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Thursday, October 19, 2017

Goodnight with no cat eye glow

Dr. Ben Watmon examining  Rwot's eye at Nebbi hospital
By Esther Nakkazi

He was quiet and frail.

The three year, little boy, had an eye problem, and obviously not enough sleep the previous night. Living 50 kilometers from Nebbi hospital, father and son had to wake up at dawn to be the first in the queue.

Still, little Jonathan Rwot was almost at the end of the long line that mostly had elderly people. He was sitting in his father’s lap. Never raising his head. Starring at the floor with his head slightly bent down all the while.

It was one of the hotter days. Rwot could have been playing hide and seek or kicking a locally made football with other kids but here he was waiting.

He had to have an examination; an operation and a referral. He was not only suffering physically but emotionally too. He was small, with a scary, protruding eye and undernourished. Such a pitiful sight. It was not his turn but got pulled out of the line. That was luck.

“He might not live beyond five years,” said Dr. Ben Watmon an ophthalmologist. He was using an ophthalmoscope to shine a bright light into Rwot’s eye as part of the examination. Only then, did Rwot, for three years look straight into another person’s eyes for a long time.

Gibert Onegi, the father was not fixated on the details of the diagnosis. Really, just some concerns loomed; If he could get his son out of pain, to play with other children and sleep with his eyes closed without crying at night. Maybe the emotional pain would go away too.

Dr. Watmon asked gingerly how and when the problem started. He probed. But Onegi had no exact answers.

It supposedly started when Rwot was four months, said Onegi. But his boy got no medical attention from its mother. She did not have much time or love for Rwot. She later found another man and abandoned her young son.

By the time Rwot was brought to his father two years after he was born, the tumor within the eye was fully grown. He was lonely. Kids didn't play with him. They shunned Rwot. But he never cried in front of them - just watched them play.

At night, Rwot’s sick eye did not close. It glowed like a cat’s eye in their pitch black small, one-roomed house. Rwot did not sleep much and only at night did he cry, Onegi said.

Rwot was diagnosed with retinoblastoma, a cancer that starts in the retina. It is a common eye cancer in children and can be sporadic or hereditary. If not treated early the tumor grows outside of the eyeball. Exactly what happened to Rwot.

“The clinical appearance shows the cancer is in advanced stages,” said Dr. Watmon who was at Nebbi hospital for an eye camp. He explained that the camp is a bridging gap for the rural poor who may never afford or have a chance to see a specialist. But he is limited in his services.
“At the camp, I do not look at itching eyes. My main work is surgery. Rwot has had a chance,” he said. Based at Gulu hospital, about 70 kilometers away, Dr. Watmon is also the one ophthalmologist in charge of the whole mid-northern region with millions of people.

That is not strange. Uganda has only 48 ophthalmologists, according to their umbrella body, the Uganda Ophthalmology Society. Eight have since retired leaving only 40 to serve an entire population of 41 million people. 26 of these remain in the country’s capital, Kampala. 14 like Dr. Watmon serve the rural populations in hard to reach areas.

Many hospitals out of Kampala, Nebbi inclusive, lack specialized services. So conditions that could be treated early and reversed go untreated until the ‘arm of God’ presents breakthroughs like the eye camp.

The Uganda Government tries to solve the problem by partnering with non-governmental organizations to provide such services through camps. For this eye camp, its partner was Amref Health Africa, Uganda branch.

But the demand for specialist services for each hospital is different. For instance, in 2016, Nebbi hospital registered 49,809 outpatients. 2.3 percent or 1,180 were eye patients, said Dr. Charles Keneddy Kissa the medical superintendent, Nebbi hospital.

“We have one ophthalmologist officer who can only handle minor eye cases such as allergies although the hospital has a beautiful eye clinic, which has not been used for 10 years,” said Dr. Kissa.

They have tried to find an ophthalmologist doctor. “We have advertised many times but got no interested candidates,” said Dr. Kissa. Undeniably, this is a hard to reach area and with no incentives, doctors are not eager to work there.

As such, conditions like glaucoma, refractive errors and cataracts, which most of the people in the line waiting with Rwot have, cannot be reversed and cured because they cannot be intercepted early.

Another solution could be getting an eye donation but organ transplant in Uganda is illegal.

Dr. Watmon had two solutions for Rwot; first to put him on chemotherapy then remove the eye or remove the eye and do chemotherapy. He opted for the latter and referred him to Ruharo eye center, the only facility in Uganda that gives free eye chemotherapy services for children.

But it is in the western part of the country while Rwot lives in the northern part.

However, there is hope. If his case is forwarded to Ruharo, as a referral, transport money will be sent to Onegi to take his son for free chemotherapy.

But at Nebbi hospital at least the journey began. Rwot’s operation was among the 42 Doctor Watmon carried out during the five-day eye camp. 106 patients were examined but some were not as lucky as Rwot. They walked long distances back home to wait for the next eye camp.

“At least Rwot will be free of pain,” said Dr. Watmon. He will sleep with both eyes closed.

ends

This article was made possible by Amref Africa- Uganda

Wednesday, October 11, 2017

Contraceptives for teens is immoral but they are having sex

By Esther Nakkazi

On the International Day of the Girl Child, Uganda is struggling with what to do with her girl child. At the tender age of sixteen or less, the average Ugandan girl is having sex. But do they need contraceptives?

According to studies, Uganda has one of the highest teenage pregnancy rates in sub-Saharan Africa. By ages 15-19, one in four Ugandan women is already a mother or is pregnant and later in life from age 15 - 24 years - the burden of HIV is high - Uganda has the second highest rate of HIV infection among women.

To wisely address this issue Uganda revised its fourth, 2015, policy, National Guidelines and Service Standards for Sexual and Reproductive Health and Rights.

After 18 months of adequately engaging all stakeholders including district leaders, service providers, religious and cultural leaders, with Uganda's Ministry of Health, particularly its reproductive health department, spearheading the review process, the Guidelines were ready to be launched.

They were, duly, signed by Uganda's Ministry of Health acting director general of health services, Prof. Anthony Mbonye who is also a member of the faculty of public health at London's Royal College of Physicians meaning his ministry endorsed them. As well the assistant commissioner of health services, Dr. Bladinah Nakiganda appended her signature.

Strategically, the revised Guidelines were to be launched on the final day of the Uganda National Family Planning Conference, held from 26th to 27th September 2017 in Kampala.

When they were presented to the state minister for primary health care, Joyce Moriku, there was hesitation and she announced that the speaker of Parliament, Rebbeca Kadaga, was not consulted so she could not launch them.

Ultimately, she refused to launch them saying, Ministry of Health officials had not been consulted and that the Guidelines intended to distribute contraceptives to 10-year-olds.

Birth control is a preventive health care strategy.

In the same breath when the Minister of health, Dr. Jane Ruth Aceng, appeared before parliament she confirmed that her ministry does not own the Guidelines and ‘acting staff’ in this case a high-level well-trained official, who is part of her team, endorsed the guidelines.

The Permanent Secretary at the Ministry of health, Dr. Diana Atwine has also told reporters that they do not agree with the guidelines and they will stick to ‘moral principles’.

Now, besides showing a lame, uncoordinated leadership at Uganda’s Ministry of health this whole fracas shows two other things. While for HIV, the leadership is worried that the money injected into prevention is not yielding matching results and will defend every coin the story is different when it comes to family planning.

This year, the Uganda teen pregnancy rate shot up by 1%. For over 10 years, the Uganda teenage pregnancy levels have stagnated, at least 25 percent of Uganda teenagers become pregnant by 19 years and face four times the risk of maternal death according to the Ministry of Health.

On the other hand, there is increased funding, even domestically, the family planning budget has grown by 40% from $3.3 million $5 million after President Museveni attended the 2012 London Family planning summit. But the leaders at the Ministry seem to be comfortable with having more funds and maintaining the miserable reproductive health stats.

Secondly, in February this year, I attended the first international symposium on community health workers held in Kampala. The Executive Director for African Centre for Global Health and Social Transformation (ACHEST) Prof. Francis Omaswa, a much-celebrated officer at the Ministry of Health advised that; ‘the best way to manage a system is not to blame an individual. I guess, in this instance, that should be advised to the ministry of health leadership.

This morning civil society had a press conference and confessed to a dangerous trend of Ministry of Health creating a ‘leadership vacuum’ and refusing to provide evidence-based policy and technical guidance on issues that relate to sex and sexuality in Uganda.

They also blamed the ministry for creating a ‘policy desert’ especially for health workers who are faced with challenges of young girls asking for contraceptives.

Apparently, the revised Guidelines are an essential technical tool to equip policymakers and health workers with the framework to provide SRHR services to Ugandans, including adolescent girls and young women.

"We have to address the reality the girls are facing. We need access to services based on science and evidence. Ministry of health should be ashamed," said Moses Mulumba, the team leader at CEHURD.

