should not be neglected while designing anti-HIV/AIDS strategies, the director general of the Uganda AIDS Commission, Dr. Kihumuro Apuuli, has said.
“It is true that research was done among gays and the trend is common in young people. We need to address the gay issue, but they are not a major driver of infections.”
Apuuli was on Monday addressing journalists at the Media Centre in Kampala ahead of the start of the Global HIV/AIDS implementers’ meeting. He noted that in Uganda, the major drivers of the pandemic were the fishing communities, sex workers, truck drivers and the armed forces.
Apuuli added that discordance and extra-marital relationships were playing a big role in the spread. A recent study in Kampala showed gay and bi-sexual men had unprotected sex with their partners yet the perception that they were at risk of HIV infection was low.
The study called for the urgent recognition that these people needed to be sensitised on the mode of infection and given treatment. The upcoming HIV/AIDS national sero-behavioral status survey due in September would help to establish the updated prevalence rates of the epidemic in the country, Apuuli noted.
The last survey put the national prevalence at 6.4%. A small percentage of people, Apuuli stated, knew their sero-status. He observed that the infection rate among the youth had fallen because of an effective campaign to promote abstinence through the Young Empowered And Healthy (YEAH) programme.
The chief medical officer of the US President’s Emergency Plan for AIDS Relief, Dr. Thomas Kenyon, said the highest rate of infections and deaths globally occurred in Africa yet most people did not know their sero-status.
He noted that the emergency plan had enabled 1.5 million people worldwide to access ARV treatment and supported interventions in children by introducing special testing equipment for babies.
This article was published in The New Vision Wednesday June 4th 2008
THE gay community in the country should not be neglected while designing anti-HIV/AIDS strategies, the director general of the Uganda AIDS Commission, Dr. Kihumuro Apuuli, has said.
“It is true that research was done among gays and the trend is common in young people. We need to address the gay issue, but they are not a major driver of infections.”
Apuuli was on Monday addressing journalists at the Media Centre in Kampala ahead of the start of the Global HIV/AIDS implementers’ meeting. He noted that in Uganda, the major drivers of the pandemic were the fishing communities, sex workers, truck drivers and the armed forces.
Apuuli added that discordance and extra-marital relationships were playing a big role in the spread. A recent study in Kampala showed gay and bi-sexual men had unprotected sex with their partners yet the perception that they were at risk of HIV infection was low.
The study called for the urgent recognition that these people needed to be sensitised on the mode of infection and given treatment. The upcoming HIV/AIDS national sero-behavioral status survey due in September would help to establish the updated prevalence rates of the epidemic in the country, Apuuli noted.
The last survey put the national prevalence at 6.4%. A small percentage of people, Apuuli stated, knew their sero-status. He observed that the infection rate among the youth had fallen because of an effective campaign to promote abstinence through the Young Empowered And Healthy (YEAH) programme.
The chief medical officer of the US President’s Emergency Plan for AIDS Relief, Dr. Thomas Kenyon, said the highest rate of infections and deaths globally occurred in Africa yet most people did not know their sero-status.
He noted that the emergency plan had enabled 1.5 million people worldwide to access ARV treatment and supported interventions in children by introducing special testing equipment for babies.
This article was published in The New Vision Wednesday June 4th 2008
Uganda: Museveni questions donor aid conditions
By Raymond Baguma and Anthony Bugembe
PRESIDENT Yoweri Museveni has criticised donors for setting stringent regulations to guide recipient countries during the procurement of HIV/AIDS drugs.
He gave an example of Uganda which has constructed an ARV manufacturing factory, which will be making ARVs, malaria drugs and other anti-biotic drugs.
“We decided to build an ARV manufacturing plant here. But there is a bureaucratic issue about using this money to buy drugs in our factories. We have to buy drugs from outside. But I do not like this,” Museveni said.
He said donors emphasise capacity building and the purchase of locally manufactured ARV drugs would be in line with this. “I am not used to using foreign drugs. Up to the age of 10 years, I never used drugs from outside my village. My mother knew which local herbs to use to treat me,” he remarked.
“Our partners are saying ‘we give you money but you must buy foreign.’ We have diverted our money to buy drugs. But provided that the drugs are effective, I do not see why the procurement regulations should not be flexible.”
He said there was need to discuss with the donors how to support the ARV factory. “It could be in partnership with affected countries. But we must be able to treat ourselves and it creates employment.” Museveni was opening the second HIV/AIDS implementers’ meeting at the Imperial Royale Hotel Kmapala yesterday.
The President also questioned the emphasis of male circumcision as a means of preventing the spread of HIV/AIDS. “When circumcised people behave recklessly, are they immune to HIV and AIDS? To me, behaviour change is the way to go.”
He said Uganda had tribes which practice circumcision as a tradition yet they remain with a high HIV prevalence rate. “If circumcision would render the body armoured, then why would we have incidents of AIDS in these tribes? I want more guidance on that. What is the point to behave recklessly as long as you are circumcised?”
The Global Fund recently signed a memorandum of understanding committing $36.3m to Uganda for 2008/9 under Phase II of Round Three. Museveni said Uganda was in the process of signing Round Seven of the global funds worth $254m for HIV/AIDS and $114m for malaria in the next five years.
This article was published in The New Vision on Tuesday June 3, 2008
PRESIDENT Yoweri Museveni has criticised donors for setting stringent regulations to guide recipient countries during the procurement of HIV/AIDS drugs.
