Health
WORLD HEPATITIS DAY: What MoH Is Doing To Stop Spread of the Viral Disease
Today, all roads lead to Kazo District playgrounds where the Ministry of Health will be commemorating World Hepatitis Day.
Officials led by the ministry’s Permanent Secretary, Dr Diana Atwine, (chief guest) will gather at the the function that seeks to raise awareness about the viral disease under the theme; “One life, one liver – Protect both.”
The day gives an gives us an opportunity to join all stakeholders such as the World Health Organization and the World Hepatitis Alliance to raise awareness on the public health importance of this silent killer and to call on Member States to invest more in the fight against Hepatitis.
To mark this day, the ministry lined up a series of activities to including Twitters spaces, sports activities and a community dialogue all aimed at raising awareness about the viral disease.
According to the UPHIA 2016 report, the prevalence of Hepatitis B among adults aged 15-64 years stands at 4.1%. However, the prevalence among men is higher at 5.4% and women at 3.0%.
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Emmanuel Lutamaguzi, 28, unexpectedly discovered he was infected with hepatitis B during a routine medical examination for a job opportunity abroad. His wife and baby boy both tested negative and received a vaccine to prevent them from getting the disease.
Emmanuel had no symptoms but recognized hepatitis B is the leading cause of death from liver diseases and cancer in Uganda. Driven by his personal experience, he recognized the need to raise awareness and help eliminate the disease, and he founded the Hepatitis Aid Organization in Uganda.
“We can triumph over even the most formidable health challenges,” says Emmanuel.
A 2014 World Health Assembly resolution called for governments and populations to take action to prevent, diagnose and treat viral hepatitis. Globally, more than 80% of people living with viral hepatitis B and C do not know they have it, and 3 000 people die of the disease every day. WHO’s global hepatitis strategy, endorsed by all WHO Member States, aims to reduce new hepatitis infections by 90% and deaths by 65% between 2016 and 2030.
The problem of hepatitis B in Uganda
Hepatitis B is a major cause of ill health and death, leading to complications including liver cirrhosis and cancer. In 2022, an estimated 1 250 Ugandans died of the disease, and around 6% of Uganda’s population remains chronically infected. The Ministry of Health of Uganda, with technical support from WHO, subsequently developed a strategy to control hepatitis B, including public awareness raising, testing, and treatment nationwide.
Hepatitis services are free of charge
With investments of around 3 million US dollars a year, and working in partnership with national stakeholders, Uganda embarked on a massive, free hepatitis B screening programme in 2015, along with widespread community mobilization and awareness-raising actions.
“The Ministry of Health took strategic and powerful action to address viral hepatitis infection in Uganda. The government will continue its efforts to provide free testing and treatment for all affected by hepatitis infection. Viral hepatitis can no longer be ignored. I, therefore, urge all Ugandans to come forward, test and know their hepatitis status. Mothers and caregivers should also endeavour to have their babies receive the hepatitis B birth dose and complete their pentavalent vaccine schedule,” said Dr Rachel Beyagira, Technical Officer on Hepatitis at the Ministry of Health Uganda.
With over 4 million people screened to date, the programme is having an impact. More than 30% of people infected with hepatitis B are aware of their status and can access comprehensive treatment services, including free medication. Around 90% of all infants receive childhood vaccinations. This success made Uganda the first country in Africa to reach and surpass WHO’s 2020 programme targets of diagnosing 30% of people living with hepatitis B, ensuring awareness of and access to care.
“You can live a full, dignified life with hepatitis B, but the most important thing is prevention, especially vaccination in new-borns. For adults, testing, linking to care, education and treatment as needed are crucial; and lifelong therapy is often needed. The hepatitis community eagerly await the new WHO hepatitis B guideline that will provide guidance to simplify service delivery and ensure that more people are on treatment,” says Kenneth Kabagambe, founder of Uganda’s National Organization for People Living with Hepatitis B, a key partner in Uganda’s effort to combat viral hepatitis.
Alongside support to the government to develop national strategic plans for hepatitis, WHO together with civil society, strongly advocated for earmarked funding for hepatitis activities, and the government responded with dedicated funding for the past 5 years. WHO also conducted a rapid evaluation of the entire hepatitis programme in Uganda and provided tailored guidance based on local contexts. It also undertakes periodic reviews and updates to national hepatitis management guidelines and develops training tools to strengthen the capacity of health workers.
“WHO is proud to support the Government of Uganda, and other national partners, in their efforts to tackle and eliminate viral hepatitis. We commend Uganda for providing free access to hepatitis testing and treatment. It is the only way to ensure health for all and it also requires strengthening adherence to care to reduce mortality,” said Dr Yonas Tegegn Woldemariam, WHO Representative to Uganda.
The recent flag-off of 116 ambulance vehicles by the Ministry of Health signifies not just an augmentation of emergency medical resources but a remarkable shift in Uganda’s healthcare landscape. This initiative, led by Dr. Diana Atwine, the Permanent Secretary, highlights a concerted effort to transform the country’s emergency response system, evolving from basic transport vans to equipped, life-saving ambulances.
Dr. Atwine’s announcement regarding the transition is significant. By 2016, Uganda possessed 173 Type A Road Ambulance Vehicles, serving merely as patient transport vans with minimal emergency care capabilities. However, the country has now surged ahead, boasting 187 Type B Road Ambulance Vehicles equipped with Basic Life Support tools, 4 Type C Road Ambulance Vehicles with Advanced Life Support equipment, 11 Type B Boat Ambulances, and 3 Type C Boat Ambulances. This stark evolution underlines the government’s commitment to phasing out outdated ambulance models and replacing them with advanced, fully-equipped vehicles.