“Our babies are having babies and it is a reality that young girls are having sex,” said Justine Balya, the Human Rights Awareness and Promotion Forum (HRAPF) Legal Consultant at the civil society press conference.

Civil Society also cited governance issues, saying it is a "failure of leadership on the part of the Ministry of Health," for the launch and later withdrawal of not only these SRHR policy guidelines but also the ‘Standards and Guidelines for reducing Morbidity and Mortality due to unsafe abortion in Uganda’ which were withdrawn in 2016.

For the National Guidelines and Service Standards for Sexual and Reproductive Health and Rights civil society which funded them said all they are interested in is providing age-appropriate family planning information to young girls and that is spelt out in the Guidelines.

Now, no one is interested in giving teens contraceptives. They are too young. But if they become teen mothers their own teen children will also have babies and the cycle will continue.  The best we can do is have an 'open and honest' conversation not mute it. With the right information, they will make the right call! Don't we get it!

ends.

Monday, October 2, 2017

Uganda's Biotech Bill Could Become Law Tomorrow?

By Esther Nakkazi

The Uganda biotechnology and biosafety bill is due to be debated in parliament for the nth time tomorrow, Tuesday (3rd, October, 2017).

If it is passed it will send a strong signal to the rest of world if not biotech experts have vowed not to mourn over it but to re-strategise, clean it up and table it before parliament again.

The man in charge is Dr. Elioda Tumwesigye, the minister of Science, Technology and Innovation (STI), a qualified medical doctor who has continuously confessed to not knowing much about agricultural biotech.

Last week, Dr. Tumwesigye was in parliament and while the the bill was on the order paper he deferred to use the opportunity begging to first hear from biotech experts who would be in Uganda attending a three-day (27th-29th September) high-level conference on application of Science, Technology and Innovation (STI) in harnessing Africa’s agricultural transformation.

Tumwesigye himself anxious for the bill to pass was seeking advise on among other things; GMO labelling, strict liability and the expedited review clause, which he has been advised to delete and have stagnated the bill at Parliament.

Experts attending the conference praised Uganda for its progress in conducting field trials but cautioned about it delaying the bill further.

At the conference,  Dr. Tumwesigye reached out to biotech experts for insights into winning over the reluctant Uganda parliamentarians. “For me I am just a medical doctor. I want to understand, if there are now more modern technologies is it still relevant for us to pass this bill,” inquired Dr. Tumwesigye who is also the first minister of the newly created ministry of STI. He was reacting to the statements below.

Answers from the biotech experts were direct and straight. 

“In Africa we like debating as opportunities pass by us. The world has now moved from biotechnology to gene editing. Africans can be leaders and not followers,” said Margaret Karembu, the director of International Service for the Acquisition of Agri-biotech Applications Africa regional office (ISAAA AfriCenter).

“We need to move with some speed so that new emerging technologies do not move ahead of us,” said Abed K. Mathagu the program officer-regulatory affairs at the African Agricultural Technology Foundation (AATF).

To which Dr. Tumwesigye wondered if it was still necessary for Uganda to adopt the biotech bill and not leap frog like Africa did with mobile telephony. “Cant we skip the biotech law and move on to gene editing if the technology is now archaic?”

"Both of these technologies (biotech and gene editing) are necessary and needed. We should not exclude one or another. They both serve different purposes. Before we can have food security people need to be secure about the food they eat," said Kevin M. Folta a professor and chairman of the HorticulturalSciences department at the University of Florida

For now, the Uganda biotech bill drafted in 2012 already has support from the highest office, the Uganda president, Yoweri Museveni, but has failed to get enough support from Parliamentarians for it to be passed.

“I have repeatedly said that there is nothing wrong with this technology. However, there are lots of controversies due to misinformation, which unfortunately seems to have been bought by some legislators,” said Yoweri Museveni.

“My government created the Ministry of Science, Technology and Innovation (MoSTI) in June 2016 to provide a basis for enhancing sector coherence and coordination,” said Uganda’s Yoweri Museveni in a speech read for him by Vincent Ssempijja the Minister of Agriculture, Animal Industry and Fisheries.

Museveni said the priority for the STI ministry is to spearhead the retabling and consideration by Parliament of the bill, which ‘must be adopted for Ugandan farmers to access biotechnology products to increase their production’.

Uganda developed and adopted the biotechnology and biosafety bill 2012, which the Ministry of STI is working towards its enactment into law.

“Uganda should learn from other countries and pass this law now. And it should be done in a way that you do not have to go back to parliamentarians for amendments. The warning is that do not repeat the mistakes of other countries,” said Bongani Maseko, general manager, AfricaBio. 

“If it is passed we are supposed to celebrate. Ultimately, it will send a strong signal to other African countries. But if it does not go through we shall re-strategise but we shall not be mourning,” said Dr. John Komen, Assistant Director and Africa Coordinator, Program for Biosafety Systems (PBS)

Dr. Komen and other biotech experts attending the conference said Uganda’s bigger challenge is actually not just passing the bill but how to operationalise it.

Currently, in sub-Saharan Africa the following countries test GM crops: Burkina Faso, Sudan, Nigeria, Ethiopia, Ghana, Cameroon, Kenya, Uganda, Tanzania, Malawi, Mozambique, Swaziland and South Africa. But only two are currently growing them: Sudan and South Africa.

ends.

Friday, September 29, 2017

Africa needs to harness the power of Science, Technology and Innovation to transform its Agriculture

By Esther Nakkazi

In an effort to transform agriculture and enhance food security, Africa needs to establish evidence-based policy and regulatory frameworks to facilitate effective utilisation of Science, Technology and Innovation (STI), a conference heard.

The three day high level conference on the application of STI in harnessing opportunities for Africa’s Agricultural transformation opened in Uganda (26th-28th), as policy makers articulated policy options to guide changes needed in Africa’s farming systems if the continent is to be bread basket for the world.

The conference marks the beginning of an annual high-level policy dialogue platform hosted by the Open Forum on Agricultural Biotechnology (OFAB) in Africa. The theme is “Integrating the Path in Africa’s Agricultural Transformation”.

It provides an opportunity to share knowledge and experiences on best technological and policy options available to stimulate sustainable agricultural development in Africa, he added.

“Agriculture is the sector upon which the success of sub Saharan Africa’s ambition for a steady economic growth rests. However, the yields of both crops and livestock in the region remains very low compared to global averages due to several challenges,” said President Yoweri Museveni in a speech read for him by Vincent Ssempijja, the Minister of Agriculture, Animal husbandry and Fisheries.

“Some of these challenges require us to harness the power of STI to transform African agriculture,” said Museveni.

“Our efforts must begin by strengthening investments in breakthrough technologies, such as climate resilient and disease resistant crops and livestock using both conventional and genetically engineered approaches,” said Museveni.

According to Dr. Denis T Kyetera, the Executive Director, African Agriculture Technology Foundation (AATF) for Africa to fully take advantage of the exiting new developments in agriculture changes need to happen in the policy front and high-level policymakers should be fully supportive of the need to integrate STI into the path towards agricultural revolution.

“There is no better way of ensuring support by the decision makers than through constructive dialogues and continuous conversations among experts, farmers and policy makers,” said Dr. Kyetera.

“Since most of the constraints for using science technology engineering and innovation in Africa are similar, we are gathered here in this high level conference for us to agree on addressing key issues that are hindering use of science, technology and innovations in commercialization of African Agriculture,” said the Dr. Elioda Tumwesigye, the Minister of Science, Technology and Innovation (STI) in Uganda .

ends

Wednesday, September 27, 2017

Museveni Supports Agricultural Biotechnology; Speech

A SPEECH BY H.E. YOWERI KAGUTA MUSEVENI

                                   PRESIDENT OF THE REPUBLIC OF UGANDA


DURING THE OFFICIAL OPENING CEREMONY OF HIGH-LEVEL CONFERENCE ON APPLICATION OF SCIENCE, TECHNOLOGY & INNOVATION IN HARNESSING AFRICAN AGRICULTURAL TRANSFORMATION


THE SPEKE RESORT MUNYONYO, KAMPALA, UGANDA,

27-29 SEPTEMBER 2017


Honorable Ministers from Uganda and all other African Countries,

Honorable Members of Parliament,

Members of Diplomatic Missions,

Members of the Media,

Ladies and Gentlemen

I wish to welcome you all to Uganda and particularly to this first ever high level conference on the Application of Science, Technology and Innovation (STI) in Harnessing Opportunities for Africa’s Agricultural Transformation.
I have repeatedly pointed out that if we do not increase our Agricultural Production, we will not feed ourselves and like in most developing countries, Agriculture still remains the most important sector of the economies of Sub Saharan Africa in terms of GDP contribution, employment and foreign exchange earnings.