He gave an example of Uganda which has constructed an ARV manufacturing factory, which will be making ARVs, malaria drugs and other anti-biotic drugs.
“We decided to build an ARV manufacturing plant here. But there is a bureaucratic issue about using this money to buy drugs in our factories. We have to buy drugs from outside. But I do not like this,” Museveni said.
He said donors emphasise capacity building and the purchase of locally manufactured ARV drugs would be in line with this. “I am not used to using foreign drugs. Up to the age of 10 years, I never used drugs from outside my village. My mother knew which local herbs to use to treat me,” he remarked.
“Our partners are saying ‘we give you money but you must buy foreign.’ We have diverted our money to buy drugs. But provided that the drugs are effective, I do not see why the procurement regulations should not be flexible.”
He said there was need to discuss with the donors how to support the ARV factory. “It could be in partnership with affected countries. But we must be able to treat ourselves and it creates employment.” Museveni was opening the second HIV/AIDS implementers’ meeting at the Imperial Royale Hotel Kmapala yesterday.
The President also questioned the emphasis of male circumcision as a means of preventing the spread of HIV/AIDS. “When circumcised people behave recklessly, are they immune to HIV and AIDS? To me, behaviour change is the way to go.”
He said Uganda had tribes which practice circumcision as a tradition yet they remain with a high HIV prevalence rate. “If circumcision would render the body armoured, then why would we have incidents of AIDS in these tribes? I want more guidance on that. What is the point to behave recklessly as long as you are circumcised?”
The Global Fund recently signed a memorandum of understanding committing $36.3m to Uganda for 2008/9 under Phase II of Round Three. Museveni said Uganda was in the process of signing Round Seven of the global funds worth $254m for HIV/AIDS and $114m for malaria in the next five years.
This article was published in The New Vision on Tuesday June 3, 2008
Uganda: Hosting world HIV/AIDS implementers’ meeting
By Fred Ouma and Raymond Baguma
THE second HIV Implementers meeting gets underway at the Imperial Royale Hotel in Kampala tomorrow till Saturday. The first was held in Kigali Rwanda last year.
The conference will be held under the theme: Scaling up through Partnerships: Overcoming Obstacles to Implementation, recognising the rapid expansion of HIV/AIDS programmes worldwide.
The meeting will bring together 1,700 practitioners from Uganda, Rwanda, Ethiopia and the rest of the world to discuss and share ideas to strengthen the global responses to HIV/AIDS, according to a statement issued by the organisers.
Speakers will touch on the several themes that cu across all HIV/AIDS programming areas. They include epidemic and response, human capacity development, linking people to resources, coordination and harmonisation, integrating services, monitoring and evaluating impact.
“Through presentations, dialogue and networking, participants expect to share information that will directly impact HIV/AIDS programmes in the coming years,” said James Kigozi, the spokesperson of the Uganda AIDS Commission.
This year’s objectives are to widely disseminate lessons learned with a focus on scaling up prevention, treatment and care programmes, build local capacity, quality and coordination among partners. It is also aimed at forging future directions of HIV/AIDS programmes with emphasis on implementation and the identification of critical barriers and integrating best practices and lessons learned.
President Yoweri Museveni will welcome more HIV/AIDS implementers. Among the personalities to attend is Dr. Peter Piot, the UNAIDS executive director; ambassador Mark Dybul, the coordinator of the US President’s Emergency Plan for AIDS Relief (PEPFAR) and Dr. Michel Kazatchkine, the executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Others are Dr. Kevin Moody, the International coordinator and chief executive officer of the Global Network of People Living with HIV/AIDS (GNP+). The five-day meeting is co-sponsored by PEPFAR, the Global Fund,UNAIDS, UNICEF, the World Bank, the World Health Organisation and GNP+.
This article was published on Monday May 31st 2008
THE second HIV Implementers meeting gets underway at the Imperial Royale Hotel in Kampala tomorrow till Saturday. The first was held in Kigali Rwanda last year.
The conference will be held under the theme: Scaling up through Partnerships: Overcoming Obstacles to Implementation, recognising the rapid expansion of HIV/AIDS programmes worldwide.
The meeting will bring together 1,700 practitioners from Uganda, Rwanda, Ethiopia and the rest of the world to discuss and share ideas to strengthen the global responses to HIV/AIDS, according to a statement issued by the organisers.
Speakers will touch on the several themes that cu across all HIV/AIDS programming areas. They include epidemic and response, human capacity development, linking people to resources, coordination and harmonisation, integrating services, monitoring and evaluating impact.
“Through presentations, dialogue and networking, participants expect to share information that will directly impact HIV/AIDS programmes in the coming years,” said James Kigozi, the spokesperson of the Uganda AIDS Commission.
This year’s objectives are to widely disseminate lessons learned with a focus on scaling up prevention, treatment and care programmes, build local capacity, quality and coordination among partners. It is also aimed at forging future directions of HIV/AIDS programmes with emphasis on implementation and the identification of critical barriers and integrating best practices and lessons learned.
President Yoweri Museveni will welcome more HIV/AIDS implementers. Among the personalities to attend is Dr. Peter Piot, the UNAIDS executive director; ambassador Mark Dybul, the coordinator of the US President’s Emergency Plan for AIDS Relief (PEPFAR) and Dr. Michel Kazatchkine, the executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Others are Dr. Kevin Moody, the International coordinator and chief executive officer of the Global Network of People Living with HIV/AIDS (GNP+). The five-day meeting is co-sponsored by PEPFAR, the Global Fund,UNAIDS, UNICEF, the World Bank, the World Health Organisation and GNP+.
