Op-ed – Global health security: How prepared is Uganda?

By Herbert Kafeero

In the recent past, Global Health Security has increasingly become a popular subject and issue, nationally and at international levels of policy making.

In an effort to attain a world safe and secure from infectious disease threats, the Global Health Security Agenda (GHSA) was launched in February 2014. The GHSA is an effort by 44 countries in collaboration with the World Health Organization, the Food and Agriculture Organization, the World Health Organization for Animal Health and Civil Society committed to elevating global health security as a global priority.

Under the leadership of the United States Department of Health and Human Services, the GHSA appeals to all nations of the world to make concrete pledges towards three key goals; Preventing, Detecting and Responding to infectious disease threats, whether they are naturally occurring, intentional or an act of bio-terrorism. The GHSA is an important step towards building capacities of all countries to contain infectious disease outbreaks and when national capacities are overwhelmed, the world moves immediately and decisively to contain the outbreak.

Since the formation of the GHSA, countries have combined efforts that have seen the development of the “Action Packages” and composition of the GHSA Steering Group in support of the GHSA.

Over the last decade, Uganda, a participating nation in the GHSA, has experienced occasional epidemics such as Cholera, Marburg, Ebola and Yellow Fever and the country has managed to contain them. However, such epidemics have the ability to rebound unexpectedly and have the potential of taking enormous lives especially those of the most vulnerable people in communities where the outbreaks often happen.

As part of the efforts to test the capacity of the Centers for Disease Control and Prevention to help other nations with their infectious disease preparedness, a pair of pilot projects were conducted in 2013 in Uganda and Vietnam. A pilot program conducted in Uganda focused on multi-drug resistant tuberculosis, cholera and Ebola virus as well as work to improve Uganda’s laboratories. At the end of the six months, laboratories in Uganda were found to have improved their scores in all assessment categories.

In addition, Uganda being one of the five pilot countries of the GHSA (besides Georgia, Peru, Portugal and the United Kingdom) was selected for the Pilot Assessment that was carried out in February, 2015 and recommendations were made in areas where improvement was needed.

The Centers for Disease Control and Prevention Atlanta is improving preparedness and response internationally by building close relationships with ministries of health and other public health partners to encourage public health and emergency management capacity building. However, there continues to be need for deliberate efforts by national governments, including government of Uganda towards achieving the GHSA and strengthening preparedness.

The government of Uganda with support from development partners has taken steps in putting in place measures that can help combat global health risks including; setting up the Uganda Public Health Emergency Operation Center and improving existing non-proprietary information systems and laboratory specimen referral networks for real-time reporting among others.

However, political instabilities in neighboring countries continue to push thousands of refugees to Uganda. The country’s porous borders and generosity permits all categories of people including traders, visitors, and refugees among others, to enter the country and settling in without proper follow ups or adequate checkups to ascertain their health. Such increases in population significantly affect health services, leaving the population with unmet health needs, demands, and create a stress on resources at both local and national level. More people in refugee camps and in neighboring communities remain vulnerable to cholera and other infectious disease outbreaks.

At policy level, the National Biotechnology and Biosafety Bill 2012 should be strengthened before it’s passed into law so that it can explicitly address,  in more depth, issues around GHSA as well as its current focus of Genetically Modified Organisms.

There are still gaps in Uganda’s preparedness to address emergent global health risks which include inadequate funding, inadequate human resources and limited surveillance in laboratory capabilities.

Uganda has however, made big strides in combating other epidemic diseases like influenza, polio, TB, malaria, Typhoid, Brucella, Anthrax, and Viral Hepatitis.

It’s also worth recognizing that Uganda has a national laboratory system which is comprised of national reference laboratories (3 primarily in Butabika, Kampala and Entebbe); 14 National/Regional Referral Hospitals, university laboratories, Health Center IV laboratories, Health Center III laboratories, and some private/Non-Governmental Organization laboratories.

However, there is need to strengthen efforts towards developing and operationalizing supportive policies and practices that reduce global health risks.

While diagnosis of human pathogens has been strengthened by Quality Assurance Programs for example strengthening laboratory management towards quick and reliable results from laboratories, the veterinary laboratories have been ignored in this endeavour.

Attention paid to zoonotic disease threats that are often spread from animals to human beings and vice versa needs to be strengthened. Enforcement of regulations including quarantines needs to be executed.

In order to fully improve Uganda’s preparedness in the face of infectious disease outbreaks, there is need for the government to commit more resources both human and financial, strengthen information and data systems towards building robust public healthcare infrastructure, and capabilities necessary to prepare and respond to the threat of infectious diseases. This is crucial because strengthening preparedness and ability to combat infectious diseases is part of keeping the world safe.

There is also need for collaboration between Uganda Wildlife Authority, Ministry of Agriculture, Animal Industry and Fisheries and Ministry of Health to develop and implement regulations that address infectious diseases since communicable diseases can be spread from human to animals and from animals to humans.

Mr Kafeero is a development worker, poet and social entrepreneur. He is also a co-founder and director of Mukono Energy Saving against Environmental Degradation, a social enterprise that manufactures energy saving cook stoves and a wide range of efficient and energy saving technologies.

kafeeroherbert25 [at] gmail [dot] com

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