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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 back ground 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 they 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 grows bigger the local sponsors become fewer. Save for government officials coming over to open and close these, the government is not injecting money in such events.

I also know that for this years 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, these are 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 them 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 such events, which are 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 realise 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 champion diversity. And many products from Mbarara University’s innovations ecosystem will be in the healthcare space soon like Sanidrop, a locally made hand sanitiser that is yet to be commercialised - and again this has been delayed by a government agency that can’t do its work.

So I suggest that next year, a crowd fund should be set up so that the Mbarara University alumni and anyone like me who cares for innovation and healthcare in this country contributes.

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.

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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.

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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.

ends

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 Obstetric 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 evidences 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 life style 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.
ends
ends

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.

Wednesday, May 17, 2017

40 years after the first Ebola outbreak are we able to handle the next epidemic?


By Esther Nakkazi

(An edited version of this piece was published in The EastAfrican newspaper (no link) in September 2016. I wrote it when I was a resident Journalist at the Institute of Tropical Medicine. Just uploaded it in light of the recent Ebola outbreak in DRC)

Driven by discoveries over the last 40 years since the first Ebola outbreak, scientists are optimistic that the new tools and data at hand will limit the damage for the next epidemic.

Since September, 1976, in Yambuku, Zaire - now the Democratic Republic of Congo, when the first outbreak of the disease was reported, 25 Ebola outbreaks have happened but the 2014 West African outbreak was unprecedented.

In nearly two years in three countries there were 11,000 deaths. Over Ebola’s existence of 40 years, 30,900 cumulative cases have occurred with12,800 deaths at an annual average death of 322. 

At the 8th International Symposium on Filoviruses in Antwerp, Belgium, hosted by the Antwerp Institute of Tropical Medicine, on 12-15 September 2016, which reviewed global progress against Ebola, scientists said they have enough Ebola arsenal; vaccines, diagnostics, clinical data and therapeutics ready for the next epidemic.

For the academia and researchers, so much has been discovered over the past 40 years. As Micheal Kurilla, the director biodefence research at the National Institute of Allergy and Infectious Diseases said at the symposium, ‘the once one pager on hemorrhagic fever in text books is now being constantly rewritten and updated.’

“The silver lining of the epidemic is that there has been some solid research from epidemiological, social, anthropological, therapeutic and vaccine research,” said Peter Piot the director of the London School of Hygiene and Tropical Medicine, UK.

Three microbiologists, Professors Peter Piot, Guido van der Groen and Jean-Jacques Muyembe are no strangers to Ebola. The two Belgians received the first ‘unknown’ virus at the Antwerp Institute of Tropical Medicine from the former who sent it from Kisansha and they discovered Ebola.

Top insights on research:

Ebola is not all the time killing it can also save some lives. ITM spearheaded the use of blood and plasma from recovered patients to cure victims although it was not very successful and has since developed diagnostics.

“We have moved relatively quickly, gained a lot of time and learned a lot of things on how to do things better,” said Prof. Dr. Johan Van Griensven who heads the HIV and Neglected Tropical Diseases Unit at ITM.

There is also a general desire to progress Ebola R&D faster through initiatives like the coalition for epidemic preparedness innovations which is creating partnerships and giving incentives to develop vaccines, therapeutics and diagnostics where there is no market to contain outbreaks of emerging infectious diseases. This is at the back drop of limited epidemic R&D market incentives.

There are also efforts to share data and not duplicate funding. What happened in the West African outbreak was terrible. Chinese came in just to pick samples, institutions owned data and refused to share it.

Now efforts have been made to share data and to encourage players to play into each other’s comparative advantage, said Dr. Barbara Kerstiens, the deputy Head Fighting Infectious Diseases and Advancing Public Health Unit, DG for Research and Innovation at the European Commission.

Overall, the WHO has also made harmonised clinical trials a blue print plan for action.

Various pharmaceutical companies have also gone ahead to develop vaccines. On 12 September, Johnson & Johnson, announced that its subsidiary Janssen Vaccines & Prevention B.V had submitted its investigational preventive Ebola prime-boost vaccine regimen to the World Health Organisation (WHO) to be used in emergencies.