This article was published on Monday May 31st 2008
Wednesday, 4 June 2008
Court halts DDT spray in northern Uganda
By Rodney Muhumuza
The High Court in Kampala has ordered the Ministry of Health to suspend the spraying of DDT until there is a ruling on a suit that seeks to stop the spraying of the chemical in northern Uganda.
According to the interim court order, issued last Friday by Justice Arach Amoko, any spraying of the insecticide will be “null and void or otherwise illegal”.
Mr MacDusman Kabega, whose Kampala firm represents some nine companies that are opposed to the use of the pesticide, said yesterday that he would tell court that the decision to introduce DDT in Uganda was unfair to the extent to which it ignored the practical concerns of communities where it is to be applied.
Mr Kabega’s clients include: Lango Cooperative Union, Lango Organic Farming Promotion, Dunavant (U) Limited, Bo Weevil (U) Limited, Shares (U) Limited, Outspan Enterprises Limited, Kyagalanyi Coffee Limited, Bakwanye Trading Limited, and Pro Biodiversity Conservationists (U) Limited.
The order, which comes about a month since indoor residual spraying of the insecticide started in two districts in northern Uganda, will frustrate government efforts to put DDT-related controversy behind it.
In effect, it will also ensure that 320 Ugandans continue to die of malaria daily. The Ministry of Health has adopted indoor residual spraying (IRS) of DDT as one of the strategies that would control malaria.
Mr Ken Lukyamuzi, the Conservative Party president who opposes DDT, was in northern Uganda over the weekend and addressed a rally to bolster his campaign.
There has been no compelling evidence of the harm posed by DDT to human health, and defenders of the chemical say that its public health benefits cannot be ignored. Uganda announced that it would start using DDT in malaria control after the World Health Organisation declared in September 2006 that it supported the use of indoor residual spraying of the substance.
It is understood that some of the companies contesting the spraying of DDT supply the British American Tobacco - Uganda. According to Mr Kabega, there is fear, for example, that the use of DDT could result in tobacco from Uganda being shunned on the international market.
Efforts to reach Dr Sam Zaramba, the director of health services at the Ministry of Health, were futile. But Dr Myers Lugemwa, a malaria expert who is on the government’s DDT team, said the ministry has the “competence and capacity to defend the use of any insecticide, including DDT, in malaria control”.
This article was published in The Monitor Uganda on 4th June 2008
The High Court in Kampala has ordered the Ministry of Health to suspend the spraying of DDT until there is a ruling on a suit that seeks to stop the spraying of the chemical in northern Uganda.
According to the interim court order, issued last Friday by Justice Arach Amoko, any spraying of the insecticide will be “null and void or otherwise illegal”.
Mr MacDusman Kabega, whose Kampala firm represents some nine companies that are opposed to the use of the pesticide, said yesterday that he would tell court that the decision to introduce DDT in Uganda was unfair to the extent to which it ignored the practical concerns of communities where it is to be applied.
Mr Kabega’s clients include: Lango Cooperative Union, Lango Organic Farming Promotion, Dunavant (U) Limited, Bo Weevil (U) Limited, Shares (U) Limited, Outspan Enterprises Limited, Kyagalanyi Coffee Limited, Bakwanye Trading Limited, and Pro Biodiversity Conservationists (U) Limited.
The order, which comes about a month since indoor residual spraying of the insecticide started in two districts in northern Uganda, will frustrate government efforts to put DDT-related controversy behind it.
In effect, it will also ensure that 320 Ugandans continue to die of malaria daily. The Ministry of Health has adopted indoor residual spraying (IRS) of DDT as one of the strategies that would control malaria.
Mr Ken Lukyamuzi, the Conservative Party president who opposes DDT, was in northern Uganda over the weekend and addressed a rally to bolster his campaign.
There has been no compelling evidence of the harm posed by DDT to human health, and defenders of the chemical say that its public health benefits cannot be ignored. Uganda announced that it would start using DDT in malaria control after the World Health Organisation declared in September 2006 that it supported the use of indoor residual spraying of the substance.
It is understood that some of the companies contesting the spraying of DDT supply the British American Tobacco - Uganda. According to Mr Kabega, there is fear, for example, that the use of DDT could result in tobacco from Uganda being shunned on the international market.
Efforts to reach Dr Sam Zaramba, the director of health services at the Ministry of Health, were futile. But Dr Myers Lugemwa, a malaria expert who is on the government’s DDT team, said the ministry has the “competence and capacity to defend the use of any insecticide, including DDT, in malaria control”.
This article was published in The Monitor Uganda on 4th June 2008
Uganda: How malaria impoverishes you
By Monitor Reporter
Until recently malaria was only known as the leadingkiller disease in Uganda and sub-Saharan Africa. Butstudies from the Ministry of Health indicate the disease is also the leading cause of poverty.
This is because it has serious impact on the economic, social and cultural aspects of society.A study carried out in 2002 in Uganda identified ill health as the most frequent cause of poverty.
The study showed that a poor malaria-stricken family might spend up to 25 per cent of its income on malaria treatment and prevention. There are also direct costs in form of treatment, treatment seeking and funeral expenses.
Industry
Malaria leads to loss of household incomes through absenteeism from work. It is estimated that workers suffering from a malaria bout can be incapacitated for five to 20 days. A study showed that a high percentage of employees were absent from work due to malaria.
