Govt intensifies war on HIV/AIDS

By Moses Mulondo and John Odyek

The Government has rolled out a new intervention dubbed Option B+ to further cut down on mother to child HIV transmission by 90% in 2015.

The health minister, Dr. Christine Ondoa, announced the new intervention on Tuesday at the Media Centre during which she sounded a wake-up call to the country to rise up and fight HIV/AIDS. The prevalence rate has risen to 7.3% from 6.4% in 2005.

Flanked by director general of health services Dr. Jane Aceng, Ondoa noted with regret that with an average of 30% mother-to-child HIV/AIDS transmission, about 26,400 Uganda babies got infected with HIV/AIDS in 2011.

The Government started a robust Prevention of Mother-To-Child Transmission (PMTCT) in 2012 using AZT prophylaxis, which is referred to as Option A.

Whereas Option A only provides anti-retroviral therapy only during pregnancy, Option B+ promotes continuous antiretroviral treatment for life for all positive women even after pregnancy.

“This means that of the estimated 264,000 expected infections among exposed babies, less than 2,000 should become infected with HIV.

In 2012, only 16,000 got infected. This means that in one year, the PMTCT programme averted 10,400 HIV infections among children,” Ondoa said.

The minister announced that free PMTCT services will be available in public hospitals and all health centre IVs, most health centre IIIs and 15% of health centre IIs.

Ondoa revealed that Uganda has received about sh6.6b from the US and another sh15.8b from the Swedish International Development Agency (SIDA) to boost the implementation of Option B+ programme to curb mother to child transmission of HIV.

The US government will also avail about sh40b each year for the next five years.

The Ministry of Health and the office of the First Lady will launch Option B+ on Friday at Itojo Hospital in Ntungamo.

The theme for the launch is: “Stand out, participate, be counted, have an HIV free baby.”

Ondoa urged Ugandans to go for HIV testing, all pregnant women to go for antenatal care early, post natal care for breastfeeding mothers and ensuring that all pregnant women deliver in a healthy facility.
Source: http://www.newvision.co.ug/news/640867-govt-intensifies-war-on-hiv-aids.html

Mother, Mulago in dispute over ‘missing’ baby

By SOLOMON ARINAITWE & ANGELLA NALWANGA
When Goretti Kajumba, 33, checked into a maternity suite at Mulago Hospital on December 3, 2012, she was full of optimism and joy, awaiting the birth of her first born.

However, the joy would soon be eroded by agony and frustration as her baby girl mysteriously went missing, minutes after birth.
The hospital insists the baby was born in “distress” and died soon after birth.

Ms Kajumba, on her part, says the baby was doing well and could have been sold by unscrupulous health workers. Her case becomes more baffling when she reveals that she was not shown the body of the baby, despite repeated requests to hospital staff.

“They [doctors] told me that the body was buried by KCCA but when I went to the mortuary, there was no such record. I have been asking doctors about my child but they kept on confusing me until I went to the director and told him that sir, you are a father, where is my baby?” a distressed Kajumba, weeping inconsolably, told journalists yesterday at Mulago hospital.

An Inpatient Discharge Form (IDF) signed by Dr Lubega shows that Ms Kajumba gave birth to a baby girl of 3kgs, with a rating of 9/10, on December 3, 2012 and was discharged on December 7, four days later.

However, Dr Baterena Byarugaba, the executive director Mulago hospital, who has been handling the case, says there “was a mix-up in documentation and that is why the baby was not recorded as dead” on the form.

“She underwent a Caesarian Section and gave birth at around midnight but the baby was taken to the special care unit and the mother to the High Dependence Unit because they both had breathing problems,” Dr Byarugaba explains.

He adds that the baby died in the SCU while the mother recuperated after a dose of intravenous fluids and blood injections.

Dr Byarugaba notes that the mother was admitted without a helper who could have assisted the hospital in indentifying the dead child.