“If listed for emergency use, the investigational Janssen vaccine regimen could be a vital prevention tool for rapid outbreak response,” said Johan Van Hoof, Global Therapeutic Area Head, Infectious Diseases and Vaccines, Janssen Pharmaceutical Companies.

It would particularly be available for health workers and vulnerable communities on the front-lines who suffer the most in Ebola outbreaks. It has already been tested and passed in animal models and for safety.

Many other vaccines have passed the test for animal models - which do not necessarily represent the pathogenesis - that occurs in humans. For many Ebola vaccines and treatments when scientists caused disease in rodent species they would be mildly affected although it was deadly in humans. Scientists therefore did not know which animal models would be predictive and this limited advancing.

When the outbreak happened in West Africa everything changed. It was a windfall. The unexpected opportunity to test the animal models under real life conditions was presented.

“It gave us an opportunity to advance and focus on the most appropriate animal models so that the future counter measures will have a much higher probability of success in the next outbreak” said Kurilla. “We got a lot of ‘proof of concept’ for interventions although at some point it was less than ideal to move forward.”

Furthermore, there are new lessons to learn from long studies. For instance, 40 years ago it was unknown that the Ebola virus is spread sexually and that it survives in survivors bodies for a long time 

And a lot to learn from research that did not work like the ITM convalescent plasma treatment that had held a lot of hope. “Data should not be undervalued because showing that something does not work is equally as important and has enormous value,” said Kurilla.

It is also new research that age and viral load where key determinants for the survival against Ebola, not necessarily solely supportive care as many thought.

The WestAfrican Ebola outbreak flipped to the usual; a humanitarian emergency having outbreaks to an outbreak becoming a humanitarian emergency. There were also unnecessary delays and a reluctance both government and international community levels to consider it a humanitarian crisis and not just another health problem until gears shifted.

Thus, institutions like World Health Organisation have made reforms. With no historical formal mechanism in countries for managing outbreaks but a clear architecture in the way humanitarian crisis are managed for conflict and natural disasters changes are underway.

“Previously, the humanitarian and outbreak departments were separate but they are now merged,” said Dr. Rick Brennan the Director, Emergency Risk Management and Humanitarian Response at WHO.

WHO is also working to create a system with standard procedures to support a more predictable mechanism with better leadership and coordination especially working to leverage that capacity to manage large scale outbreaks, said Brennan.

“We need more experience of the humanitarian sector, which is dominated by logistics, organisation, coordination that could be more boring and bureaucratic but I believe we need more of that in the first place,” said Piot.

WHO has also linked up with the World Bank for a ‘unified framework for preparedness’ . This will strengthen preparedness at the country level not just for outbreaks but for emergencies.

The reasoning is that every country is prone to emergencies and its capacity to respond to them needs a baseline study to understand the average patterns faced and how they can prepare.

“We have done this because regardless of the event there are some basics that you always need,” said Brennan. These include good medicine management, information capacity, communication capacities, strong logistic.

WHO has also put in place a special procedure to fast track R&D the WHO Emergency Use Assessment and Listing (EUAL) that can be implemented when there is an outbreak with high rates of morbidity and mortality and a lack of treatment or prevention options.

Janssen Vaccines & Prevention B.V has submitted its investigational preventive Ebola prime-boost vaccine regimen for it.

“If the WHO grants an emergency use listing, this will accelerate the availability of Janssen’s investigational vaccine regimen to the international community in the event another Ebola crisis occurs,” said Paul Stoffels, the Chief Scientific Officer, Johnson & Johnson.

The DRC which has recorded seven outbreaks, the highest ever in a single country, also has lessons. At the epic of the West Africa outbreak it had its own.

“The first thing is to detect, report and test. We now have a good surveillance system and we have trained some health workers,” said Prof Muyembe.

Muyembe who leads the national coordinating committee on Ebola in the country and is the director general of the National Institute of Biomedical Research (INRB) said these are key ingredients to control the virus.