In Apac District 54 per cent of workers cited malaria as the reason for absenteeism, in Kampala 33 per cent and 50 per cent in Rukungiri. On the average out of seven working days, between four to nine days were lost per malaria episode. This means that recovery would take longer than a week in some workers.
During such a period some companies pay for workers’ treatment while the employees are not productive at the moment. Company production is affected leading to lower profit levels and higher costs of production. And this occurs several times a year in many families. This affects the national budgets because the lower the output, the lower the taxes paid to the government. As such, the government cannot meet the obligation of providing services such as in health, thus creating a vicious cycle of poverty.Apart from direct effects of malaria to industries is the additional low demand level. A sick and perennially poor population has low consumption levels. Because of low household incomes, such a population can hardly afford basic necessities in life.
This makes it difficult for such a country to attract investment because of the small market available. The opportunities that go with investment (jobs, taxes, social infrastructure and a higher standard of living) are lost.
In industry and agricultural enterprises like tea, sugarcane, coffee, rice, tobacco estates, malaria accounts for the greatest number of man-hours lost, which maybe up to or more than 50 per cent all the man-hours lost. This affects production and revenue for the industry, families and the nation as well.
Malaria also leads to loss of investment funds thus affecting the economy. It is known that investors are not much interested in investing in countries where most of their profits will be eroded through absenteeism from work due to malaria and on treatment of malaria infected workforce.
Agriculture, Education
This means there are high chances that children in such families will not be able to attend school. This affects performance. It is estimated that in endemic areas like Uganda, malaria may impair as much as 60 per cent of the schoolchildren’s learning ability.
Children from such families will perform poorly, go to poor schools and have fewer or no opportunities to higher education. This makes them miss out on good employment opportunities and they end up doing low skilled labour intensive jobs.
In case the dead person is the breadwinner for the family, children will automatically drop out of school and are condemned to living a wretched life.In agriculture, the period parents (mostly mothers) spend nursing sick children is lost whereas it could be used to grow crops for food and income.
Hence, an episode of malaria affects health, education, agricultural activity and food security. All these build up to increasing poverty in homes.Statistics from the Ministry indicate that malaria afflicted families on the average can harvest only 40 per cent of the crops.
It must be remembered that Uganda is basically an agricultural-dependent country. About 90 per cent of the population is engaged in agriculture. The country earns more from agriculture than from any sector. When this mainstay of the economy suffers, the very fabric of the country is threatened.
Malaria is transmitted by the anopheles mosquito and it spreads faster during the rainy season. Unfortunately this is the main farming season, when families can least afford to be sick. Hence malaria interferes with farm activities increasing poverty in homes.
Social-cultural Impact
Malaria has also caused serious socio-cultural consequences in families.Frequent illness or deaths of children due to malaria can lead to misunderstandings within families (especially polygamous families) and between families.Those with sickly children or children dying often arelikely to accuse others whose children do not fall sick or die often of bewitching their children, which may result into a fight or hatred.
Families with a lot of problems (frequent illnesses, poverty, low education levels and inability to fend for children) are usually unstable.
In most parts of rural Uganda (if not all) it is conceived insensitive if a person continues with farm work like digging. Until a person is buried no digging is permitted. Yet during this period the bereaved families provide food for mourners although some neighbours assist.
This increases poverty and food insecurity as President Yoweri Museveni noted. Whereas food is being consumed, no production is taking place thus creating not only food deficit but increasing poverty since agriculture is the income earner in rural Uganda.
Cost of Treatment
Dr John Bosco Rwakimri, the National Malaria Control Programme manager in the Ministry of Health says Uganda loses at least $690 million to malaria every year. This is in terms of treatment, prevention, time lost due to sickness not counting burial expenses.
According to the Ministry of Health direct cost of treatment for an episode of malaria is estimated at Shs8,000 ($4.10) in urban settings and Shs3,300 ($1.80) in rural populations.
Assuming that 50 per cent of the 5,200,000 children under five years old currently in Uganda suffer an average of six episodes annually and are treated in health facilities at Shs2,000 per episode, then Ugandans are spending (50/100 x 5,200,000 x 6 x 2,000) = Shs31,200,000,000 annually for malaria treatment of the under fives only! (US$20 million, ed. note)
This does not include other expenses incurred, such as transport while seeking treatment, treatment for adults, and children over five years old, treatment of adults and children admitted in health facilities, the higher costs of treating the under 5s and other family members in private clinics and urban areas, chloroquine failures which require more expensive drugs, funeral expenses for children and adults who die, aerosol sprays, mosquito coils, mosquito nets and other mosquito control expenses.
It therefore follows that controlling malaria is not only a health concern but a socio-economic and cultural obligation for all sectors. It is one way of improving human development and fighting poverty in Uganda.
Statistics used are from the Ministry of Health obtained from www.health.go.ug. However, some adjustments have been made to reflect the growth in population and the currency exchange rate, although the figure for treatment of malaria has remained at Shs2,000 as per study.
This article was published in The Monitor Uganda on 4th June 2008
Until recently malaria was only known as the leadingkiller disease in Uganda and sub-Saharan Africa. Butstudies from the Ministry of Health indicate the disease is also the leading cause of poverty.
This is because it has serious impact on the economic, social and cultural aspects of society.A study carried out in 2002 in Uganda identified ill health as the most frequent cause of poverty.
