Vaccine Equity Affirms Human Rights And Should Ideally Be Accessible And Affordable For All

By Esther KamedeCenter for Health, Human Rights and Development

World health day | 7 April 2021

“The COVID-19 pandemic has been a stark and painful reminder that nobody is safe until everyone is safe”.

The Pandemic Century!

On March 11, 2020 the World Health Organization declared the novel coronavirus (COVID-19) outbreak a global pandemic. Just weeks later, we went from sharing memes and jokes about the virus to actually experiencing a life-altering year that globally turned our lives upside down. On 1st April, announcements came in of a 14day nationwide lockdown. We now went to staying and working from home, pulling our children out of school, getting scared of dying, business loss and very steep falls in income.

More than a year later, the virus continues to plague the world with new deadly variants in sight, novel viruses should never be taken lightly; this one is highly infectious yet often causes no symptoms for some time. It also deepened vulnerabilities and inequalities including cracks in our health systems especially the unpreparedness and response in dealing with a pandemic. At this point the sign of hope are vaccines!-the key to overcoming the pandemic. Vaccines stimulate our immune system to produce immunity to a specific disease, protecting and preventing us from disease. This is what makes vaccines and immunization such powerful medicine and such an essential public good for all. Governments are responsible for managing public health crisis in line with human rights and fundamental freedoms. When it comes to vaccination, this involves ensuring that everyone, without discrimination, is offered a fair opportunity to receive a safe and effective vaccine.

Uganda receives its Vaccines!

On 5th March, 2021 Uganda received 864,000 doses of the AstraZeneca COVID-19 vaccine, from the global COVAX facility-that aims to ensure even low income countries have access to the vaccines. On 10th March launched its mass COVID-19 vaccination program, joining a host of countries in Africa to initiate the inoculation. Each phase is planned to cover 20 per cent of the population – approximately 4.38 million people, 20% is not enough, 60% would suffice this means low income countries may not realize equitable access to Vaccines. A number of determinants come into play for example the cost of the vaccines, buying vaccines for 90% of Uganda’s population would plunge the economy into borrowing and further debt .The Auditor General warned that by 2022, the country’s debt would be unsustainable. This cost would also deplete the 32.8%bn budget allocated to the health sector for the entire fiscal year, also the surplus doses from high income economies could be enough to inoculate 90% of the population.

The world has two economies!

We have two economies, the wealthy economies-high income and the poor economies-low income, this partially explains the inequities in vaccine distribution. The low income countries cannot afford vaccine equity. For example Aljazeera reported rich countries have bought more than half of the world coronavirus vaccines and are estimated to have received 90% of the delivered vaccines in sharp contrast, 9 out of ten people in poor nations may not get vaccinated. Africa has secured a meagre 300m doses of the vaccine for its population of 1.3bn people!

This World Health Day, the pandemic is still with us and its devastating impact. We hold the hope that as we fight to overcome the COVID-19 pandemic together, we are better prepared for future generations and learn from the incredible human ability to drive change and innovation even in a pandemic. We take home that ensuring universal and equitable access to safe, efficacious and affordable vaccines and medicine is building a fairer and healthier world together.

Mulago Hospital Held Accountable For The Loss And Disappearance Of Babies

FOR IMMEDIATE RELEASE

Tuesday 22nd March 2021

Kampala – Uganda. Center for Health, Human Rights and Development (CEHURD) will today file a report at the High Court [Civil Division], regarding Mulago National Referral Hospital’s progress on improving safety in handling babies delivered at the facility.

The report documents the steps Mulago hospital has taken, which include;

  • Installation of security cameras in maternity wards to monitor the movement of babies
  • Placing security guards at the entrance of the Hospital to register people entering and exiting the hospital
  • Tagging newborn babies to their mothers for easy identification.
  • Establishing a compassion ward where mothers who have lost the babies receive counselling services

Background

On 24th January 2017, the Honourable Lady Justice Lydia Mugambe Ssali delivered a landmark judgment in High Court [Civil Division] Civil Suit No. 212 of 2013. In the suit,CEHURD, Micheal Mubangizi and Jennifer Musimenta sued the Executive Director of the Mulago National Referral Hospital and Attorney General, challenging the systemic gaps in the health care system, which resulted into the loss/ disappearance of Micheal Mubangiz and Jennifer Musimenta’s baby.

