Aceng explains how US investors will boost Uganda’s health sector

Uganda’s Health minister Dr Jane Ruth Aceng

What you need to know:

  • For three days, more than 40 African heads of state converged in the US capital, Washington DC, for the second US-Africa Summit.
  • President Museveni invited the Americans to pump funds into the manufacture of vaccines and expansion of pharmaceuticals. Arthur Arnold Wadero caught up with Uganda’s Health minister Dr Jane Ruth Aceng on the side lines of the meetings. 

How timely was this summit and what were the major highlights?
The notable highlight, of course, is the very high-level meeting on partnering for sustainable health cooperation. We had heads of state and secretary for health of the US. We had high-level representations; the CDC director, the director of USAID, and CEOs from the US. And this meeting and partnering for sustainable health cooperation came from the backdrop of the Covid-19 pandemic that exposed lots of health inequities, especially for the African continent. 

Many of you will recall that when Covid-19 came in, the West thought about themselves and forgot about Africa. Everybody was trying to ensure that their citizens survive. What that meant was that each country would focus on ensuring that they have test kits, enough laboratory equipment, medicines [and] ICUs for their citizens and not thinking about the world as one globe where a disease anywhere can reach anybody at the same time. 
We experienced the disadvantage of not being able to have equipment and commodities at the time when we needed them the most and that opened opportunities for African leaders. We need to be self-sustaining. 

We need to ensure that we have the capacity to have pharmaceuticals, vaccines, test kits, and adequate human resource that is well trained to handle the issues so that we are not dependent on the West. Many of you will recall that His Excellency the President [Museveni] during the pandemic actually reached out to many manufacturers and requested them to reprogram their manufacturing and focus on health commodities. So we have sanitisers, gloves, cover rolls and all those things being manufactured in Uganda. So it was easy to access them at that time.
Apart from that, in all these inequities we are talking about the availability of resources. Readily available resources that we can tap into, in the event that we have outbursts. So for me the highlight for this meeting was the emphasis from our President and, of course, their other presidents on the issue of pharmaceuticals, vaccines to have sustainable health in Africa. If we can have our own medicines, our own vaccines. 

What has Uganda been able to secure from these meetings?
Usually in the bilaterals that we have, we share ideas. We don’t get commitments right there. The commitments can come after. So I have had the opportunity to meet with the CDC [Centers for Disease Control] director and the USAID director. Right now [Wednesday] you got me meeting with the [US] special assistant to the president and senior director for global health security and bio defence.
We have been discussing potential areas of collaboration where for me as the minister for Health, I think they should focus on if we are to ensure health security. In the areas of the laboratories, we need to focus on the biosafety in the laboratories. Safety of samples, of the workers and avoiding spillage of potentially dangerous samples. We have also discussed the safety in relation to bio-terrorism. 

We have also discussed handling epidemics in real-time and that can only be done if we strengthen communities. So you cannot disengage yourself from communities in every action because outbreaks [and] all diseases begin in the communities and can be ended by the communities being empowered. We have experience from all our Ebola outbreaks, but particularly the last outbreak where we empowered the communities and they took it by themselves to spread information door-to-door to ensure that the outbreak does not spread out of proportion. You can see that it is barely three months, it is coming to an end. It is not magic, it is the communities. 
So the need to emphasise community empowerment but also in that relation, specifically having community health extension workers deliver because this work was done by the village health teams. Our villages currently are too many and the majority are too old. They are not to read and write. We need a breed of young people who can move from door to door.

What do we need to attract them?
They are willing and ready but what will attract them is when there is motivation and monthly allowance. This is what I have been talking about all through. I need the President to understand and buy in. Many of the countries have community extension workers that are paid a monthly allowance. I am talking about an allowance, not a salary. You know there is a limit to voluntarism. There must be some form of motivation to get somebody to do that. We have run pilots in two areas; Mayuge and Lira districts.

So how far with that pilot?
We have finished training and we released them out but they are being paid for by USAID a monthly allowance. So we want to demonstrate the impact [that] they can have. We were not able to do this in Kasanda and Mubende because they were already in an outbreak. We need people who can do much more than that. Why do I say this? Because we need records to be taken. We need data to be sent in real time. We need people who can use smartphones and send information for us for planning. What many of you don’t know is that we have an EOC [emergency operation centre]. Information is relayed to that EOC in real-time for us to take action. 

What other deals were secured to bolster Uganda’s health sector?
There were a lot of discussions about partnering with the private sector and how to move forward. Many of our issues are supported by the private sector. For instance, the Sabin vaccine that we have in the country for the Ebola Sudan was a private sector and they had to run the race to make the vaccine available from previous samples of Ebola Sudan. 

Partnering with the private sector has an advantage in that it provides a base for readily available resources and also for a wider discussion about what you want to do together for mutual benefit. If we partner with the private sector that wants to manufacture vaccines, right now Uganda will carry out the research they will benefit. If we prove that their vaccines will work, then later on they can start selling their vaccines. 
We also benefit in that we are given the opportunity to carry out the research and the reference will be Uganda. But like I said the challenge comes in patenting that needs to be discussed at all times when we are having such collaborations.

But from experience, I can tell you that Uganda has already been collaborating with the private sector in the areas of global health security. We [previously] had the private sector round table that brought on board nearly about seven partners that came in to support Uganda in the aspects of training, digitisation for real-time data on epidemics for strengthening our in-house sharing of information that was supported by the private sector. 
We also have resolved to save lives which is a philanthropists’ [move] that has been supporting human resource capacity and port health at the boarders. You know in our work, we have to ensure that there is safety for the people coming and moving out. So we have what we call port health where we screen, detect and respond even at the boarder points of entry, not only at the airport but even at the boarder points.

On the overall, what was unique in all these meetings?
I want to say it has been a good forum for Africa and the US to reflect on some of the gaps that are existing, but also potential areas where we can partner and have mutual benefit. And for me in the health sector, it is a wide area but the business forum has discussed many other areas including trade, security and others that I have not privy to.