The study showed that a poor malaria-stricken family might spend up to 25 per cent of its income on malaria treatment and prevention. There are also direct costs in form of treatment, treatment seeking and funeral expenses.
Industry
Malaria leads to loss of household incomes through absenteeism from work. It is estimated that workers suffering from a malaria bout can be incapacitated for five to 20 days. A study showed that a high percentage of employees were absent from work due to malaria.
In Apac District 54 per cent of workers cited malaria as the reason for absenteeism, in Kampala 33 per cent and 50 per cent in Rukungiri. On the average out of seven working days, between four to nine days were lost per malaria episode. This means that recovery would take longer than a week in some workers.
During such a period some companies pay for workers’ treatment while the employees are not productive at the moment. Company production is affected leading to lower profit levels and higher costs of production. And this occurs several times a year in many families. This affects the national budgets because the lower the output, the lower the taxes paid to the government. As such, the government cannot meet the obligation of providing services such as in health, thus creating a vicious cycle of poverty.Apart from direct effects of malaria to industries is the additional low demand level. A sick and perennially poor population has low consumption levels. Because of low household incomes, such a population can hardly afford basic necessities in life.
This makes it difficult for such a country to attract investment because of the small market available. The opportunities that go with investment (jobs, taxes, social infrastructure and a higher standard of living) are lost.
In industry and agricultural enterprises like tea, sugarcane, coffee, rice, tobacco estates, malaria accounts for the greatest number of man-hours lost, which maybe up to or more than 50 per cent all the man-hours lost. This affects production and revenue for the industry, families and the nation as well.
Malaria also leads to loss of investment funds thus affecting the economy. It is known that investors are not much interested in investing in countries where most of their profits will be eroded through absenteeism from work due to malaria and on treatment of malaria infected workforce.
Agriculture, Education
This means there are high chances that children in such families will not be able to attend school. This affects performance. It is estimated that in endemic areas like Uganda, malaria may impair as much as 60 per cent of the schoolchildren’s learning ability.
Children from such families will perform poorly, go to poor schools and have fewer or no opportunities to higher education. This makes them miss out on good employment opportunities and they end up doing low skilled labour intensive jobs.
In case the dead person is the breadwinner for the family, children will automatically drop out of school and are condemned to living a wretched life.In agriculture, the period parents (mostly mothers) spend nursing sick children is lost whereas it could be used to grow crops for food and income.
Hence, an episode of malaria affects health, education, agricultural activity and food security. All these build up to increasing poverty in homes.Statistics from the Ministry indicate that malaria afflicted families on the average can harvest only 40 per cent of the crops.
It must be remembered that Uganda is basically an agricultural-dependent country. About 90 per cent of the population is engaged in agriculture. The country earns more from agriculture than from any sector. When this mainstay of the economy suffers, the very fabric of the country is threatened.
Malaria is transmitted by the anopheles mosquito and it spreads faster during the rainy season. Unfortunately this is the main farming season, when families can least afford to be sick. Hence malaria interferes with farm activities increasing poverty in homes.
Social-cultural Impact
Malaria has also caused serious socio-cultural consequences in families.Frequent illness or deaths of children due to malaria can lead to misunderstandings within families (especially polygamous families) and between families.Those with sickly children or children dying often arelikely to accuse others whose children do not fall sick or die often of bewitching their children, which may result into a fight or hatred.
Families with a lot of problems (frequent illnesses, poverty, low education levels and inability to fend for children) are usually unstable.
In most parts of rural Uganda (if not all) it is conceived insensitive if a person continues with farm work like digging. Until a person is buried no digging is permitted. Yet during this period the bereaved families provide food for mourners although some neighbours assist.
This increases poverty and food insecurity as President Yoweri Museveni noted. Whereas food is being consumed, no production is taking place thus creating not only food deficit but increasing poverty since agriculture is the income earner in rural Uganda.
Cost of Treatment
Dr John Bosco Rwakimri, the National Malaria Control Programme manager in the Ministry of Health says Uganda loses at least $690 million to malaria every year. This is in terms of treatment, prevention, time lost due to sickness not counting burial expenses.
According to the Ministry of Health direct cost of treatment for an episode of malaria is estimated at Shs8,000 ($4.10) in urban settings and Shs3,300 ($1.80) in rural populations.
Assuming that 50 per cent of the 5,200,000 children under five years old currently in Uganda suffer an average of six episodes annually and are treated in health facilities at Shs2,000 per episode, then Ugandans are spending (50/100 x 5,200,000 x 6 x 2,000) = Shs31,200,000,000 annually for malaria treatment of the under fives only! (US$20 million, ed. note)
This does not include other expenses incurred, such as transport while seeking treatment, treatment for adults, and children over five years old, treatment of adults and children admitted in health facilities, the higher costs of treating the under 5s and other family members in private clinics and urban areas, chloroquine failures which require more expensive drugs, funeral expenses for children and adults who die, aerosol sprays, mosquito coils, mosquito nets and other mosquito control expenses.
It therefore follows that controlling malaria is not only a health concern but a socio-economic and cultural obligation for all sectors. It is one way of improving human development and fighting poverty in Uganda.
Statistics used are from the Ministry of Health obtained from www.health.go.ug. However, some adjustments have been made to reflect the growth in population and the currency exchange rate, although the figure for treatment of malaria has remained at Shs2,000 as per study.