In addition, there is strong community engagement and ownership to implement, control and prevent Ebola. For them dialogue is important and only negotiated solutions are implemented. Ebola survivors are used to disseminate information.

“Many people can now identify Ebola. If the outbreak happened right now they would know exactly what to do,” said Muyembe.

“I think that indirectly DRC demonstrates that you can control this epidemic in the absence of a fantastic health system. A strong leadership, experience and an equipped laboratory were able to bring the epidemic under control,” said Piot.

But the environment was also very different. Currently, the urgency has waned. Unless something is done it is back to business as usual.

In 1977, Piot a young doctor, attended his first WHO meeting after visiting Yambuku. At the WHO meeting strong statements were made like ‘we shall invest in epidemic preparedness, support to build health systems and primary health care’ and believed it.

In 2015 Piot travelled with Muyembe back to Yambuku to see what had come of all the promises.

“We arrived at the mission and what we saw was very sad. A nurse survivor who had survived Ebola in 1976 was there. He runs the hospital laboratory of the hospital. He has a decent microscope and some reagents and that is it. No one pays him.”

Except for tonnes of plumpy’nut which is not required in this region that hardly suffers from malnutrition, there were no anti-HIV and malaria drugs.

“We owe it to the people who died in this epidemics to do much better. When the headlines have gone we should continue with the work,” said Piot.

ends

(An edited version of this piece was published in The EastAfrican newspaper in September 2016. I wrote it when I was a resident Journalist at the Institute of Tropical Medicine. Just uploaded it in light of the recent Ebola outbreak in DRC

Monday, May 8, 2017

Building Capacity for REDD+ among Academia in East Africa

By Esther Nakkazi

Reducing Emissions from Deforestation and forest Degradation (REDD) is a complex subject and so is having academia research about it.

But a project to build capacity for higher education and research on climate change for improved ecosystem health through reduced greenhouse gas emissions and sustainable livelihoods has managed to do just that in East Africa.

The REDD-EA project is a five year project (2014 - 2018) that supports masters, PhD and post graduate studies at Makerere University in Uganda and the University of Dar-es-Salaam (UDS) in Tanzania with short stays at Norwegian University of Life Sciences.

Funded to the tune of $3m by the Norwegian Programme for Capacity Development in Higher Education and Research for Development (NORHED), the project has largely remained on track- meaning they have so far achieved their target.

Prof John Tabuti at the department of Environment Management Makerere University said the first batch of fellowships is on track at both universities. In total, Uganda will build capacity for 34 and Tanzania 15 students.

But like all REDD+ projects, which remains a complex subject, implementers still think that like any other such to have an impact even the academia need to focus on one issue - community engagement.

Officials say that without doubt, community understanding is at the heart of REDD+ projects to be successful. Why? Most of the projects work with communities. Since REDD+ is defined as a multilateral policy that is meant to reward actions that conserve forests, communities are at the core of their success.

The REDD+EA project overall aims to strengthen scientific and institutional capacity of academic institutions to deliver quality research on REDD+ and to generate evidence based results for policy, said Tabuti also the principal investigator of the REDD-EA project.

So far, Uganda has trained 7 PhDs and 24 masters, while the University of Dar-es-Salaam is training 6 PhDs and 6 masters. More students will be recruited this academic year said Tabuti.

In Tanzania, ‘Students are already at various stages of their research and dissertation writing. They are expected to translate their theses into scientific papers as a way of wider dissemination of their findings,’ said Dr Edmund Mabhuye a faculty member center for climate change studies at the University of Dar-es-Salaam.

The trained students will also ensure that functional and specialized training programs on REDD+ are created within universities, according to the REDD-EA project aims.

Kellen Aganyira a PhD student at Makerere university on the REDD-EA project fellowship said the opportunity for research and capacity building in higher education for REDD+ can only be got from such projects.

“Building our capacity as researchers is important. If we go down there and find out what is happening on the ground we inform policy makers,” said Aganyira.