After failing to make headway, the mother reported the case to Inspector General of Police Kale Kayihura, who in turn directed the Commander Kampala Metropolitan police Felix Kaweesi, to take up the matter.

Mr Kaweesi yesterday met the directors of the hospital and the latter agreed to co-operate in the investigations.
Source: http://www.monitor.co.ug/News/National/Mother–Mulago-in-dispute-over–missing–baby/-/688334/1725002/-/t5uw7r/-/index.html

Uganda: The Law – Abortion’s Biggest Hurdle

By Patience Akumu,
When the woman entered Kiggundu’s office and requested an abortion, he felt his hands were tied: abortion is essentially illegal in Uganda. Kiggundu, a law-abiding citizen, told her that while he appreciated her predicament, he could only refer her for proper antenatal care so that she could deliver safely.

Three days later, he was called to the emergency gynaecology ward. And there, on the verge of death, was the same woman. “She was now a sick-looking, dirty young woman,” Kiggudu recalls. “Her intestines were out of her vagina and she was bleeding profusely.” The doctor asked the woman what happened.

“You are asking me what happened?” she answered. “I was here three days ago and you refused to help me; I did what I had to do.”

Kiggundu had to perform an operation to remove her uterus to save her life. She spent four weeks in the hospital recovering. Yet it could have been worse for Kiggundu’s patient. In 2008, the ministry of Health estimated that abortion-related causes accounted for 26% of all maternal mortalities in Uganda.

Uganda’s maternal mortality rate from abortion is 8% higher than that of East Africa which stands at 18%. The restrictive legal and ethical regime means that many women continue to die as a result of unsafe abortions both in and outside the hospital setting. The Constitution forbids abortion except as authorised by law, while the penal code criminalises abortion except where it is necessary to save the mother’s life.

Prof Ben Twinomugisha, a health law expert and lecturer at Makerere University, says that at the end of the day it is not really about statistics and legal provisions but, rather, about the woman who should be placed at the centre of the abortion debate.

“There is law and there is ethics. But what does the woman say?” he argues. “Whenever Kiggundu thinks of the woman without a uterus, he has regrets.”

According to Twinomugisha, the law is only restrictive and not prohibitive, and in fact he recognises that there can be lawful abortions. He points out that health workers are not utilising the law to provide abortions to women for whom having babies would mean adverse effects on their psychological and physical health. The 2006 National Policy Guidelines and Service Standards for Sexual and Reproductive Health and Rights provide for circumstances where a woman should be able to terminate her pregnancy.
Resource: http://allafrica.com/stories/201303110138.html

Experts want pact extended

By JOSEPH OLANYO

Trade experts, legislators and civil society organisations have called for an indefinite extension of the World Trade Organisation (WTO) Trade Related Aspects of Intellectual Property Rights (TRIPS) agreement until poor countries like Uganda develop.

The TRIPS agreement requires East African countries and all other WTO member countries to protect and enforce all kinds of Intellectual Property (IP) – a legal concept that refers to creations of the mind for which exclusive rights like copyrights, trademarks and patents are reserved. The extension period is critical for EAC owing to the state of the affected sectors such as health and agriculture. But even then, the partner states have not developed positions yet on approaching the important process.

On the basis of their economic and financial constraints, the extension was given on the assumption that by 2013, Least Developed Countries (LDCs) like Uganda would have developed their technical capacities and industrial base. The extension period granted to LDCs expires in July 2013. But LDCs contend that they need extra time to build their capacities to produce drugs, ensure food security and review and modify their laws to ensure they provide for public welfare through flexibilities.

At a recent meeting organized by the Open Society Institute in conjunction with SEATINI Uganda, participants called for the period to be extended.

“It is absurd that we were not able to create capacity at the time we were given. However, we have no choice but to get the extension unless they want to suffocate us,” said Bernard Mulengani, a Member of the East African Legislative Assembly (EALA).

“Capacity may be available but funding is a challenge. So, we need a very informed technical team that can negotiate. Otherwise, without an extension, the population will suffer,” he added.