This article was published in The Monitor Uganda on 4th June 2008
Uganda: Museveni questions donor aid conditions
By Raymond Baguma and Anthony Bugembe
PRESIDENT Yoweri Museveni has criticised donors for setting stringent regulations to guide recipient countries during the procurement of HIV/AIDS drugs.
He gave an example of Uganda which has constructed an ARV manufacturing factory, which will be making ARVs, malaria drugs and other anti-biotic drugs.
“We decided to build an ARV manufacturing plant here. But there is a bureaucratic issue about using this money to buy drugs in our factories. We have to buy drugs from outside. But I do not like this,” Museveni said.
He said donors emphasise capacity building and the purchase of locally manufactured ARV drugs would be in line with this. “I am not used to using foreign drugs. Up to the age of 10 years, I never used drugs from outside my village. My mother knew which local herbs to use to treat me,” he remarked.
“Our partners are saying ‘we give you money but you must buy foreign.’ We have diverted our money to buy drugs. But provided that the drugs are effective, I do not see why the procurement regulations should not be flexible.” He said there was need to discuss with the donors how to support the ARV factory.
“It could be in partnership with affected countries. But we must be able to treat ourselves and it creates employment.”
Museveni was opening the second HIV/AIDS implementers’ meeting at the Imperial Royale Hotel Kmapala yesterday.
The President also questioned the emphasis of male circumcision as a means of preventing the spread of HIV/AIDS. “When circumcised people behave recklessly, are they immune to HIV and AIDS? To me, behaviour change is the way to go.”
He said Uganda had tribes which practice circumcision as a tradition yet they remain with a high HIV prevalence rate. “If circumcision would render the body armoured, then why would we have incidents of AIDS in these tribes? I want more guidance on that. What is the point to behave recklessly as long as you are circumcised?”
The Global Fund recently signed a memorandum of understanding committing $36.3m to Uganda for 2008/9 under Phase II of Round Three. Museveni said Uganda was in the process of signing Round Seven of the global funds worth $254m for HIV/AIDS and $114m for malaria in the next five years.
This article was published in The New Vision Uganda on 4th June 2008
PRESIDENT Yoweri Museveni has criticised donors for setting stringent regulations to guide recipient countries during the procurement of HIV/AIDS drugs.
He gave an example of Uganda which has constructed an ARV manufacturing factory, which will be making ARVs, malaria drugs and other anti-biotic drugs.
“We decided to build an ARV manufacturing plant here. But there is a bureaucratic issue about using this money to buy drugs in our factories. We have to buy drugs from outside. But I do not like this,” Museveni said.
He said donors emphasise capacity building and the purchase of locally manufactured ARV drugs would be in line with this. “I am not used to using foreign drugs. Up to the age of 10 years, I never used drugs from outside my village. My mother knew which local herbs to use to treat me,” he remarked.
“Our partners are saying ‘we give you money but you must buy foreign.’ We have diverted our money to buy drugs. But provided that the drugs are effective, I do not see why the procurement regulations should not be flexible.” He said there was need to discuss with the donors how to support the ARV factory.
“It could be in partnership with affected countries. But we must be able to treat ourselves and it creates employment.”
Museveni was opening the second HIV/AIDS implementers’ meeting at the Imperial Royale Hotel Kmapala yesterday.
The President also questioned the emphasis of male circumcision as a means of preventing the spread of HIV/AIDS. “When circumcised people behave recklessly, are they immune to HIV and AIDS? To me, behaviour change is the way to go.”
He said Uganda had tribes which practice circumcision as a tradition yet they remain with a high HIV prevalence rate. “If circumcision would render the body armoured, then why would we have incidents of AIDS in these tribes? I want more guidance on that. What is the point to behave recklessly as long as you are circumcised?”
The Global Fund recently signed a memorandum of understanding committing $36.3m to Uganda for 2008/9 under Phase II of Round Three. Museveni said Uganda was in the process of signing Round Seven of the global funds worth $254m for HIV/AIDS and $114m for malaria in the next five years.
This article was published in The New Vision Uganda on 4th June 2008
Uganda: MP wants AIDS drugs in villages
By Chris Ocowun
ANTI-RETROVIRAL drugs should be made available at health units in the villages to save residents from travelling long distances to the main hospitals.
The Gulu district Woman MP, Betty Aol Ocan, made the appeal at the weekend while touring Palaro health centre. She asked the health ministry and other stakeholders to stock the health units with the drugs since many HIV-positive people were suffering in the villages because they did not have the transport fare to the main hospitals in Gulu town or to the sub-county health centres.
Health workers had said many residents were coming for voluntary counselling and testing but those found HIV-positive couldn’t access the life-saving drugs since the health units did not have them.
The medical officer for Palaro health centre, Denis Komakech, said the demand for the drugs was high yet they did not have them. “People living with HIV/AIDS have to walk up to Awach health centre IV to access ARVs. But many of them are weak and cannot walk long distances,” he explained.
“My major concern is reproductive health and I am happy to report that no mother has died in labour in Palaro sub-county because of the good job done by the health workers,” Komakech said.
“I thank the International Committee of the Red Cross, which has built for us an incinerator. We can eradicate malaria and cholera but cannot stop reproduction among our mothers.”
Aol also urged the health ministry to do more to improve reproductive health and prevent mother-to-child transmission of the virus. She noted that many IDPs were abandoning the camps and returning to the villages.
This article was published in The New Vision Uganda on 4th June 2008
ANTI-RETROVIRAL drugs should be made available at health units in the villages to save residents from travelling long distances to the main hospitals.