The shift is a testament to Uganda’s dedication to enhancing emergency medical services. The shift from basic vehicles without standard equipment to advanced ambulances equipped with life-saving tools signifies a conscious effort to prioritize the well-being of citizens during emergencies. It’s a leap from mere transportation to providing critical care on the move.
Dr. Atwine’s vision, aiming for a fully operational National Ambulance Service by FY 2025/26, reflects the government’s forward-looking approach. The significance of this milestone extends beyond the numbers; it represents a comprehensive strategy to address emergency medical needs, aligning with global standards of care and response.
The inclusion of boats as ambulance vehicles also underscores a holistic approach to addressing emergencies, particularly in regions accessible only by waterways. This diversification of resources demonstrates a nuanced understanding of Uganda’s geographic diversity and a commitment to ensuring emergency care reaches even the most remote areas.
As Uganda moves towards this new era in emergency medical services, the focus remains on efficient utilization and adherence to stringent guidelines for ambulance usage. Dr. Atwine’s emphasis on proper management and utilization, including trained personnel and approved protocols for ambulance dispatch, signifies a holistic approach to maximizing the impact of these life-saving resources.
The shift from basic transport to advanced care within the ambulance fleet is not just a numerical upgrade; it’s a paradigm shift towards ensuring that every Ugandan, regardless of location or circumstance, has access to critical and timely medical care during emergencies.
Uganda is making strides in the sector as it seeks to provide quality services to the citizenry. As part of efforts to achieve this, the government through the Ministry of Health has established three state-of-the-art Specialized Reference Laboratories under National Health Laboratory and Diagnostic Services (NHLDS).
They are; The Central Public Health Laboratories (CPHL), the National Tuberculosis Reference Laboratory (NTRL) and National Microbiology Reference Laboratory (NMRL), all of which are accredited to International Standards, meaning that their results are trusted anywhere in the world.
These reference Laboratories are supplemented by the Lab capacities in research institutes such as the Uganda Virus Research Institute (UVRI) Laboratory, Joint Clinical Research Centre (JCRC) and universities (Makerere, Mbarara, Gulu, etc) whenever need arises.
Major Capacities in the Reference Laboratories
The major Capacities of the National Health Laboratory Services are as follows: –
✓ Capacity to test for COVID-19 in Butabika, and with mobile Laboratories currently placed in Tororo, Adjumani Hospital (for Elegu border crossing), Mutukula and Mubende Regional Referral Hospital. Additionally, all the Regional Referral Hospitals have been equipped with GeneXpert machines which the department activates any time additional testing capacity is needed. These Laboratory has been the cornerstone in the Ministry’s strong response in the prevention, management and control of the ongoing COVID-19 by providing quality and real-time results for decision-making.
✓ Capacity of National TB Reference Laboratory (NTRL) to consistently provide surveillance and early detection of Multidrug Resistant Tuberculosis (MDR-TB) and Extremely Resistant TB (XDR-TB) to help in early detection and isolation of cases to prevent spread and protect life.
✓ Capacity to provide testing for diagnosis of HIV and Hepatitis B including Viral Load for up to 2.5 million tests every year thereby providing access door to life saving ARVs and treatment monitoring for people living with HIV/AIDS and Hepatitis B including babies and pregnant mothers.
✓ Capacity for sickle cell disease confirmation, Heme Path Cancer Diagnosis and other non-communicable and lifestyle disease diagnosis.
✓ Capacity for routine diagnostic check-ups for functions of the Kidney, Liver, Heart and other vital organs of the body.
✓ Established the genomic Laboratories at the Central Public Health Laboratory (CPHL) and National Tuberculosis Reference Laboratory (NTRL) for routine surveillance of any genetic changes in disease–causing microorganisms that may result in being very dangerous (like resistance to treatments) or weaker and therefore milder.
✓ Capacity of the National Microbiology Reference Laboratory to carry out routine bacterial culture and sensitivity for Antimicrobial Resistance (AMR) surveillance.
✓ Developed laboratory information management systems which is used at the in the refence Laboratories (CPHL and NTRL) to track patients’ samples and relay results to the Doctors. For example, the TB Lab information system tracks patient samples and rely results to MDR treatment sites in the country, which has greatly improved turn round time for TB culture and drug susceptibility results.
✓ The External Quality Assessment (EQA) Laboratory. The reference Laboratories at NHLDS produce Proficiency testing panels that are accredited to ISO Standards which are used to expertly control the quality of Laboratory diagnosis across the national health laboratory network.
✓ Equipment Calibration Centre. The NHLDS has an internationally accredited equipment calibration Centre that supports calibration and standardization of equipment in the whole Laboratory sub-sector in the country to ensure they provide accurate results.
✓ The Laboratory Department (through NTRL and CPHL) Supports 26 countries in Africa as part of the World Health Organization – given mandate, and has supported ISO 15189 accreditation of 11 National Reference laboratories in the region. This is marketing Uganda’s healthcare system internationally.
Ther Ministry of Health PS, Dr Diana Atwine, on Tuesday, commissioned the newly refurbished maternity ward at Butenga HC IV in Bukomansimbi District.
It was refurbished with support from Korean Foundation for International Health (KOFIH).
Additionally, KOFIH also supported the construction and equipping of the Surgical Ward, OPD and Emergency Unit Block.
Digital X-rays, ambulance and emergency care equipment and supplies have been procured to support health service delivery at Bukomansimbi District.
“Once we have buildings, equipment and health workers, patients will come and receive quality services,” Dr Atwine said during the ceremony.
She added, “All this capacity is enabling Butenga HCIV to handle referrals from Bukomansimbi, Masaka, Lwengo, Ssembabule and Kalungu and from as far as Gomba.”
https://x.com/DianaAtwine/status/1701522964896776336?s=20
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