Private Sector and CSO officials from East Africa note that if the transition period is not extended, LDCs face the specter of failure to avail affordable goods like scholastic materials, seeds and medicines to impoverished citizens. SEATINI Country Director Jane Nalunga said it was important that “we as actors in this process speak the same language on critical processes that affect our development”

Elizabeth Tamale, the Assistant Commissioner External Trade, ministry of Trade, Industry and Cooperatives, said there was need for a national framework that brings different agencies together and harmonises positions on trade discussions.

“We need to think of what provisions are there in the law, study them and develop a framework as we seek for the extension. It should avoid compromising issues either for developing countries or LDCs,” she said.

Source: http://www.observer.ug/index.php?option=com_content&view=article&id=24021:experts-want-pact-extended&catid=38:business&Itemid=68

Contraceptives can reduce the number of unsafe abortions

By Henry Zakumumpa

More than half of all pregnancies in Uganda are unintended and nearly a third of them end in abortion, according to survey results unveiled by Dr Charles Kiggundu, a consultant gynaecologist at Mulago hospital.

“Probably half of all of you seated in front of me today were not intended by your parents,’’ Dr Kiggundu told a fully- packed Palm conference room at Kabira Country Club in the outskirts of Kampala.

The study results released by the US-based, Guttmacher Institute and the Centre of Health, Human Rights and Development, also reveal that Ugandan women on average wished they had at least two children less, a phenomenon also called excess fertility.

On average, each woman in Uganda gives birth to 6.7 children which is high even by Sub-Saharan African standards. The study results are based on analysis of Uganda’s 2011 Demographic and Health Survey.

At the centre of the millions of unintended pregnancies in Uganda, is non-use of contraception.

Only an estimated 25 per cent of women in Uganda have access to modern contraception methods pointing to a staggering lack of access to modern and safe contraception.

One in three married women in Uganda had an unmet need for contraception according to the survey results.

“It is also a question of having less options of contraception,’’ added Dr Frederick Mugisha, a health economist, who maintained that Ugandan women do not have many choices when it comes to contraception.

Clearly, investments targeted at increasing access to family planning and contraception for women of reproductive age in Uganda would save the country phenomenal sums of monies spent on treating post abortion complications and having fewer mouths to feed, educate and would be kinder to the environment. If all Ugandan women had met their wish of having two children less than they currently have, the population of Uganda would have been undoubtedly impacted by gains in per capita income and a better quality of life achieved for millions of Ugandans.

It emerged at the meeting that myths and misconceptions about modern contraception methods causing cancer and fibroids is widespread and is a barrier to contraception utilisation by Ugandan women.

The traditional medicinemen have hijacked contraception education. There are several programmes on local radio and television stations that are misinforming many women on safe contraception in preference for crude and riskier methods.

Dr Zainab Akol of the Ministry of Health regretted that the medical profession in Uganda has ceded the ground for offering scientific and evidence-based contraception information to misinformed “medicine men” on whose inaccurate advice many rural and uneducated women depend for decisions on birth control and family planning.

Unsafe abortion and contraception is a human rights, public health, legal and moral issue in Uganda that must be addressed,’’ emphasised Moses Mulumba, head of the Centre for Health, Human Rights and Development, who revealed that 26 per cent of all maternal deaths are attributed to unsafe abortion.

Prof Ben Twinomugisha, dean of the School of Law at Makerere University, emphasised that human beings have a right to enjoy sex and then when debating issues surrounding abortion, “the woman should be at the centre” of the debate.

Studies done by the Guttmacher institute show that there is a co-relation between restrictive laws on birth control and increased abortion. Countries, especially in Europe, which have a liberal stance on birth control have fewer deaths from unsafe abortions and spend less on post abortion complications.

Source: http://www.monitor.co.ug/artsculture/Reviews/Contraceptives-can-reduce-the-number-of-unsafe-abortions/-/691232/1712464/-/13kqg7lz/-/index.html