The Gulu district Woman MP, Betty Aol Ocan, made the appeal at the weekend while touring Palaro health centre. She asked the health ministry and other stakeholders to stock the health units with the drugs since many HIV-positive people were suffering in the villages because they did not have the transport fare to the main hospitals in Gulu town or to the sub-county health centres.
Health workers had said many residents were coming for voluntary counselling and testing but those found HIV-positive couldn’t access the life-saving drugs since the health units did not have them.
The medical officer for Palaro health centre, Denis Komakech, said the demand for the drugs was high yet they did not have them. “People living with HIV/AIDS have to walk up to Awach health centre IV to access ARVs. But many of them are weak and cannot walk long distances,” he explained.
“My major concern is reproductive health and I am happy to report that no mother has died in labour in Palaro sub-county because of the good job done by the health workers,” Komakech said.
“I thank the International Committee of the Red Cross, which has built for us an incinerator. We can eradicate malaria and cholera but cannot stop reproduction among our mothers.”
Aol also urged the health ministry to do more to improve reproductive health and prevent mother-to-child transmission of the virus. She noted that many IDPs were abandoning the camps and returning to the villages.
This article was published in The New Vision Uganda on 4th June 2008
Monday, 2 June 2008
Uganda hosts world HIV/AIDS implementers’ meeting
By Fred Ouma and Raymond Baguma
THE second HIV Implementers meeting gets underway at the Imperial Royale Hotel in Kampala tomorrow till Saturday.
The first was held in Kigali Rwanda last year. The conference will be held under the theme: Scaling up through Partnerships: Overcoming Obstacles to Implementation, recognising the rapid expansion of HIV/AIDS programmes worldwide.
The meeting will bring together 1,700 practitioners from Uganda, Rwanda, Ethiopia and the rest of the world to discuss and share ideas to strengthen the global responses to HIV/AIDS, according to a statement issued by the organisers.
Speakers will touch on the several themes that cu across all HIV/AIDS programming areas. They include epidemic and response, human capacity development, linking people to resources, coordination and harmonisation, integrating services, monitoring and evaluating impact.
“Through presentations, dialogue and networking, participants expect to share information that will directly impact HIV/AIDS programmes in the coming years,” said James Kigozi, the spokesperson of the Uganda AIDS Commission.
This year’s objectives are to widely disseminate lessons learned with a focus on scaling up prevention, treatment and care programmes, build local capacity, quality and coordination among partners.
It is also aimed at forging future directions of HIV/AIDS programmes with emphasis on implementation and the identification of critical barriers and integrating best practices and lessons learned.
President Yoweri Museveni will welcome more HIV/AIDS implementers. Among the personalities to attend is Dr. Peter Piot, the UNAIDS executive director; ambassador Mark Dybul, the coordinator of the US President’s Emergency Plan for AIDS Relief (PEPFAR) and Dr. Michel Kazatchkine, the executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. Others are Dr. Kevin Moody, the International coordinator and chief executive officer of the Global Network of People Living with HIV/AIDS (GNP+).
The five-day meeting is co-sponsored by PEPFAR, the Global Fund,UNAIDS, UNICEF, the World Bank, the World Health Organisation and GNP+.
This article was published in The New Vision, Uganda on 2nd June 2008
THE second HIV Implementers meeting gets underway at the Imperial Royale Hotel in Kampala tomorrow till Saturday.
The first was held in Kigali Rwanda last year. The conference will be held under the theme: Scaling up through Partnerships: Overcoming Obstacles to Implementation, recognising the rapid expansion of HIV/AIDS programmes worldwide.
The meeting will bring together 1,700 practitioners from Uganda, Rwanda, Ethiopia and the rest of the world to discuss and share ideas to strengthen the global responses to HIV/AIDS, according to a statement issued by the organisers.
Speakers will touch on the several themes that cu across all HIV/AIDS programming areas. They include epidemic and response, human capacity development, linking people to resources, coordination and harmonisation, integrating services, monitoring and evaluating impact.
“Through presentations, dialogue and networking, participants expect to share information that will directly impact HIV/AIDS programmes in the coming years,” said James Kigozi, the spokesperson of the Uganda AIDS Commission.
This year’s objectives are to widely disseminate lessons learned with a focus on scaling up prevention, treatment and care programmes, build local capacity, quality and coordination among partners.
It is also aimed at forging future directions of HIV/AIDS programmes with emphasis on implementation and the identification of critical barriers and integrating best practices and lessons learned.
President Yoweri Museveni will welcome more HIV/AIDS implementers. Among the personalities to attend is Dr. Peter Piot, the UNAIDS executive director; ambassador Mark Dybul, the coordinator of the US President’s Emergency Plan for AIDS Relief (PEPFAR) and Dr. Michel Kazatchkine, the executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. Others are Dr. Kevin Moody, the International coordinator and chief executive officer of the Global Network of People Living with HIV/AIDS (GNP+).
The five-day meeting is co-sponsored by PEPFAR, the Global Fund,UNAIDS, UNICEF, the World Bank, the World Health Organisation and GNP+.
This article was published in The New Vision, Uganda on 2nd June 2008
Uganda: Include Gays in Aids Fight, Reports Say
By Kakaire Kirunda
A study conducted recently in Kampala and whose findings were published this month in the journal Aids Behaviour says recognition of gay and bisexual men in local HIV prevention programmes and education messages is urgently needed.
