Govt plans to cut Covid test cost

Tuesday July 20 2021

A health worker carries out a Covid test in Kampala on July 12. PHOTO/STEPHEN OTAGE

By Tonny Abet

The government has said discussions are underway to regulate the high cost of Covid-19 testing in accredited laboratories which is limiting access and greatly affecting pandemic fight.
Dr Susan Nabadda, the commissioner of laboratory and diagnostic services at the Ministry of Health, said free Covid-19 testing is only provided in public facilities to those with Covid-19 symptoms due to limited resources.

“Whoever just wants to know their status but they don’t have symptoms, will have to go to [any of] these accredited private laboratories and take the test at a cost. We are also seeing the issue of regulating the cost so that more people can know their status,” she said.
Dr Nabadda made the remarks at the weekend while officiating at the dissemination of the report of a survey on Covid-19 testing in the country. 
Twaweza, an NGO,  carried out the study last month in Kampala, Kyotera and Tororo districts covering respondents in 1,950 households. 

Dr Misaki Wayengera, the head of government Scientific Advisory Committee on Covid-19, told Daily Monitor that up to 80 per cent of people who contract Covid-19 don’t develop symptoms.  The common symptoms include fever, dry cough, tiredness, headache and body pain among others. 
Whereas the government is not providing free Covid-19 testing for those without symptoms, the World Health Organisation (WHO), said: “Whether or not they have symptoms, infected people can be contagious and the virus can spread from them to other people.”

The Twaweza study states that although there is an overall increase in the number of people who were going for Covid-19 testing in July this year compared to last July, issues of high cost, false negative and positive, and high turnaround time are the key setbacks. A cumulative total of 1,384,388 Covid-19 tests had been done in the country and 86,755 cases were detected as of July 8 this year compared to 219,627 tests that had been done and 1,000 cases detected as of July 8, 2020. 

In the study where respondents were reached through phone calls, Ugandans said they are being charged between Shs80,000 and Shs250,000 for Covid-19 tests. Some high-end facilities are charging up to Shs500,000 for a Covid-19 test, according to Twaweza.
Mr Andrew Nsawotebba, the operations manager of Entebbe International Airport Testing Centre, said the main drivers of the cost include purchasing test kits, data management, personal protective equipment (PPEs) and personnel. He said Test and Fly Laboratory is providing Covid-19 testing at the airport.
“In future, Ministry of Health should look at how private labs can be supported to acquire kits at a lower cost. Maybe we should start manufacturing the kits in the region so that they can be acquired at a low cost,” Mr Nsawotebba said.

However, last year Dr Diana Atwine, the Ministry of Health permanent secretary, announced that the government had reduced the cost of Covid-19 for people without symptoms and those seeking Covid-19 certificates for travel. 
“Ministry of Health has reduced the cost of testing for Covid-19 from $65(about Shs240,500) to$50 (about Shs185,000). This is against the background that the cost of transporting lab test kits and other supplies has since reduced due to the resumption of international flights,” Dr Atwine said.


Although the cost reached after slicing a few shillings was a bit low, it was still largely unaffordable to many people given the low per capita income of 
Dr Nabadda, however, said the cost of tests varies depending on the type of kit used. Rapid diagnostic tests (RDTs) for Covid-19 in most facilities are at around Shs80,000 while Polymerase Chain Reaction (PCR) tests are at Shs250,000. 

Resorting to self-medication
In the survey, a significant number of people in Kampala, Kyotera and Tororo would opt for self-medication if they suspect that they have Covid-19 instead of going for a Covid-19 test.
Up to 28 per cent of 750 people interviewed in Kampala said they would do self-medication using herbal remedies if they experience symptoms while 14 per cent would self-medicate with pharmaceutical drugs.

This is not so different from the 19 per cent of the 600 people interviewed in Kyotera who would also resort to herbs after getting symptoms.
But in Tororo, of the 600 interviewed, only 7 per cent said they would do self-medication using herbs.

Dr David Nahamya, the secretary for the National Drug Authority (NDA), said the vice will worsen the problem of drug resistance the country is grappling with.
“Why should you take the drug when you are not infected? What if it is a different illness? What if you take the wrong dose?” Dr Nahamya said.
Dr Nabadda said the country could significantly reduce the number of people who are self-medicating by expediting the process of making Covid-19 tests more affordable.

Status of results
Prof Pontiano Kaleebu, the director of Uganda Virus Research Institute, said they are addressing discrepancies in Covid-19 results from the 25 laboratories which have been accredited to do Covid-19 testing. He said false negative or false positive results can arise from the type of kits and machines used for Covid-19 diagnosis, how the sample was collected and mistakes made by laboratory technicians during testing. Prof Kaleebu said RDTs have low sensitivity in detecting Covid-19 infection.