Africa-Press – Uganda. With Covid-19 deaths and infections soaring and a new lockdown in place, the person in the eye of the storm is the re-appointed Health minister, Dr Jane Ruth Aceng, Uganda’s lead on the pandemic fight. Featuring on NTV-Uganda’s On-the-Spot show last Thursday, host Mr Patrick Kamara asked whether Uganda is losing Covid-19 fight. Daily Monitor’s Zadock Amanyisa brings you an abridged version of the interview.
Are we losing the fight against the virus?
That is a difficult question to answer at this point in time, but allow me to encourage Ugandans [that] Uganda has the capacity to handle any [epidemic] outbreak. This capacity has been built over the years with the several outbreaks that we have had.
This particular pandemic is a social-behavioural issue. It requires that me and you are responsible citizens and are determined to protect one another. Therefore, it calls for the citizens of this country to work together with the teams that are handling the pandemic. We are not losing the battle. We just need the population to come on board and work with us and do whatever they are advised to do.
For the people who are in the hospitals that are highly overwhelmed, for people now who have just lost their loved ones, for those who are in Intensive Care Unit and High Dependency Units, you tell them that we are not losing the battle!
If I may take you a little back, there are many countries which have gone even beyond the stage where we are. I don’t think you want to say they lost the battle. There are stages where you reach a peak and you come down, but like I said, winning this battle depends on the individuals, the population of this country. In my [previous] addresses, I repeatedly said the power to win this battle is in the hands of the population and I want to repeat it again; it is in your hands, it is in your power.
… what is Uganda’s pandemic status?
Our positivity rate could be about 17-18 per cent, which is extremely high, meaning the infection is widespread and from the tests that we do, very high per cent [of the people] are positive. Not all positive cases are severe or critical; some of them are mild, some are asymptomatic and some critical. The mild cases are handled at home. How do you handle home-based care to ensure the sick person does not infect others at home?That is a very difficult thing to do because we live where there is crowding and the majority of the people have not understood it. Home-based care means when you test positive, you ought to go home and be in isolation. The isolation is practical if you have your own room and your own sanitary facilities. However, in a situation where that is not available, maintain your social distance and keep your mask on. And keep sanitiser and soap all around you.
This is a war. Dr Aceng, you are the general in the fight. How did we lose our guard?
Mr Kamara, there is a (video) clip of His Excellency the President in [which he tells] people that ‘we have told you all that we have to tell you, we have educated you on how to protect yourselves and you still refuse to listen, you are going to see deaths rising here and when you see deaths, don’t say we didn’t tell you’. In the first wave, lockdown was good. It prolonged the time for us to get into such a state and the population was with us [and observed all the standard operating procedures].
Unfortunately, after the elections, people forgot that there was Covid in Uganda [and SOPs became a thing] of the past. Second, the new variants. We have five variants in the country and these variants are highly transmissible, very aggressive and cause high mortality.
Lockdown was successful in 2020, but some people noticed political motive…
There was absolutely no political motive; it was about lives of the people.
But now people are dying, the pandemic is more aggressive and yet you have not protected the lives like you did in the past.We learnt a lot of lessons from the lockdown, many countries at that time were instituting lockdowns to try and control the pandemic, it wasn’t only Uganda. First of all, we had challenges of managing the other disease conditions, we lost people, we lost pregnant mothers, children, cancer patients who could not access facilities like radiotherapy.
We had to feed people. You saw the challenges we had with distributing food, it was not easy. Why we need this lockdown more than ever, there is need to plan properly and put in place measures to ensure that other disease conditions are well attended to. In the first wave, we lost 334 people [to Covid], but we lost more people to other disease [and] conditions than to Covid because of the lockdown.
HIV patients could not access their medicines and it was a challenge managing cases of malaria. So right now, we are looking at all those options and by the way, Covid has affected the economy of many countries. It is a challenge to collect revenue, the resources are not there, and every country is literally struggling.
So, you cannot tell the head of state to get up and lock, when he locks, what do we hope to achieve? There must be systems in place that will ensure continuity of the other essential services and people will be able to access services. [The next day, President Museveni imposed a total lockdown – Editor]. There is the issue of exorbitant hospital bills [for Covid patients], upwards of Shs47 million…I condemn that act (high billing), and clearly, it’s happening in the private sector, not in the public sector. It’s very unfortunate that some people are taking advantage of the vulnerable to make money during this time of Covid. This is not a time to make money, this is a time to save lives.
But the public hospitals are overwhelmed, people are desperate…
Mulago has 900 beds, which is adequate. The challenge I already told you; people come when they are already critical and they are all scrambling for Intensive Care Units…If you come when you are not critical, we can admit you and attend to you. It is not Mulago’s duty to only attend to critical cases, so that is the challenge. We opened up [treatment] to the private sector, and they are charging Shs5m per day, some families have paid up to Shs200m and they have lost their loved ones! It is completely unacceptable and I think the private sector needs to apologise to the people.
PCR tests cost Shs180,000 upwards…do you really care about Ugandans with limited means?
Yes, we do. At this point in time we have over 25 laboratories all over the country that can carry out the PCR test. But what is important for the population to know is that the PCR test kits are not cheap, they are expensive and that is why the private sector charges all what it does although at times it is exorbitant.
Is there a plan for mass testing Ugandans?
That would be the ideal. However, the PCR test kits are also not readily available even if you had the money to buy.We have vaccinated close to a million people, but now we don’t have (enough) vaccines. Today, Uganda received 175,000 more doses of Oxford-AstraZeneca jabs.
Who is going to be priority in the second round of vaccination?
We are not creating a new priority group because we did not cover all the health workers. Of the 150,000 health workers, we only vaccinated about 69,000. We need to vaccinate more health workers than ever before because sick people go to them and you cannot know what a sick person is suffering from. We need to get our teachers vaccinated because we need our children back in school…
There was money given to the ministry to buy vaccines and also through the Covax facility, we were also supposed to be getting vaccines. So, if you have the money, what are the issues?
The production of vaccines has been low to meet the global demand, it is too low and there is a lot of scramble for vaccines all over the world. Because of low production, many of the rich countries buy off the vaccines before the poor countries can get them. Our government gave us money. First, we had $5 million to buy vaccines.
Just before we could pay for the vaccines, India had a crisis and India said ‘no, we’re not giving vaccines anymore.’ The government gave us more Shs23 billion to add to the money for buying vaccines. We tried many of the manufacturers, but they were saying we have huge orders and we are not able to give vaccines. So, we made a decision to pay for the vaccines and told them, we are joining the queue. We have paid for the vaccines.
We have had reports of stock outs of PPEs … What is the ministry doing to get health workers the protection they need in this fight?
We have to thank His Excellency the President who saw the need to have the PPEs manufactured in the country … However, they are not cheap, they are expensive and you know very well that the more critical cases you have, the more PPEs you will need.
Those PPEs are not easy to wear, when people wear them they can’t stay for long they need to come out and discard so you can imagine the volume of PPEs that is used at Mulago National Referral Hospital on a daily basis and then translate that to the entire country. The cost is in billions of Shillings.
