Minister Aceng blasts Northern Uganda leaders over poor malaria response
Prime Minister Robinah Nabbanja holds a baby at the launch of the malaria vaccination exercise in Apac District on March 02, 2025. PHOTO | TONNY ABET
What you need to know:
- In 2023, Uganda ranked among the top five African countries with the highest malaria burden, alongside Nigeria, the Democratic Republic of Congo, Ethiopia, and Mozambique.
Health Minister Dr Jane Ruth Aceng has used the World Malaria Day celebrations to criticize civil and political leaders across northern Uganda for weakening government efforts to eliminate malaria from Uganda within the next five years.
While the government has set a target to eliminate malaria by 2030, Dr Aceng said leaders in the north are deliberately reluctant to support initiatives such as immunization and indoor residual spraying, which are aimed at achieving this goal.
“I speak to you, people of the Acholi sub-region. Your immunization coverage is poor for all antigens, and mortality is high, yet you have the vaccines. We need you to pull up your socks in immunization, and we have 14 antigens in the schedule, and we should not be having epidemics of vaccine-preventable diseases in the Acholi sub-region,” Dr Aceng said on Friday, April 25.
"I'm tasking our leaders, the cultural leaders, my technical teams in health, we need to work harder and emulate the other districts, don't again lead from the bottom in malaria vaccination, let us stop the mortality, you have the tools, meaning children under five years are eligible to receive this vaccine," she said.
In 2023, Uganda ranked among the top five African countries with the highest malaria burden, alongside Nigeria, the Democratic Republic of Congo, Ethiopia, and Mozambique.
Although the Ministry of Health believes that the malaria vaccine can potentially prevent at least 800 cases of severe malaria among children every day and ease the financial burden on families, Dr Aceng said households in the north remain reluctant to embrace the initiative.
She expressed disappointment that such reluctance has kept malaria prevalence astonishingly high in the north, even during dry seasons when mosquito populations typically decrease.
“So we must hype our game. We are the ones that are blocking our pathway to ending malaria by 2030, we must work really hard so our children can go to school. We have only 5 years to 2030 to reach our target, in many parts of the world, malaria has been eliminated. But here we have failed, because we made friends (with malaria),” Dr Aceng said.
Malaria remains a leading cause of illness and death in Uganda, with the country ranked as the third-highest contributor of global malaria cases and the tenth-highest contributor to malaria-related deaths.
On April 2, 2025, the government, with support from Gavi, the Vaccine Alliance and other partners, launched a countrywide malaria vaccination campaign in Apac District, making Uganda the 19th African country to introduce the malaria vaccine into routine immunization.
The R21/Matrix-M malaria vaccine, administered in four doses at 6, 7, 8, and 18 months, targets 1.1 million children under two years in 105 high and moderate transmission districts, with plans to expand coverage nationwide.
While eliminating malaria by 2030 may seem ambitious, Dr. Aceng said it is achievable through the concerted efforts of all actors, sustained action, and bold investments.
"I call upon the city district leaders and the VHTs to ensure that you lead the fight against malaria here in the Acholi Sub-region. I urge you to ensure that the health task forces and the committees are fully constituted and functional," she added.
Malaria is responsible for up to 40% of all outpatient visits, 25% of hospital admissions, and 14% of hospital deaths in Uganda, according to 2022 World Health Organization (WHO) data.
At the event, Mr Geoffrey Toopiny Onyuta, Gulu City Health Educator, said malaria remains a significant health concern, with 38,727 malaria cases recorded out of 324,854 patients who visited health units in the city.
“Children under five were most affected, which underscores the need for more efforts to be made on preventative measures,” Mr Toopiny said.
While the vaccination drive targets 105 moderate and high-burden districts, the Ministry is working with several partners, including Pilgrim Africa-Uganda, to procure more vaccines to cover the remaining districts.
Dr Aceng also addressed negative political theories circulating against the vaccination drive.
"The vaccine is pre-qualified and registered in Uganda through the National Drug Authority for use. Meaning Uganda has studied the vaccine and found it safe for use. It is also pre-qualified by the WHO. And after serious research, it was found safe and effective, and we are giving it free of charge," Dr Aceng explained.
Pilgrim Africa Uganda, a government partner in the malaria fight, is also expanding indoor residual spraying (IRS) from communities to schools, aiming to curb malaria infection among children.
Mr Wyclef Odude, a Vector Control Specialist at Pilgrim Africa, said:
“We have deliberately decided to enter schools, an area which has not been covered by the government. Most of the schools have been utilizing only nets as a preventive measure but inside these dormitories, you see the beds the way they are stacked, it is very hard for these kids to use nets."
"We have started in the Teso region, and we are expanding to other regions to make sure these learners are protected from malaria, make sure that the absenteeism is reduced, if we do indoor spraying, in both dormitories and classrooms, we are protecting a huge percentage of the population," Mr Odude stated.
However, Mr Odude noted that these efforts have been hampered by recent funding cuts from the US government.
"The recent stop-work order from the U.S government curtailed a lot of activities, and several partners were put on the stop. Most of the funds, unfortunately, that we are using to implement these activities are donor funds, and we have very little local resources that we are putting into this fight," Mr Odude said.
While the Ministry had targeted about 55 districts for spraying, Mr Odude said:
"We haven't reached even a quarter of the targets they are intending to spray, and most of these activities require funds which are not available, unfortunately."
According to the Ministry of Health, 30-40% of outpatient visits are due to malaria, while 20% of admissions and 10% of inpatient deaths are attributed to the disease.
Despite the high burden, Uganda has made progress, reducing malaria parasite prevalence in children under five from 42% in 2009 to 9% in 2019.
Meanwhile, Dr Kasonde Mwinga, the WHO Representative to Uganda, warned that without treating the malaria fight as a national development priority, elimination efforts may falter.
"Today, a significant part of malaria funding in Uganda comes from external donors, a model that is fragile and unsustainable. If we are serious about ending malaria, we must treat it not just as a health issue, but as a national development priority," Dr Kasonde said.
"Our fight is anchored in two key frameworks, the Malaria Reduction and Elimination Strategic Plan and the Malaria Mortality Reduction Strategy, but without sustained domestic financing and political will, their full potential will remain unrealized," she added.