Agriculture is the sector upon which the success of Sub Saharan Africa’s ambition for a steady economic growth rests. However, the yields of both crops and livestock in Sub Saharan Africa remains very low compared to global averages due to several challenges. Some of these challenges require us to harness the power of Science, Technology and Innovation (STI) to transform African agriculture.

Africa has an opportunity that can help transform its agriculture to be a force of food security and economic growth. There are several advances in science, technology and innovation worldwide that offer Africa new tools needed to promote sustainable agriculture. Our efforts must begin by strengthening investments in breakthrough technologies, such as climate resilient and disease resistant crops and livestock using both conventional and genetically engineered approaches.

Science, Technology and Innovation is making a profound impact on agriculture production globally. The agriculture of the future will be very different from the agriculture of today and vastly different from the agriculture of the past.

One of the key technologies that is of particular focus is Agricultural biotechnology. I have repeatedly said that there is nothing wrong with this technology. We have been using it for generations and there is nothing wrong with it. However, there are lots of controversy due to misinformation which unfortunately, seems to have been bought by some legislators.

The origin of this controversy seems to have been partly legitimized through international biosafety legal instruments, the Convention on Biological Diversity (CBD), and the Cartagena Protocol on Biosafety (CPB). The CPB required each signatory to put in place a national legal framework for safe development and commercialization of Genetically Modified Organisms. As a consequence, most countries in Africa have either put in place, or are working to develop, legal frameworks for development and deployment of GMOs.

My government is committed to using Science, Technology and Innovations (STI) to advance economic development. This is well articulated in my 23 Strategic Guidelines and Directives to the cabinet and in the NRM Manifesto of 2016-2021 as minimum standards for Uganda to attain the middle-income status.

Throughout history advances in Science and Technology have always been the primers for social change. STI has accordingly emerged as the major driver of national development globally. Scientific, technological and innovation advancement are a critical precursor for industrialization and socioeconomic development. 

They enable the creation of new firms and/or industries that act as avenues for translating Research and Development (R&D) outputs into commercialized outcomes comprising of new products, processes and enterprises. As Uganda aspires for faster, sustainable and inclusive growth, as expressed in the Vision 2040 and the National Development Plan II (NDP II), the Ugandan Science Technology Engineering and Innovation (STEI) ecosystem with the advantages of a large demographic dividend and the huge talent pool, will need to play a defining role in achieving the national Vision and Goals. The national Science Technology Engineering and Innovation (STEI) enterprises must become central to national development.

My government created the Ministry of Science, Technology and Innovation (MoSTI) in June 2016 to provide a basis for enhancing sector coherence and coordination.

One of the priorities for the Ministry is to spearhead the retabling and consideration by Parliament of the National Biotechnology and Biosafety Bill 2012. This Bill must be adopted for Ugandan farmers to access biotechnology products to increase their production.

I support the proposal by the Minister of Science, Technology and Innovation to establish a high level platform for Science, Technology and Innovation (PFST) Chaired by myself whose goal will be to identify, synthesise and articulate policy and strategic issues to support coherent and evidence-based decision-making by various arms of Government on STI matters especially matters related to biotechnology.

For all guests outside Uganda and in Africa, I call upon you to support your governments to embrace use of Science, Technology and Innovation in development. On the subject of GMOs, let us all move as a block and all decisions should be based on sound science. This technology is working elsewhere and we should not be left behind, the way we missed out during the green revolution that brought food security to South East Asia. We should not allow activists to continue confusing our legislators.

For God and My Country.

H.E. YOWERI KAGUTA MUSEVENI

PRESIDENT OF THE REPUBLIC OF UGANDA

(The speech was read by the Minister of Agriculture, Animal Industry and Fisheries, Vincent Ssempijja) 

Friday, September 22, 2017

Age limit; Museveni Speeches Tell It All

Esther Nakkazi

Uganda medics have an uphill task. President Museveni asked their opinion on the most contentious issue in the country today. Age limit for a president.

The Uganda constitution spells out that a president should be between 35 and 75 years old. Last week, Friday 15th September, Yoweri Museveni celebrated his 73rd birthday meaning if the constitution is not amended, he cannot participate in the next elections due in 2021.

It will be Museveni’s sixth term as he has been Uganda’s President since 1986.

But in 2012, while appearing on a television show, Museveni said leaders over 75 lacked the necessary rigour and that, that was ‘scientific logic’. Now that logic needs scientific evidence from the Uganda medics.

Recently, Museveni was put on the spot, over his very remarks and not wanting to backtrack or eat his words asked the medics to give their opinion - if a 75 year old would really be ‘fit to lead or not’.

It was not the first time that Museveni sought solid scientific evidence to enable him make his next move.

When Uganda was about to pass the tough Anti-homosexuality law, Museveni was quoted by the Aljazeera news outlet as asking from scientists; "What I want them to clarify is whether a combination of genes can cause anybody to be a homosexual. Then my task will be finished and I will sign the bill.” He even invited scientists from the US to help.

This week the Uganda Medical Association (UMA), an association of Uganda medical doctors said they are waiting for a ‘formal request’ from Museveni to provide an answer. The Savings and Credit Cooperative Organization (SACCO) of UMA got a a large donation of 2 billion shillings from Museveni.

So can any of them speak up and tell the emperor that he has no clothes?

For sure even without a formal request, medics can tell Ugandans that older people in general have cognitive decline and impairment. We have all observed Museveni become less articulate, using less sophisticated vocabulary, using more fillers like ‘um’ ‘ho’ 'ni-ni' and even repeating himself, not only for speeches but even word for word.

But worse he is even getting vulgar. When he was addressing the press in 2015 at Mbale State lodge, this is how he was quoted by the Observer newspaper, "if you put your hands in the anus of a leopard, you are in trouble” "...If you go and put your finger in the anus of a leopard. You are in trouble, you are in trouble. Ho! Ho! I cant believe how people could do so. NRM?, you attack NRM people in Uganda here? If it is in South Sudan or Kenya, yes we may have some problems. But in Uganda here? Where do go? Where do you go? So there will be no problem here. Those people made a big mistake, those individuals and those children are going to regret."

Sometimes Museveni’s speeches have turned biblical and hilarious like the one he made at mark of the anniversary of Entebbe 40 year raid. The UK’s DailyMail had a fitting headline; Ugandan president Yoweri Museveni’s bizzare rambling speech. He literally said nothing much.

At most public gatherings, Museveni doses off in-front of cameras but he has defended that saying he is ‘not sleeping but meditating’. It could be stress, fatigue because he is said to put in long hours but it could also be another medical condition or age.

It is just obvious that a human being at 70 is not as sharp as they were at 40. If you analyse Museveni's speeches that is evident. At first he had brilliant ideas like barter trade among developing countries, which he explained in speeches that were peppered with phrases like ‘the most unfavorable exogenous factor is lack of access to markets in North America, EU, Japan, China, India and Russia’’.

"All protectionism, especially in the OECD countries, must end. Yet these are the countries that evangelise in the name of free trade! What a paradox that is quite unfortunate! These double standards must end,” were his signature phrases.

For the ‘State of the Nation’ address on April 11,1989 his speech was like; “I am very proud to see that one of my long-held wishes—to see the emergence in Uganda of a reasonable measure of national consensus, as well as a nonsectarian forum— is at last beginning to be realized.”

“Currently, Africa is one of the most backward continent in the whole world. Elsewhere, I have defined backwardness as the absence of a reasonable degree of development. I have also defined development as man's ability to tame his environment and utilize its natural laws for his own benefit. I am using the word "reasonable" because man's mastery of nature— even for the advanced countries—is still only relative. Nevertheless, there are those who have reasonably mastered certain aspects of nature and have, consequently, improved their lot on earth. If one, therefore, takes "development" and "backwardness" as defined above, you will agree that Africa is one of the most backward continents.”

Those were well turned in sentences with explanations showing a sharp brain at 45 years.

But these days he makes more unrealistic speeches of Uganda getting middle income status by 2020 even when organisations like the World Bank have made it clear that it is impossible. You just wonder if he lives in an alternate reality.

All he cites are investment in infrastructure, discovered oil that will create thousands of jobs. But he never mentions fundamental issues like the ever increasing corruption or even by the very least bringing down the fertility rate to 2.2% which would stabilise the population.

Uganda’s fertility is one of the highest in the world at 5.6%. By 2050, Uganda’s population will be 101.2 million and by 2040 about 75.6 million people.

Medical studies have proven that linguistic and cognitive decline often happen at the same time and verbal fluency reflects brain performance. It is normal as people age. No one can be as sharp at 73 as they were at 45.