“Training researchers is one way of reaching many practitioners since one researcher can disseminate knowledge to stakeholders across scales and levels,” said Mabhuye by email.

Doing it differently;

REDD+ is defined as a multilateral policy meant to reward actions that conserve forests. It involves payment through carbon credits. Since it is communities that should conserve forests, their participation and understanding is key for them to consent and protect forests if the projects have to succeed.

But it is a difficult concept to understand. For instance researchers report farmers asking them how they should pack carbon in order to sell it. Aganyira whose PhD is focussed on community participation in carbon projects agrees that it is a difficult sell.

“Communities do not seem to understand how they arrive at the amounts paid to them,” she said.
And that is not all. The carbon money delays so much that communities loose interest and land policies do not make it any easier. While payments require legal documents of ownership of land most forest land is communally owned.

It was therefore imperative for the REDD-EA project to focus on a deeper understanding of one topic - community engagement. Instead most REDD-EA fellowships students focussed on a wide rage of topics ranging from land tenure, community understanding, carbon in wetlands, carbon credits, REDD+ law, economics and a wide range of other topics.

“The challenge was that we went into many directions. I am a bit unhappy because we have not gone so deep,” said Tabuti. “It should have been narrowed down so that all PhDs focus on one theme to deepen our understanding.”

At Makerere University the next intake promises to be focused. “If I had to do this again I would go for community engagement. At the community you want them to understand and make informed choices,” said Tabuti.

ends

Tuesday, April 25, 2017

From Russia With Love; Uganda Nuclear Power Plant

By Esther Nakkazi

On April 19th, the leading Uganda daily newspaper, The New Vision carried on its front page a story ‘Russia to build Nuclear plant for Uganda’. The story went ahead to state that talks about the project are in the final stages.

When I read the story I did not react much but an expat in energy and infrastructure from Holland hung onto the story and was perplexed. He asked me about the Chernobyl disaster and I knew nothing about it but later found time to read about it.

The Chernobyl disaster occurred in April 1986 and is recorded as the most disastrous nuclear plant accident in history. It spilled over the whole of Europe and was costly in terms of cash and casualties. And its still consuming money and causing damage to humans and wildlife.

We could say that the Russians learnt a lot since then and they are the best country to teach us on how to avoid a similar scenario, read- ‘everlasting disaster’ but there are some issues that are so ‘Ugandan’ I do not know that my country can handle nuclear technology, which requires the highest level of safety.

If you travel on Ugandan roads you would be sorry with the level of careless accidents, safety does not exist! If you watch our construction industry you will be alarmed at how buildings collapse half way and kill workers. So you clearly understand that safety is not an issue in Uganda. For the Chernobyl disaster to happen there was among other things an overlap in safety.

If Uganda has to go ahead with this project there some key questions; who will own the nuclear plant? Is it Uganda or Russia?. If it is Uganda do we have the money to sustain it for hundreds of years after the Russians leave? We must be aware that it continues to eat money even when it is generating no money at all. 

The plant will generate radio active waste, which is harmful to people and the environment. Do we have the capacity to handle such waste which causes cancer if it is not well managed?

Where will the it be built? It has to be built near water because it operates with pressurised water, generates steam and needs water for cooling. So I suppose it will be on Lake Victoria or River Nile, all water bodies shared with partner States. The politics of that will be interesting to watch.

Nuclear energy is good so don’t get me wrong. It is the cheapest form of energy and is carbon-dioxide free during production. You can also use its radiation to treat cancer.

But it is also high end technology, requires discipline and I repeat 'maximum level of safety', which at this point I am afraid to say Uganda does not have. So hopefully the Uganda Ministry of Energy officials who are okaying this project have the capacity to question some of these issues and others that I may not mention here before the project takes off.

Wednesday, April 19, 2017

Stellenbosch University Software Donation troubles Makerere

By Esther Nakkazi

Makerere University will upgrade or all togather overhaul its system responsible for storage of administration, finance and student data, officials said.

The International Tertiary System (ITS) that integrates finance, human resource and academic data was brought in to Makerere from Stellenbosch University about ten years ago. It was a donation costing about $700,000.