On 14th March 2012, Jennifer Musiimenta went to Mulago hospital with labour pains and delivered a set of twins on the same day. One of the babies mysteriously disappeared. The Hospital informed her and her husband that the second baby was born dead but could not produce the dead body. Eventually, on 17th March 2012, the Hospital gave the couple a dead body. The couple, however, rejected the body because it was of a baby who had just died.

Later, DNA examination confirmed that the body did not belong to their baby. The couple were aggrieved that their baby had disappeared in the hospital and they were denied information relating to their baby. The couple and CEHURD took Mulago hospital to Court for the unlawful disappearance of their baby, demanding that the hospital surrender their baby, dead or alive. In addition, they sought several declarations and orders from court.

The Court found that the failure of Mulago hospital to account for Micheal and Jennifer’s baby subjected them to psychological torture. Additionally, this was a violation of their right to be free from cruel, inhumane and degrading treatment, and the right to health. These rights are recognised under Objectives XX, XIV (b) and Articles 24, 44 and 45 of the 1995 Constitution of the Republic of Uganda and international human rights instruments.

Filing the report

In addition to these findings, the Court ordered that Mulago hospital award Michael and Jennifer compensatory damages, and CEHURD should file a report to the Court on the implementation of the Judgment. This is the report that CEHURD is filing today.

We applaud the hospital for complying with the orders of the Court after a series of engagements. We also call upon all healthcare facilities in Uganda to put in place reliable and credible systems that ensure the proper handling and movement of babies from the point a pregnant woman is admitted up to the point she is discharged from the health care facility.

We also call upon anyone who has suffered a maternal health rights violation to reach CEHURD on our toll free line 0800 300044 to pursue justice.

For more information contact: info@cehurd.org and copy in nsereko@cehurd.org or call our toll free line 0800 300044.

Reduce maternal mortality and morbidity; Adopt best practices in safe motherhood during and post COVD-19

Finalise and pass the National Health Insurance Scheme Bill into law that recognises the unique maternal functions of women by ensuring their ability to access affordable quality maternal health care services from both public and private health facilities.

Esther Dhafa, Programme Officer – Campaigns, Partnerships and Networks Programme, CEHURD

 

Every year, Uganda commemorates the Safe Motherhood day 17th October.The Center for Health Human Rights and Development (CEHURD) joined the country to commemorate this day by calling upon the Government of Uganda to actualise the declarations in the landmark case, Constitutional petition No. 16/2011. This can happen through enhancing and promoting best practices of safe motherhood during and post COVID-19 TO reduce maternal mortality and morbidity. By doing this, we can realise the “Every Woman Every Child” Global Health Strategy Commitments (EWEC) His Excellency the President of the Republic of Uganda made on 15th May 2016 . 

Uganda’s EWEC commitments include among others; ensuring that comprehensive Emergency Obstetric and Newborn Care (EmONC) services in hospitals increase from 70 per cent to 100 per cent and in health centers from 17 per cent to 50 per cent. It also includes ensuring that basic EmONC services are available in all health centers; ensuring that skilled providers are available in hard to reach/hard to serve areas; and reducing the unmet need for family planning from 40% to 20%; increasing focused Antenatal Care 4th visit from 42 per cent to 75 per cent, with special emphasis on prevention of mother-to-child transmission (PMTCT) and treatment of HIV to ensure elimination.

Small steps towards safe motherhood

We do commend the government for the great efforts in reducing the high rates of maternal mortality from 438/100,000 live births in 2011 to an estimated 336/100,000 live births in 2016 (per the Uganda Demographic Health Survey 2016). However, we also note the little progress being made as a country in addressing health related issues that continue to kill women in Uganda  helplessly during childbirth.  As a best practice therefore, maternal health care services should be available, accessible, acceptable and of good quality in order to enhance safe motherhood. 

