By Esther Kamede –Center 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 1^st 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 5^th 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 10^th 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.

FOR IMMEDIATE RELEASE

Tuesday 22^nd 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 24^th 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 14^th 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 17^th 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.

PRESS STATEMENT

FOR IMMEDIATE RELEASE:

Friday 26th March 2021

Kampala, Uganda. Center for Health, Human Rights and Development (CEHURD) recognises the government’s efforts to ensure that pregnant girls sit for final examinations. However, we assert that this is not enough, especially in light of recently revised guidelines for the prevention and management of teenage pregnancy in school settings in Uganda.

In 2020 the Ministry of Education and Sports issued these guidelines, which stated that girls must undergo mandatory periodic pregnancy tests. The guidelines add that if found pregnant, the girl is forced to go on maternity leave when she is at least three months pregnant. The guidelines allow pregnant girls to sit for final examinations. However, on 16^th March, 2021, Uganda National Examinations Board (UNEB) through their official Twitter handle noted that pregnant girls will be allowed to sit for the exams but warned that “the leeway may not continue after Covid era”. It went on to warn that UNEB does not condone teenage pregnancy and as such, learners should concentrate on studies before they think of babies. We find the warning by UNEB that the “leeway may not continue after covid” contrary to the guidelines issued by the Ministry.

On the revised guidelines, we are concerned about the provision requiring mandatory maternity leave in case of pregnancy. Allowing girls to sit exams while denying them an opportunity to attend class effectively amounts to violation of the right to education.

Teenage pregnancies indeed have grave consequences on the girl’s life and their future including the fact that she is more likely to die during pregnancy or childbirth.  With an estimated 34% of school girls dropping out of school, Uganda will be raising a generation where women are locked out of education because of teenage pregnancy. We will be raising a generation where women significantly suffer long term effects such as limited skills essential for productivity and employability.

Call to Action

We ask that instead of taking action that punishes young girls, the government must take proactive measures that reduce teenage pregnancy while enabling pregnant teenagers to stay in school, prepare for and sit for their exams. We specifically ask that;

• Parliament uses its mandate to summon the Hon Minister of Education and Sports to update parliament on the progress of the National School Health Policy as it would address such issues.
• The government prioritizes management of school health programmes in times of health pandemics,
• The government promotes access to youth sexual and reproductive health and rights.
• That parliament in the exercise of its oversight mandate follows up on the implementation of the parliamentary resolutions to end teenage pregnancies of
• The relevant government line ministries give a status on the   implementation of the parliamentary resolution of 2011 urging the government to institute measures to address maternal mortality and other matters considering that teenage pregnancies are one of the big contributors to maternal deaths.
• That the Ministry of Gender, Labour and Social Development fast tracks the effective implementation of the National Strategy on Ending Child Marriage and Teenage Pregnancies in Uganda of 2015.

About CEHURD

Center for Health Human Rights and Development (CEHURD) is a non-profit, research and advocacy organisation pioneering the justifiability of the right to health in Uganda.  Founded in 2010, CEHURD has moved from the margins to the center stage of advancing social justice and health rights in health systems including the rights of health workers in Uganda, East African Region, Pan-African and Globally.

For more information contact: info@cehurd.org or call out toll free line 0800 300044.

CEHURD today shines the light on Tuberculosis (TB) as we commemorate the World Tuberculosis day under the theme “The clock is ticking”. This is a call to action towards commitments made by government to end TB especially in the face of the ongoing COVID 19 pandemic which puts these efforts at a risk. The World TB day is commemorated to raise public awareness about the devastating health, social and economic consequences of TB and to call on government to step up efforts to end the global TB epidemic. According to the World Health Organization (WHO), TB remains one of the deadliest infectious killer diseases and each day nearly 4,000 people lose their lives to TB and close to 28,000 people fall ill with this preventable and curable disease. A total of 1,400,000 people in the world died of TB in 2019 alone.

These glaring statistic do not get any better at home as Uganda is one of the 30 WHO designated countries with a high burden of TB and HIV. In 2019 the estimated incidence was 200 per 100,000 people with a mortality rate of 35 people per 100,000.  It is indeed worrying that the cases of TB have even gone up given the little attention to the disease. According to WHO reports, in 2019 Uganda had 65,897 cases of TB notified which is an increase from 57,756 cases notified in 2018.  There have also been reports of high drug resistance which poses a real challenge to the efforts towards controlling the infection. 87% drug resistance was reported in 2019 alone and this calls for more efforts towards research and investment for new medicines. There is however a lurking risk of patents on new medicines which may make these medicines expensive and thereby becoming a barrier to access for many TB patients.

It should be noted that most TB patients in Africa suffer catastrophic treatment costs making access to quality TB treatment impossible despite the disease being curable. In Uganda it is reported that 53% of TB patients suffer catastrophic costs of treatment as indicated in the WHO factsheets on the TB situation in Uganda. Although government has made some efforts toward the control and management of TB through commitments made under the National Tuberculosis and Leprosy Control Program 2016-2020 which aligns with the WHO End TB strategy, more is needed to ensure equitable access to quality treatment for TB patients.

It is disheartening to see that Uganda’s TB financing indicates very little of Government’s political will to end TB as committed under the Control Program and WHO End TB strategy. In 2019 the national budget for TB control and management was USD 37,000, 0000 of which government only contributed 5% while 56% of the financing was by international partners and 39% of the budget was unfunded. The second health sector development plan 2015/2016-2019/2020 is designed to support  government’s commitment to achieving Sustainable Development Goals which among others seeks to “Achieve universal health coverage including financial risk protection, access to quality essential health care services and access to safe , effective quality and affordable essential medicine and vaccination for all by 2030”.

This is to therefore call upon government on this world TB day to fulfil its commitment towards the END TB strategy by;

1. Increasing domestic funding towards TB management and control to ensure equitable access to TB quality treatment
2. Investing in research and development for new and effective medicines to find lasting solutions to drug resistance
3. To utilize the flexibilities in the Trade Related Aspects of Intellectual Property Rights to ensure that Intellectual Property Rights do not pose barriers to accessing the new and more effective medicines