Museveni who has a habit for speaking extemporaneously - never staying on his written speeches - is sometimes hilarious, biblical, historical and even grandfatherly so we can just follow the speeches to say what the medics can't say.  No need for medical examinations!

ends

Conference to share the status of Agriculture in Africa; the current, past and future trends

By Esther Nakkazi

Uganda in partnership with the African Agricultural Technology Foundation, the African Union Commission and the Common Markets for Eastern and Southern Africa are organizing a three-day (27th-29th September) high-level conference on the application of Science, Technology, and Innovation (STI) in harnessing opportunities for Africa’s agricultural transformation.

"The meeting targets policymakers and is going to promote technologies that are applicable in Africa," said Dr. Denis Kyetera, the Executive Director, African Agriculture Technology Foundation (AATF).

"Ministers will engage each other and share what technologies are available in their countries. This will eventually create a conversation between the different ministries," said Dr. Kyetera.

For Africa to benefit from cutting-edge science, technology and innovation it needs to address five key issues said Dr. Elioda Tumwesigye, the Minister of Science, Technology, and Innovation (STI) in Uganda.

"The unpredictable STI policy environment; the presence of strict liability bio-safety regulatory frameworks; low technology access; insufficient command among its leaders on STI; low public investments in agricultural research, development and public perceptions."

Dr. Tumwesigye particularly pointed out that Uganda like other African countries needs urgent interventions to find ways of mainstreaming utilization of STI to transform its agriculture needs.

The conference will showcase the current and potential impact of the application of science, technology and innovation for improved agricultural productivity, value-addition and poverty reduction. 

According to Dr. Tumwesigye, participants will also share a synopsis of the current status of agriculture in Africa capturing the past, current and future trends as well as showcase the significance of enabling systems in optimizing the impact and benefits of modern biotechnology to African agriculture.

But most importantly, it will facilitate constructive dialogue amongst high-level policymakers, experts, farmers, investor, regulators, communicators, development partners and the media on the role of STIs in sustainable food systems and nutrition in Africa.

Among the topics to be discussed will be; the state of agriculture in Africa, contributions of conventional STI to modern agriculture, integrating modern biotechnology into Africa’s agriculture for food security, securing smallholder farmers’ resilience to impacts of climate change, fostering evidence-based policies for transformational change in Africa’s agriculture, strengthening intellectual property rights to catalyze transformational change in Africa’s agriculture.

Other topics will be about inspiring a Climate for Change to enhance food security, regional approaches to biotech adoption and trade in Africa, winning political patronage//support to advances science in the age of ‘alternative facts’, repositioning agriculture in Africa towards agribusiness entrepreneurial ship, biosafety gate-keeping experiences in Africa: Case study of NBMA of Nigeria and South Africa  and the role of strategic communication in technology adoption for impact.

Targeted participants of the conference include leaders and decision-makers, including H.E. General Yoweri Kaguta Museveni the President of the Republic of Uganda, Benjamin Mkapa former president of Tanzania, the Rt. Hon. Dr. Ruhakana Rugunda, Ms. Gina Grey Ivey from the Bill and Melinda Gates Foundation. 

Others are Dr. Hamadou Biteye the managing director Rockefeller foundation, Prof. Kevin Folta the University of Florida, Dr. C.D Mayee president Asian Biotechnology, Cyprian Ebong Executive director ASARECA, cabinet ministers, lead scientists/experts, farmer union leaders, industry captains, biotech advocacy/communication networks, senior science journalists/editors, Professors, UN representatives and development partners.

Uganda is one of the African countries with a ministry devoted to STI. The Uganda Ministry of Science, Technology, and Innovation (MoSTI) was created in June 2016 in recognition of the need by Government to explicitly prioritize issues relating to STI as a key driver for Economic Development. 

ends



Thursday, August 31, 2017

Uganda Government does not support young Innovators

Young innovators at the 2015 CAMTech Medtech hack-a-thon
By Esther Nakkazi

For five straight years, Mbarara University of Science and Technology (MUST) has been holding medical technology or Medtech Hack-a-thons.

The Mbarara University style is like it all starts in the evening with a cocktail reception and dancing through the night.

By 8.00 am the next day, the youngsters mostly undergrads, form teams comprised of different disciplines - engineers, clinicians, entrepreneurs, nurses and at the 5th hack-a-thon, they even had villages health workers as part of some of the teams. That is all inclusive!

Thereafter, they pitch an idea targeting a medical problem. Teams have 48 hours to come up with a prototype.

At this point the hack-a-thon room visibly has unbelievable energy, discussions, prototype materials, the coffee and snacks table is equally busy, soft music is in the background as well mentors are at hand to guide the young innovators.

At the end of this exercise, a jury awards the best and most innovative products with a cash prize and other awards. The Kangroo+ team with an innovation that modifies traditional kangaroo care by combining a thermometer and skin-to-skin contact won this 5th CAMTech UGANDA Medtech Hack-a-thon and took home $782 and access to webinars and peer-to-peer learning engagements.

By all means, these gatherings are fancy for young people, they may put in long hours but equally reap from it so much more. They all eventually become innovators, become better thinkers, learn something new, meet new people and we suppose that the network and collaborate beyond the event.

Year after year, I travel to Mbarara University to document and see what happens at these hack-a-thons. I have seen these hack-a-thons grow bigger as the numbers that apply to attend also increases. This year had 250 participants, in 2015 they had 220, 2014 and 2013 had 150 and 100 participants respectively.

Unfortunately, as the numbers of interested students ready to come up with new innovations grow bigger the local sponsors become fewer. Save for government officials coming over to open and close these young people's innovation functions, the government is not injecting money in there.

I also know that for this year's budget, the government committed 30 billion Uganda shillings or $8.5m to support innovations and technology but these funds will be to aid innovators and researchers to commercialise their products. Unfortunately, this money is not for young innovators.

You would expect local companies to be interested in ‘putting money in what they can see’ as the Ugandan saying goes but no. This time even the usual suspects like mobile phone companies and Uganda Communication Commission (UCC), which is supposed to champion such declined.

Instead, you see many companies and organizations falling over themselves to sponsor the KCCA carnivals, where people go to drink, dance and wine, you wonder where our priorities are placed.

The lack of local funding of Uganda's innovation base ecosystem, which is the basis for young people who are coming up with new innovations that will solve critical health care problems underscores the Uganda government’s claim to care for innovations, new ideas, the youth and finding ways to engage them and make them productive.

How do we even explain that the prize money is down from $3,000 to $2,000 and all this year after year has to come from the Boston based Mass General Hospital Global Health? Surely, no one can realize that at some point these kids will come up with an innovation - either a medical device or an app that can unlock a healthcare problem forever?

I do not want to see these Hack-a-thons that are based at universities stop or the energy and talent in those rooms burn out. I suppose that they are cheap because they are hosted in universities as opposed to fancy hotels.

It is also great that every year we see new faces, hear new ideas and that these hack-a-thons are strengthening the innovation ecosystem. And many products from Mbarara University’s innovations ecosystem will be in the healthcare space soon like Sanidrop, a locally made hand sanitizer that is yet to be commercialized - and again this has been delayed by a government agency that can’t do its work.

So I suggest that next year, a crowdfund should be set up so that the Mbarara University alumni and people like me who care for innovation and healthcare in this country contributes to it.

We can as well ignore the Government and the mobile companies. Maybe they are interested in innovators that do not deliver on their promises and have the same old faces, present the same old stuff using the same old jargon and come in with new wrinkles and more grey hairs each year.

ends

Monday, August 28, 2017

Innovation to improve Kangaroo mother care wins young innovators competition

Team Kangaroo+ at the 5th Medtech CAMTech hack-a-thon 

By Esther Nakkazi

Madina Nalubega is a graduate of nursing at Mbarara University for Science and Technology (MUST). She is waiting to go for internship. 

Nalubega was one of the 250 young innovators who attended the 5th Annual CAMTech UGANDA Medtech Hack-a-thon that happened over the weekend. She was in the the Kangaroo+ team, one of the 30 that presented prototypes to a panel of judges. 

Kangaroo+ team won the innovating to improve neonatal and maternal health at the  CAMTech UGANDA Medtech Hack-a-thon and they received $782 USD or Uganda shillings 2,500,800 and six months of acceleration support as the grand prize winners.

"Their affordable medical technology, Kangaroo+, modifies traditional kangaroo care by combining a thermometer and skin-to-skin contact," the judges that included Richard Zulu the founder of Outbox, innovation hub.

"We came up with this innovation because at the current situation babies are born prematurely and they use Kangaroo care," said Nalubega at the hack-a-thon at Mbarara University. The device will cost up to $10 on the market.

Kangaroo care is a method of holding a baby that involves skin-to-skin contact. The baby, who is naked except for a diaper and a piece of cloth covering his or her back (either a receiving blanket or the parent's clothing), is placed in an upright position against a parent's bare chest. 

In Uganda, of the about 1.5 million children born annually, 90 percent of the more than 200,000 are pre-term babies born before 37 weeks of being in the womb and die before their first birthday. Ideally, babies should spend 40 weeks in the womb.  