The study that was based on 224 gay and bisexual men's views found that "37 percent had unprotected receptive anal sex in the last six months, 27 percent were paid for sex, 18 percent paid for sex, 11 percent had history of urethral discharge".
Yet perception that gay and bisexual men are at risk for HIV infection was low, according to the authors.
"Our study demonstrates that gay and bisexual men in Uganda are willing to identify themselves and participate in research and prevention campaigns," write the authors, further showing that 61 percent and 39 percent reported themselves as gay and bisexuals respectively.
Similarly, the newly released Sexual Minorities Uganda (SMUG), MSM -LGBTI HIV/AIDS Report 2008 calls for the inclusion of gay people in the fight against HIV and Aids.
"Having a programme for HIV prevention is a national priority in Uganda which is held back because most people 'hate' homosexuals," reads the report.
"This is [a] real problem where all Ugandans can do something. Isolated interventions by the minority homosexuals are very limited in their impact.
They need the acknowledgement and support of the majority heterosexual Ugandan population and together HIV can be curbed."
The report is punctuated by testimonies from gay people who have reportedly been mistreated each time they seek sexual health related services.
Uganda has a generalized HIV epidemic, meaning it affects all sections of the community, but most of the prevention, treatment and care programmes for the sick mainly target heterosexuals.
The current national HIV/Aids strategic plan shows no programmes that specifically target men who have sex with fellow men (MSM). Efforts to get a comment from the Uganda Aids Commission, which co-ordinates the HIV/Aids response in the country, were futile.
However, Dr Elioda Tumwesigye, the chairman of Parliament's HIV/Aids committee, said although involving MSM in the fight against HIV is essential, it is not something that can be done easily. "Given that anal sex that those people perform is one of the most effective ways of transmitting HIV, there should be cause for concern," he said.
"Unfortunately, under the current legal framework they can't be helped as a group. However, they can make use of the available programmes as individuals."
According to Dr Tumwesigye, until gay activities are decriminalised, it may not be easy even for organisations that are willing to help to involve this minority community in the fight against HIV.
Anti-gay activist Martin Ssempa said Uganda needs to send a clear message to homosexuals that they are engaging in a suicidal and un-natural risk that fuels HIV and other infections such as hepatitis.
"These people are just looking at ways of legitimising their practice, which is illegal and deviant in our society," said Pastor Ssempa. "Our previous experience showed us that bringing homosexuals into campaigns against HIV only gives them a chance to propagate their illegal and unnatural acts."
Makerere University School of Public Health Dean David Serwadda said the fight against HIV requires the participation of all in the community.
This article was published in The Monitor, Uganda on Saturday 24th May 2008
A study conducted recently in Kampala and whose findings were published this month in the journal Aids Behaviour says recognition of gay and bisexual men in local HIV prevention programmes and education messages is urgently needed.
The study that was based on 224 gay and bisexual men's views found that "37 percent had unprotected receptive anal sex in the last six months, 27 percent were paid for sex, 18 percent paid for sex, 11 percent had history of urethral discharge".
Yet perception that gay and bisexual men are at risk for HIV infection was low, according to the authors.
"Our study demonstrates that gay and bisexual men in Uganda are willing to identify themselves and participate in research and prevention campaigns," write the authors, further showing that 61 percent and 39 percent reported themselves as gay and bisexuals respectively.
Similarly, the newly released Sexual Minorities Uganda (SMUG), MSM -LGBTI HIV/AIDS Report 2008 calls for the inclusion of gay people in the fight against HIV and Aids.
"Having a programme for HIV prevention is a national priority in Uganda which is held back because most people 'hate' homosexuals," reads the report.
"This is [a] real problem where all Ugandans can do something. Isolated interventions by the minority homosexuals are very limited in their impact.
They need the acknowledgement and support of the majority heterosexual Ugandan population and together HIV can be curbed."
The report is punctuated by testimonies from gay people who have reportedly been mistreated each time they seek sexual health related services.
Uganda has a generalized HIV epidemic, meaning it affects all sections of the community, but most of the prevention, treatment and care programmes for the sick mainly target heterosexuals.
The current national HIV/Aids strategic plan shows no programmes that specifically target men who have sex with fellow men (MSM). Efforts to get a comment from the Uganda Aids Commission, which co-ordinates the HIV/Aids response in the country, were futile.
However, Dr Elioda Tumwesigye, the chairman of Parliament's HIV/Aids committee, said although involving MSM in the fight against HIV is essential, it is not something that can be done easily. "Given that anal sex that those people perform is one of the most effective ways of transmitting HIV, there should be cause for concern," he said.
"Unfortunately, under the current legal framework they can't be helped as a group. However, they can make use of the available programmes as individuals."
According to Dr Tumwesigye, until gay activities are decriminalised, it may not be easy even for organisations that are willing to help to involve this minority community in the fight against HIV.
Anti-gay activist Martin Ssempa said Uganda needs to send a clear message to homosexuals that they are engaging in a suicidal and un-natural risk that fuels HIV and other infections such as hepatitis.
"These people are just looking at ways of legitimising their practice, which is illegal and deviant in our society," said Pastor Ssempa. "Our previous experience showed us that bringing homosexuals into campaigns against HIV only gives them a chance to propagate their illegal and unnatural acts."
Makerere University School of Public Health Dean David Serwadda said the fight against HIV requires the participation of all in the community.
This article was published in The Monitor, Uganda on Saturday 24th May 2008
Subscribe to:
Posts (Atom)