Over the years and for this specific year,  CEHURD continues to work tirelessly to ensure that women and girls are able to access affordable maternal health care services. This has been done  through a number of approaches including strategic litigation, research, evidence based advocacy and  collective voicing to amplify the need for better health care and service packages countrywide. With these approaches, coupled with government efforts and adoption of best safe motherhood practices, Uganda will be able to reduce  maternal deaths caused due to preventable health causes. These causes include haemorrhage (blood loss), unsafe abortion, hypertension, embolism, sepsis, and other direct causes like complications of anaesthesia and  caesarian sections, and postnatal depression suicide.

As we continue to commemorate Safe Motherhood, CEHURD remembers all the mothers that have died while giving birth. Unfortunately, an estimate of 6,000 women die annually in Uganda as a result of pregnancy related complications making it about 16 women dying per day (UDHS 2016). This means that today 16 women have died, tomorrow 16 will die and 16 more will die the following day which is very unacceptable. With such scary statistics therefore, Government’s obligation to promote safe motherhood becomes important, to ensure that no woman, or baby dies or is harmed by pregnancy or childbirth. This begins with the assurance of basic safety living for all expectant  girls or women in our society. 

Landmark judgment for maternal health

The Justices of the Supreme Court of Uganda in CEHURD, Prof Ben Twinomugisha, Rhoda Kukiriza, and Inziku Valente Vs Attorney General (Constitution Petition/\ 16/2011) finally made a nine-year long journey of collective voicing and persistence worthwhile. The justices set a precedent on maternal health care in Uganda to the joy of various civil society organisations under the Coalition to Stop Maternal Mortality in Uganda (CSMMU), development partners, grassroot women and well-wishers who were have been pushing for better maternal health care. Court declared among others that the Government’s omission to adequately provide basic maternal health care services and emergency obstetric care in public health facilities violates the rights to health, life, rights of women, subjects women to inhuman and degrading treatment. The Court also stated that this is inconsistent with and in contravention of Articles 8A, 22, 33, 39 and 45 read together with objectives XIV and XX of the National Objectives and Directive Principles of state policy of the Constitution. 

Rhoda Kukiriza and CEHURD staff celebrate the positive judgment on Petition 16. CEHURD PHOTO/Jacqueline Twemanye

This suit was filed in 2011 seeking to challenge the Government’s omission to adequately provide basic maternal health services and commodities in public health facilities as contravening the right to health, rights of women, and right to life and freedom from cruel, inhuman and degrading treatment. It’s premised on the wrongful deaths of the late Anguko Jennifer who died on 10th December 2010 in Arua Referral Hospital and the late Sylvia Nalubowa who died on 19th August 2010 in Mityana District hospital. Both women died during childbirth when they needed caesarian sections but failed to access the commodities and human resources required to obtain the same.

Call to action

We thus call upon the Government of Uganda to fulfill its statutory obligation by;

  • Providing basic maternal health care services to  women in Uganda which include among others prenatal care services, skilled medical officers in health facilities, and provision of Emergency Obstetric Care and postpartum care. 
  • Investing in family planning, antenatal care, safe delivery, newborn care & Post-natal care, and Emergency obstetric care which are the key pillars of Safe Motherhood. 
  • Prioritizing basic maternity care, primary health care and equity for all women to enable them fully enjoy and fulfil their natural maternal functions which is a fundamental human right (Art 33 of the Constitution).
  • Finalise and pass the National Health Insurance Scheme Bill into law that recognises the unique maternal functions of women by ensuring their ability to access affordable quality maternal health care services from both public and private health facilities.

Lastly, informed and effective advocacy is the starting point for bringing about change. We thus call upon all stakeholders to join us in sensitizing the women including the youth and adolescents about safe motherhood and their right to receive and impart accurate sexual reproductive health information and empower them to make informed decisions to be able to keep and stay healthy since a healthy population is able to efficiently contribute to sustainable development. Safe motherhood values the girl child and implies the availability, acceptability, and easy access to health care for women’s prenatal, birth, postpartum, family planning and gynecological needs. 

Let us adopt a multisectoral approach to SRHR and Safe motherhood, for better health and healthy lives.

EVERY WOMAN DESERVES TO BE AND FEEL SAFE AS A MOTHER OR MOTHER TO BE.