So Nalubega's team came up with a jacket that can be used instead of a blanket or a clothing. The jacket has straps that go to the back and the baby is held at the chest of the parent. But they also added a colour coded monitory tool that can show the temperature of the baby.

"When the temperature is high the tool shows a green colour and the mother can remove the baby, when the baby gets cold and is not on its parents chest the monitor shows a red colour," said Nalubega.

CAMTech UGANDA awarded the 2017 hack-a-thon winners over $2,000 USD (6,702,400 UGX) in prize money. Other winners were Team Safe and Dry as First Runner-Up, Team MBT as Second Runner-Up and Team 54 as Third Runner-Up. 

Team Safe and Dry received $625 USD (2,000,000 UGX) for innovating a fistula collection tool, Team MBT received $469 USD (1,500,800 UGX) for a device treating menstrual cramps and Team 54 received $219 USD (700,800 UGX) for a low-cost infant warmer.

In addition to receiving prize money, CAMTech UGANDA offered the winning teams access to webinars and peer-to-peer learning engagements. Each winning team will also compete in a 90-day post-hack opportunity for membership in the CAMTech Accelerator Program (CAP)

An initiative on the CAMTech Innovation Platform, the CAP provides milestone-based funding, a CAP Coach, participation in the CAP Cohort, expert match-making and six-months of acceleration support.

More than 250 clinicians, engineers, entrepreneurs, students and designers convened at MUST for 48 hours to develop innovative medical technologies to improve neonatal and maternal health in low-resource settings.

Participants identified clinical challenges related to newborn and maternal health, formed multi-disciplinary teams, prototyped solutions and developed business models before presenting their ideas to an expert panel of judges.

“We heard from all aspects of the community,” said Dr. Kristian Olson, Director of CAMTech. “We’ve heard problems that were really rooted in culture and in economics, and yes in technical difficulties for certain things, but also in scaling and in communication.”

Dr. Elioda Tumwesigye, Uganda’s Minister of Science, Technology and Innovations, and Dr. Frank Tumwebaze, Uganda’s Minister for Information Communication Technology, addressed innovators during the hack-a-thon to represent the Government of Uganda’s commitment to innovating affordable medical technologies.

“The Ministry and the government are interested in supporting you, and we are here for you,” Dr. Tumwesigye said. “In the coming years, we shall see the prototypes from the hack-a-thon being funded in the country.”

Prior to the hack-a-thon on 26-27 August, CAMTech UGANDA hosted a Clinical Summit on 25 August, featuring panel discussions focused on pediatric and neonatal health, nursing, midwifery, obstetrics and gynaecology.

“It’s the time where we get to know and hear in better detail what problems are there affecting the frontline health workers who are battling to save lives on a day-to-day basis,” said Dr. Data Santorino, CAMTech UGANDA Country Manager.

Additionally, CAMTech UGANDA organized visits to Mbarara Regional Referral Hospital, Ishaka Adventist Hospital, Holy Innocents Children’s Hospital and Itojo Hospital, where participants learned directly from healthcare workers about the challenges they face in delivering neonatal and maternal healthcare services. 

With support from Massachusetts General Hospital Global Health, CAMTech UGANDA organized the annual hack-a-thon to develop disruptive innovations that have the potential to achieve widespread public health impact.

The Consortium for Affordable Medical Technologies (CAMTech) is a global network of academic, corporate and implementation partners whose mission is to build entrepreneurial capacity and accelerate medical technology development through an open innovation platform. CAMTech innovators who come from public health, clinical medicine, engineering and business work with end-users in low-and middle-income countries (LMICs). 

CAMTech UGANDA is administratively housed at MUST and supports local innovators to transform ideas into solutions that can revolutionize health outcomes for people living in Uganda and across the globe.

“It can be the start of a journey,” Olson said. “CAMTech Boston together with CAMTech UGANDA under the leadership of Dr. Data started five years ago with this idea that if we talk to people who are focusing on challenges that are in their own communities, they’ll come up with better solutions.”

Saturday, August 26, 2017

5th CAMTech Hack-a-thon aims to improve neonatal and maternal health

By Esher Nakkazi

It all starts with an idea in your head. You are an innovator. It can be anyone because anyone can be an innovator. Teams are formed each with a clinician, engineer, entrepreneur, student and a designer. A solution to a problem that’s been bugging is pitched.

Teams have 48 hours to make their vision come true and are challenged to develop a fully functional prototype. At the end of this intense phase, a jury will award the best and most innovative products.

In other words: Welcome to the 5th CAMTech Uganda hack-a-thon happening now at Mbarara University of Science and Technology (MUST) with a theme ‘innovating to improve neonatal maternal health’.  

The three day hack-a-thon, 25-27 August has more than 250 participants who are trying to innovate to improve neonatal and maternal health for patients around the world.The winning team will take home a grand Prize: $782 USD (2,500,800 UGX), the first Runner-Up: $625 USD (2,000,000 UGX), second Runner-Up: $469 USD (1,500,800 UGX) and third Runner-Up: $219 USD (700,800 UGX)

In addition to receiving prize money, CAMTech Uganda will offer the three winning teams access to webinars and peer-to-peer learning engagements. Each winning team will also compete in a 90-day post-hack opportunity for membership in the CAMTech Accelerator Program (CAP).

Prior to the hack-a-thon, CAMTech UGANDA hosted a Clinical Summit on 25 August, featuring panel discussions with community health workers, midwives, nurses, pediatricians and obstetricians. As well, there were visits to local clinical sites where participants heard directly from healthcare workers about the challenges they face in delivering neonatal and maternal healthcare services.

Some of the clinical challenges identified were miscarriages and abortions; infertility; premature babies; malformation of the fetus; eclampsia; anaemia; malaria; poor feeding; poor structure for patient follow up; low male involvement; antenatal care ignorance; poor relationship between health workers and pregnant mothers, placental insufficiency; teenage pregnancies; poor record keep=kig in health systems.

An initiative on the CAMTech Innovation Platform, the CAP provides milestone- based funding, a CAP Coach, participation in the CAP Cohort, expert match-making and six- months of acceleration support.

CAMTech UGANDA is part of the Consortium for Affordable Medical Technologies (CAMTech) and is administratively housed at Mbarara University of Science and Technology (MUST).

The Consortium for Affordable Medical Technologies
(CAMTech) is a global network of academic, corporate and implementation partners based at the Massachusetts General Hospital. CAMTech's mission is to build entrepreneurial capacity and accelerate medical technology innovation to improve health outcomes in low- and middle-income countries.

With support from Massachusetts General Hospital Global Health, RENU and the Uganda Communications Commission, CAMTech UGANDA organized the annual hack-a-thon to develop disruptive innovations that have the potential to achieve widespread public health impact.

CAMTech UGANDA is part of the Consortium for Affordable Medical Technologies (CAMTech) and is administratively housed at Mbarara University of Science and Technology (MUST).

Stay tuned for more about the 5th hack-a-thon 

Monday, August 21, 2017

Uganda trains coffee stakeholders ahead of first ever auction

By Esther Nakkazi

Ahead of the annual coffee 'Taste of Harvest' competition and Uganda's first ever coffee auction to be held 22 to 26 January 2018, the Uganda Coffee Development Authority, (UCDA) in partnership with the African Fine Coffees Association (AFCA) will provide specialty coffee training.

A three-day training for 20  coffee producers, exporters, processors and roasters in Uganda at Hotel Africana beginning tomorrow, August 22, and will be conducted by UCDA’s highly skilled quality and promotions staff in collaboration with AFCA. 

The training will provide participants with the skills to prepare and process high quality specialty coffee beans and enable them to prepare to participate in the Taste of Harvest (TOH) competition, said Mr. Edmund Kananura, Director Quality and Regulatory Services.

The training will highlight the benefits of the 'Taste of Harvest' competition and Auction as well as provide skills on how to prepare and process high quality specialty coffee beans. As well it will include improved coffee processing practices and proper use and handling of coffee equipment and drying materials, as well as quality management to ensure efficiency and consistency of coffee, said a statement from UCDA.

The training will be conducted with grant support from the American people through the USAID/East Africa Trade and Investment Hub. The USAID East Africa Trade and Investment Hub works to boost trade and investment with and within East Africa.

The 'Taste of Harvest' annual competition will be held alongside the first ever coffee Auction Uganda, at the Uganda Coffee Development Authority Quality Lab in Lugogo, Kampala, under the theme, “Accessing specialty coffee markets through the new Taste of Harvest Coffee Auction System” from 22nd to 26th January 2018.

At the competition, interested farmers submit their best coffee samples for grading. The grading of coffee is determined by specialists known as Q and R graders.

Coffee that scores above 80 is considered to be a specialty coffee and automatically attract good market and even better prices. The competition therefore serves to show that good practices can benefit farmers, said a UCDA statement.

As part of its mandate, UCDA regularly trains farmers across the country to produce quality coffee through good handling practices. As a result there are areas which do produce high quality coffees such as in Kanungu, Sipi, Iganga and Luwero.

Ugandan coffee in general has great taste. It is just a matter of handling it the right way. Farmers must work hard to get more and better quality coffee across the board.

UCDA is excited about the opportunities that the auction and competition will bring to Uganda’s coffee industry, said a statement from UCDA. "Through these two events, producers of high quality coffees, including smallholder coffee farmers, will access new markets and create an international brand for their coffees. UCDA is pleased to be working with AFCA to achieve this reality for Ugandan farmers."

Uganda Coffee Development Authority is mandated to promote and oversee the coffee industry through supporting research, promoting production, controlling coffee quality and improving the marketing of coffee in order to optimize foreign exchange earnings for the country and payments to the farmers.

ends

Increased male circumcision does not mean Uganda will meet its target

By Esther Nakkazi

The latest 2016 Uganda Population HIV Impact Assessment (UPHIA) survey includes much to celebrate. The proportion of men aged 15-49 years that are circumcised increased from 26% in 2011 to 43% in this survey.

"This is good progress which must be lauded," said Angelo Kaggwa Katumba program officer at AVAC. "Question is, is this pace fast enough for Uganda to achieve its Voluntary Medical Male Circumcision (VMMC) targets?"

It has been documented that between 2010 to 2016, the total number of VMMCs performed in Uganda increased from 9,052 to more than 3.4 million. However, an estimated 4.2 million men and boys between the age of 10-49 years remain uncircumcised.

In terms of funding, U.S President's Emergency Plan for AIDS Relief (PEPFAR) continues to be the principal donor for VMMC – supporting about 85% of all circumcisions during this period.

"If it has taken us 6 years to circumcise 3.4 million men then definitely its going to be tricky reaching the 4.2 million uncircumcised men by 2020 and given that Uganda's targets are used to meet the global targets this is going to impact on the global performance," said Kenneth Mwehonge -Program Officer- Advocacy & Networking Coalition for Health Promotion and Social Development (HEPS Uganda).

The report shows that the proportion of men circumcised ranges from 14% in Mid Northern region to 69% in Mid-Eastern region. The prevalence of male circumcision was highest among young people l5-29 years at over 45%.

It also shows that about 6% of of Uganda's adult population aged 15-49 years in Uganda are living with HIV. Among children under five and 5- 14 years, HIV prevalence is 0.5%. Based on the survey results, the total number of adults and children of all ages living with HIV in Uganda is estimated to be approximately 1.3million.

The 2016 UPHIA, is a nationwide survey that was conducted to provide estimates of HIV incidence, HIV prevalence, viral load suppression, syphilis, hepatitisB infection, and other important HIV/AIDS programme indicators. 

Data were collected in all districts of the country from a sample of households that are representative of the Ugandan population. The survey was conducted from August 2016 to March 2017 from 12,483 households and achieved very high participation rates of over 95% for both interviews and blood draws.

A total of 16,670 women and 12,354 men aged 15-64 years were interviewed and tested for HIV, syphilis and hepatitisB. In addition, 10,345 children aged 0-14years were tested, including 6,527 aged, 0-4years and 3,818 aged 5-14 years. 

The 2016 UPHIA was led by the Government of Uganda and conducted by the Ministry of Health in collaboration with ICAP at the Columbia University. Funding for the survey was provided by the U.S President's Emergency Plan for AIDS Relief . 

Technical assistance was by the U. S Center for Disease Control and Prevention (CDC) other collaborating partners included Uganda Virus Research Institute, Uganda Bureau of Statistics, WHO and UNAIDS. 

In the survey results released on 17th August, adult HIV prevalence was found higher among women at 7.5% compared to 4.3% among men. The HIV prevalence among young people 15-24 years was 2.1% (0.8% in men and, 3.3% among women). 

Among adults, HIV prevalence is lowest in those 15-19 years and highest among men aged 45 to 49 years at 14%. Among women, HIV prevalence is highest in the age groups of 35 to 39 years and 45 to 49 years at 12.9% and 12.8% respectively. 

"Let us first first salute everyone involved in the fight against HIV as there is something to celebrate in terms of the general HIV prevalence in Uganda, however when we dis-aggregate data, we realize that there is a significant increase of prevalence among certain categories of people like adolescents, young girls and women," said Mwehonge.

It was also higher among residents of urban areas at 7.1% compared to 5.5% in rural areas.  There was also differing magnitude depending on the geographical region from 2.8% in West Nile, 3.4% in North East region, 4.4% in East Central(or Busoga region); 4.8% in Mid-East region; 5.5% in Mid-West region. 

The survey found HIV prevalence was higher in urban areas at 6.6% in Kampala; 7.4% in Central 2 (Greater Mubende, Luwero and Mukono); 7.6% in central region (greater Masaka) to 7.7% in south Western region. This is similar to the findings of the 2011 Uganda AIDS Indicator Survey (UAIS) when Mid-Eastern showed the lowest and Central the highest estimated HIV prevalence, a press statement from the Ministry of Health said.

The 2011 UgandaAIDS Indicator Survey estimated national HIV prevalence among adults at 7.3% compared to 6.0% in the 2016 UPHIA. Among women and men, HIV prevalence declined from 8.3% and 6.1% in 2011 to 7.5% and 4.3% in 2016 respectively.

In urban areas, it declined from 8.7% to 7.1%, while in rural areas it fell from 7.0% to 5.5%. These declines in HIV prevalence may be due to a decreasing number of new infections in recent years due to the impact of the intensified HIV prevention and treatment services in the country.
 
The 2016 UPHIA also established the rates undetectable virus or suppressed HIV viral load(VLS). UPHIA showed that adults age 15-49 years had a VLS of 57.4%. This finding shows that with support from development partners such as PEPFAR, the Global Fund and other programs, the Government of Uganda's HfV programme is having an impact and making great progress toward the UNAIDS and national goal of having population level VLS of at least 73% by 2020.

Data from UPHIA identified existing gaps in HIV programmes and specific populations that need special focus. For instance, HIV prevalence the 15-19 year olds was 1.1% (1.8%in girls and 0.5% in boys) there was an increase to 3.3% among those aged 20-24 years (5.1% in young women and 1.3% in young men) which suggests that new infections remain an issue in these age groups said the Ministry of Health statement.

"This continuing infection risk necessitates innovative interventions to prevent new infections in young people beginning around age 20."

Furthermore, women 15-24 and men under 35 years of age who are living with HIV have rates of VLS <500h. 'These lower rates of VLS are driven by younger people being unaware of their HIV status and not accessing available services. Interventions are needed to ensure young people know their statusand if HIV positive are linked to care.

UPHIA also established the magnitude of syphilis and hepatitisB infection in the general population. The prevalence of active syphilis among adults aged 15- 49 years was l.9% (2% among women and 1.8% among men).This was similar to the findings in 2011, in which the prevalence of syphilis was l.8%. 

The prevalence of active hepatitisB infection among adults was 4.3% (5.6% among men and 3.l% among women). HepatitisB prevalence was highest in the Northern Region, Mid North(4.6%), followed by North East(4.4%), and WestNile (3.S%).

HepatitisB infectionwaslower in the rest of the country with a range of 0.8% in the South West region to 2.7% in East Central Region. The preliminary results of 2016 UPHIA demonstrate that Uganda has made significant progress in the national HIV as HIV prevalence has declined across socio-demographic subgroups and across the country.

"This decline may be a result of falling new HIV infections. Furthermore, almost 60%of people living with HIV (PLHIV) have undetectable HIV, which means that treatment programs are successfully reaching the majority of the population with HIV," said the MoH statement. But there needs to be more  prevention awareness creation and treatment is needed for those 15-29 years.

"Moving forward, the PHIA results demonstrate the urgent need to prioritize and fast track the roll-out of high impact interventions if we are to meet the global set targets and achieve epidemic control," said Mwehonge.

"There is need for innovative approaches to reach the 4.2m men by 2020 especially the men between 45-49 years whose HIV prevelance was reported at 14%," Sylvia Nakasi, Policy and Advocacy Officer, Uganda Network of AIDS Service Organisations (UNASO).

"With the launch of the Presidential Fast Track Intiative to end HIV by 2030 in June 2017 by the President,  I hope there is an opportunity to increase investment in prevention and care interventions among vulnerable populations. With this pronouncement its an opportunity to advocacte and hold our leadership accountable," concluded Nakasi.

ends

Friday, August 11, 2017

Media Role in Africa Research

The New Vision Letter's page reaction to sperm count article 
The New Vision cartoon on the sperm count article








































By Esther Nakkazi 

On July 31st we published a news release from a paper published in the African Health sciences journal.

I and a team from the journal as well as Bernard Appiah based at Texas A&M now volunteer to do this for some of the exciting papers published in this journal. It helps that is is open access. 

I help further do the dissemination because of my contacts most of whom I got from my work with the World Federation of Science journalists. 

And I immediately put it out on my blog this one - it has a few eyeballs, 56 today, compared to my other posts, which make it to over 100+ instantly. 

We went into this mode after I met most of these people at a 'building the bridges' 26-28th April, workshop in Kampala that was sponsored by the US National Library of Medicine with partners like Association of Health Care Journalists, Partnerships in Health Information (Phi) and the Alfred Friendly Press Partners.

We are all volunteers in this so we help each other out without really meeting physically. All of us are busy! But what we really aim to achieve is to help Africans appreciate research,  so I think the letter and the cartoon ↑- I didn't add the article written by the New Vision yet -but I will- its offline,  are just a good start to have this conversation. 

We also want African researchers and scientists to be seen not only in 'peer reviewed journals'  but also by their own African media. Maybe, that will improve the way Africans view research and ultimately African governments will fund research more. What they put in now is just peanuts. Africans will do research with their own agenda we hope. That will be super. I am just thinking aloud!

So here below I highlight the author and co-author's reaction and some people just called me to express themselves about the article. 

Uchenna I Nwagha, Professor of Obstetric Biology and Reproductive Medicine, Department of Obstetrics and Gynecology/Physiology College of Medicine, University of Nigeria, Enugu Campus (co-author of the paper). This is reaction to the letter published in The New Vision by Patrck Odongo

I am happy with the controversy generated by this topic. We performed a systematic review of the studies available at our disposal since we did not get any RCT on the subject matter in the African population.

We are aware that our conclusions do not provide a grade A evidence but at least, it provided some epidemiological evidence. It is thus not right for Paul Odongo to dismiss our findings just like that considering the peculiar socio-economic characteristics of the study population.

We are very much aware that it is only a systematic review and meta-analysis with RCT, which give the highest degree of evidence. However, we did not find any RCT but used epidemiological studies to raise the alarm

Even case reports or expert opinions are not dismissed in scientific circles as they too provide some degree of evidence for a new situation or escalation of an existing problem. I know that most people have encountered this situation in their day to day clinical practice but have been unable to put them down due to the lack of writing culture. We worked with what was available, followed strict guidelines, and came up with some evidence, which is a cause for worry.

One researcher called me to ask why the paper did not talk about sperm quality. He said it is not the the count but the quality that matters. Here is Dr Pallav Sengupta, the head of Physiology Unit, Faculty of Medicine, Lincoln University College, Malaysia reaction. He was the principal investigator and I sent that concern to him.

Our report is on sperm count only, not semen quality. Semen quality includes four parameters: semen volume, sperm count, sperm morphology and sperm motility. Our report is not describing changes in other parameters, it is entirely concerned on sperm count changes.

This newspaper report is describing some weaknesses of this study. We appreciate it. It will definitely help us to improve the quality of our future articles.

We are patting ourselves on the back as we await more comments and as we think of writing another press release from another paper from the African Health Sciences journal!



Tuesday, August 8, 2017

Funding Cancer; Today’s research is treatment tomorrow

By Esther Nakkazi

On 8th August 1967, the lymphoma treatment research centre was born in Uganda. The Irish surgeon, Denis Burkitt who was treating tropical diseases was interested in Burkitt’s Lymphoma - a highly curable paediatric lymphoma.

This disease, which was later named after the Irish surgeon, was a strikingly disfiguring tumour, with malaria and viruses as causative factors and was commonly manifested among the young male population.

In 1972, when Uganda’s president Idi Amin threw out all foreigners from the country, the expatriates left the lymphoma treatment centre in the able hands of Prof Charles Olweny. Olweny and his staff kept the UCI alive and thriving, they followed up almost all their patients.

Dr. Tom Tomusange (RIP) and his team navigated through thickets and roadless places during these patient safaris to follow up on patients. As a result, for a patient cohort of over 200 patients only about 6 were lost to follow up. That was just one of the successes.

At a press conference to mark 50 years, today, Dr. Marissa Mika, a historian and anthropologist who has been studying the history of cancer in Uganda since 2010, took us through the 1950s, 1960s and 1970s, when UCI conducted cutting edge chemotherapy clinical research trials on Burkitt’s lymphoma.

According to Dr. Mika, the data from these clinical trials continues to inform treatment protocols across the globe. Also for its excellent work at that time, the UCI won the Lasker award for research on Burkitt’s lymphoma in 1972.

It was no easy feat for UCI to be bestowed upon the Lasker award, about the equivalent of today’s noble prize, but they had done profound research against Burkitt's lymphoma, which could be put into remission and eventually healed and with very limited funding.

As the lymphoma treatment centre now the Uganda Cancer Institute (UCI), turns half a Century old, it is also celebrated as the oldest cancer research and public oncology facility in Africa. Recently, it was designated as a centre for excellence in oncology by the East African Development Bank.

“UCI is making an impact in East Africa and it is on its way to becoming an example in Africa,” said Jackson Orem the executive director of UCI.

But what can it take for UCI to win the Lasker award again? And does it mean Uganda Burkitt’s lymphoma was wiped out and is no more? Unfortunately not. Burkitt’s lymphoma continues to be a major paediatric problem in Uganda.

The problem according to Dr. Orem is that the gains that were made at the time Burkitt’s lymphoma was healed were never followed up. The other problem is limited funding for cancer.

“When investment in an area is made it should be followed up. In 1967 they were emphasising generation of new knowledge. We are trying to put that back at UCI,” said Dr. Orem at the half Century mark.

The man at the helm of UCI says unlike other African countries that may be waiting for ready made solutions, his Institute is putting research at the forefront of fighting cancer.

But we all know that research is impossible without funding. And to this he says; research must be funded. It should not be considered a luxury. For today’s research is tomorrow’s treatment.

Ultimately, at the UCI, the research that was done 50 years ago is treatment today.

ends

Monday, August 7, 2017

Uganda to set Sweetpotato Seed Standards

By Esther Nakkazi

Uganda is creating a sweetpotato seed system with standards for inspection and certification.

Under the seed system farmers will buy clean, high quality planting materials from certified suppliers, which will ensure high yields and reduce the spread of pests and diseases.

Sweetpotato is vegetatively propagated where each cropping cycle is started by planting vine cuttings or root sprouts most of them sourced from farmers own fields or their neighbors.

This way there is no check on the quality of vines planted and increases the risk of spreading diseases despite farmers’ efforts to select healthy-looking vines. This also facilitates accumulation of pests and diseases leading to significant decline in yield. But this will change.

“We have developed and piloted seed standards and inspection procedures for sweetpotato so that farmers can access quality planting material of the right varieties and at the right time,” said Dr. Godfrey Asea, the director, National Crops Research Resource Institute (NaCRRI)

The sweetpotato standards have been developed with leadership from Prof Settumba B Mukasa, a plant genetic and lecturer at the school of Agricultural Science Makerere University who is working with the Phytosanitary and Quarantine Services of the Ministry of Agriculture and Fisheries (MAAIF), HarvestPlus, International Potato Center (CIP) and other seed system stakeholders.

“The standards are currently in form of technical guidelines for field inspection primarily based on tolerance levels for visual disease readings, pest incidence varietal mixtures in the seed crop, land use history, source of planting material for the seed crop and laboratory testing,” said Prof Settumba.

As well, the team is also developing inspection instructional materials for sensitizing, training and technically empowering the plant inspectors, seed producers, laboratory operators, and net protected nursery multipliers, said Prof Settumba.

For Uganda and the other sub-Saharan countries that are members of the Sweetpotato for Profit and Health Initiative (SPHI) it is key to have policies that would ensure sustainability of a model of production for delivery of quality planting material.

The SPHI with 11 participating countries ̶ Burkina Faso, Ethiopia, Ghana, Kenya, Malawi, Mozambique, Nigeria, Tanzania, Burundi, Uganda̶̶ and Zambia have a target of reaching 10 million households in sub-Saharan Africa by 2020.

To reach this goal, the provision of quality sweetpotato seed or planting material is critical and it requires strong seed systems, said Margaret McEwan, senior project manager for sweetpotato seed systems at International Potato Center.

Participants from SPHI participating countries meeting in Uganda last month under the annual ‘Community of Practise’ get togather exchanged information on how to create and sustain sweetpotato seed systems.

“Scaling up sweetpotato seed systems is not only about the technologies, but also the factors which create an enabling policy environment, the social and behavioural change and new organizational arrangements which are needed, so that farmers can access quality sweetpotato planting material of the right varieties, at the right time,” said Asea.

Prof Settumba emphasised the same issue saying although there are a number of seed classification systems, whatever system is used, standards and guidelines are set by the government.

As well, to maintain sweetpotato seed systems, there is need to identify policy issues that would ensure sustainability of a model of production and delivery of quality planting material,” said Settumba.

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Tuesday, August 1, 2017

72% decline in sperm count in African men over 50 years

By Esther Nakkazi

A press release from the African Health Sciences says sperm count for African men has declined by 72% over the past 50 years. The data is from a paper published in the African Health Sciences journal of June 2017.

“This is a threat to the procreation of the future generations,” said Dr. Pallav Sengupta, the head of Physiology Unit, Faculty of Medicine, Lincoln University College, Malaysia.

“I was amazed at the magnitude of the problem. 72% decline over time is a dangerous downward trend.This situation is indeed scary,” said Uchenna I Nwagha, Professor of Obstetrics Biology and Reproductive Medicine, Department of Obstetrics and Gynecology/Physiology College of Medicine, University of Nigeria, Enugu Campus.

The current concentration is also very near to the World Health Organisation (WHO) cut-off value of 2010 of 15×106/ml, which is a major issue of concern.

The data is also in line with other studies of other men worldwide.

After a systematic review and meta-analysis that retrieved data following MOOSE guidelines and PRISMA checklist, they found that the major possible causes are poorly treated sexually transmitted infections (STIs) and hormonal abnormalities, consumption of excessive alcohol and tobacco smoking.

Other published articles cited exposure to pesticides and heavy metals as principal triggers of decreased sperm count among African men.

"We have put forth the evidence of the decline and discussed various causative factors over the past 50 years like lifestyle, food habits, disease prevalence and others,” said Dr. Sengupta also the lead author.

“More than one factor is involved in this decreasing trend, correlation with a single factor is difficult to establish. But we are also working on their correlations for our upcoming reports,” said Dr. Sengupta.

In the meta-analysis conducted, the researchers retrieved data from fourteen studies that have been conducted during 1965 and 2015 on altering sperm concentration in the African male. The studies were done in Nigeria, Tunisia, Tanzania, Libya, and Egypt among males aged 19 to 55 years.

After analysis of this data, a time-dependent decline of sperm concentration (r = -0.597, p = 0.02) and an overall 72.6% decrease in mean sperm concentration was noted in the past 50 years.

In 1991, WHO estimated that almost 20-35 million couples were infertile in Africa. Nigeria was suggested to have been suffering from highest infertility problems among the other African countries, the male infertility factor accounting for 40-50%.

“In recent times, in the course of managing infertility in Nigeria, I have observed the apparent decline in sperm count in men and a decrease in ovarian reserve over time in women,” said Prof Nwagha.

Said Prof Nwagha, “Apart from lifestyle and others, one situation in Nigeria is the effect of environmental toxins from generators. Most Nigerians rely on generator sets for electricity as public power is grossly inadequate, unreliable and epileptic, in the face of enormous urbanization and deforestation. The resultant effect of the environmental toxins from generator fumes on the germ cells over time may be a significant contributor to what we are experiencing today.”

“We, therefore, advocate for more epidemiological studies to identify the possible etiological factors to enable us to halt this dangerous trend, and to avoid natural reproductive extinction,” added Prof Nwagha

Other studies have shown a significant decrease in sperm concentration worldwide in men in North America, Europe, and New Zealand. Overall studies show a 57% decline in sperm count worldwide from 1980.

Other researchers in the study included Dr. Emmanuel Izuka from the College of Medicine, University of Nigeria, Enugu Campus, Nigeria and Dr. Sulagna Dutta of Lincoln University College, Malaysia.
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Tuesday, June 6, 2017

Pregnant African Women’s Neglected Disease

By Esther Nakkazi

Twenty-two year old Lorriane Akampurira thought she had minor problems with her pregnancy. Her feet were swollen. Later her whole body too. It was her first pregnancy.

“People started saying that it was because I was carrying twins. Others said the baby was big,” said Lorraine. When she started feeling real sick she went to hospital. At that point her whole body was swollen like ‘there was water in it and it could burst anytime.’

Lorraine's husband was worried all the time but had no answers. They are a young couple, newly married and with no experience. “My wife could not sleep at night yet people kept on saying the body swelling was normal. She was in pain all night, very night. I kept on asking myself about this normal swelling?,” said Mr. Akampurira.

When Lorraine arrived at the hospital, one look at her from the doctor was enough. The baby had to be removed immediately in order to save the life of mother and baby. She was diagnosed with Pre-eclampsia.

Pre-eclampsia and eclampsia remain ‘neglected diseases’ among African women.

On 22nd May, the Akampuliras joined the rest of the world to commemorate the inaugural world Pre-eclampsia day. In Uganda, the event was organised by the Health Systems Advocacy Partnership (HSAP) project under the theme; ‘Take the Pre-eclampsia Pledge; know the symptoms. Spread the word.’

Pre-eclampsia is a common pregnancy complication that is characterised by new-onset of hypertension. Studies show that women in the developing world are 300 times more at risk of dying from pre-eclampsia.

In Uganda, 368 women die from pregnancy and childbirth-related causes per 100,000 live births and hypertensive disorder, or pre-eclampsia and eclampsia is the second most common cause of maternal death after postpartum haemorrhage.

The cause of pre-eclampsia is unclear but it has been observed to run in families suggesting that there is a genetic predisposition to it. It is still an unknown disease, with no local language equivalent and no clinically useful screening test. Health workers can detect pre-eclampsia by diagnosing persistent hypertension and the presence of protein in urine.

Dr Annettee Nakimuli, the head of the gynaecology and obstetrics department at Mulago referral hospital said at least 4 women die per day at Mulago due to pre-eclampsia and it is responsible for 8% of admissions of pregnant women at this hospital.

Nakimuli said the condition presents with signs like swelling of the body but generally there is no pain. Because of this many women suffer ignorantly. On top of this, pre-eclampsia is surrounded by myths; some say it is witchcraft, a pregnancy of twins, a baby girl as well it is labelled as ‘a disease of cheating women.’

Nakimuli said all women are at risk but more so those in the extreme age bracket; below 19 or over 40 years of age as well as those who get pregnant through IVF.

When Lorraine’s baby girl was delivered at six months she was assured that the body swelling would stop but it did not. Even as she attended this world pre-eclampsia day, her legs were still swollen. She also suffered from kidney disease and was on her way to hospital for another check up of her heart which could have been damaged.

The Akampurira’s baby lived for only nine days and died. She had breathing problems.

In Uganda, pre-eclampsia is also the leading cause of pre-marital birth. The babies are usually born pre-term, they are small for age and their survival is limited.

“Death is the worst. Women with pre-eclampsia get complications and remain sick forever,” said Nakimuli. Complications include stroke, breathing problems, kidney failure, cardiovascular disease and others.

At Mulago, the gynaecology and obstetrics Unit remits the biggest number of patients for dialysis. “The urologists are always complaining to us because we send them the most patients,” said Nakimuli. 

Efforts to end pre-eclampsia in Uganda;

On 22nd May, the Health Systems Advocacy Partnership (HSAP), a project seeking to bring stronger health systems so people in Sub-Saharan Africa, particularly Uganda gain better access to sexual and reproductive health services joined the world to bring attention to pre-eclampsia and other hypertensive disorders.

“Hypertensive disorders are not rare complications of pregnancy,” said Denis Kibira the executive director of HEPS-Uganda. Kibira said the government needs to expand access to proven under utilised interventions and commodities for prevention as well as avail early detection and treatment of pre-eclampsia and eclampsia.

Luckily, Uganda knows what to do with pre-eclampsia but there are still some hurdles along the way.

Dr. Jessica Nsungwa Sabiiti, the commissioner in charge of Reproductive Health at the Ministry of Health said Uganda has a policy that recommends the use of Magnesium Sulphate, for use for women suffering from pre-eclampsia.

Magnesium Sulphate, a cheap drug, is one of the 13 UN Lifesaving Commodities for women and children on the Uganda national essential medicine list. Its overall availability in Uganda health facilities is 77 percent.

Unfortunately, health workers especially nurses and midwives, who are the first contact for mothers with pre-eclampsia are not prescribing the drug, said Nsungwa. “They fear the toxicity so their lack of confidence prevents them from prescribing it.”

As a result of fear to prescribe, the nurses wait for the doctors at the detriment of the mother’s health and yet there are just a few of these in primary health care.

But with the awareness growing and government committed to train health workers there is some light at the end of the tunnel. Let alone the condition getting world recognition.

“I was so excited that there is at last world pre-eclampsia day. It will create awareness. We are on our way to success,” said Nakimuli.

After the event, Akampurira and her husband said they were on their way to pick the ‘heart-health’ results from the hospital. Hopefully, the young couple will have the next baby survive.

ends.