However, Makerere University officials say their staff in the academic Registrar’s department who have already been arrested, allegedly tampered with the system which, caused a delay in issuance of transcripts to students who graduated in February this year. But some sources say this is not the case.
The staff also allegedly altered students’s marks and listed some 58 students into the 67th graduation booklet. Makerere administration has been apologising to the affected students and promised quick action.

Now the University wants to upgrade the ITS, which is unique and was tailor-made for Stellenbosch university, and has also since become obsolete.

“We have been operating a system purchased from South Africa but it is now obsolete that is why some unscrupulous staff managed to beat it. So we shall either upgrade it in the medium term or buy a new system,” said Prof Barnabas Nawangwe, the deputy vice chancellor in charge of finance.

Prof Nawangwe explained that either decision would rely on the cost but only if they failed to agree on upgrading the ITS with a new version would they buy a new system.

When Makerere administration realised that there were anomalies on the 67th graduation list, they halted the issuance of transcripts which affected over 14,895 students.

Prof John Ssentamu Ddumba, Makerere University vice chancellor, instructed the IT team to clean up the system and ensure that it is not tampered with again.

In mid March, Mr. Alfred Masikye, the academic registrar wrote to all university stakeholders alerting them on a temporary shut down in processing transcripts which alarmed the recently graduated students who wanted their transcripts for either further studies or to apply for jobs.

According to Masikye’s communication the university management had discovered that names of 58 students had their marks altered and henceforth withdrew them pending further investigations.

Press reports show that as early as 2015, Makerere withheld about 14,000 students’ transcripts until they verified their results. Prior to that incident, in 2008 a meeting had noted that the ITS was insecure and ill functioning.

A source who did not want to be named told this reporter that since inception, the ITS has always had major flaws and was incompatible with Makerere University.

One of the reasons is that the ITS was never configured to Makerere’s requirements but implemented the way it was working at Stellenbosch University, the source said. “It was like do it here as you did it there. It was also a donation and the administrators could not refuse it.”

Stellenbosch University and Makerere University have major variables. As a software that was tailor-made to Stellenbosch, its failures or repairs meant calling someone from South Africa, which was costly, the source said.

She said the two universities with major differences could not be aligned to fit the ITS at Makerere. For instance while the ITS was using the calendar year in Stellenbosch, Makerere uses an academic year so data inout and storage was a challenge.

Makerere university, as its legacy, has always registered students using registration numbers but the ITS system uses a ten-digit student number. When this anomaly was realised the Makerere administration started issuing student numbers on top of the registration numbers to fit the system.

Users at the administration level complained and they requested that one of numbers be dropped but Makerere had to keep its legacy of registration number so both of them were maintained causing more chaos.

The other issue is that the ITS would allow students to register online only after paying at least 60 percent of the tuition fees. The way the ITS was modelled is that it would automate registration with that data input from finance and enable the student to register.

Since Stellenbosch University is a state-subsided most of its students would have no problem with that requirement but Makerere has been in running battles with students to pay their school fees on time. 

However, another source who also preferred anonymity says the students results management system responsible for input, storage and administration of student marks and production of transcripts was locally designed.

He said Makerere is just not saying the truth about the problem and not effectively managing issuing of transcripts to graduated students on time.

Makerere University officials, however said the two were aligned so the locally made system, which was tampered with by its staff was aligned to the ITS and students records would be imported into it. But the matter would soon be resolved.

Ends.  

Monday, April 3, 2017

Ebola Vaccine induced longest reported immune response

By Esther Nakkazi

An investigational “prime-boost” Ebola vaccine regimen, induced a durable immune response in 100% of healthy volunteers over one year, the longest duration follow-up reported researchers said.

The data was reported in The Journal of the American Medical Association (JAMA) on 14th March. The Phase 1 study is the longest duration follow-up reported for any heterologous prime-boost Ebola vaccine regimen.

This follows recent evidence of the persistence of Ebola virus in bodily fluids and the potential for sexual transmission among Ebola survivors, which reinforce the urgent need for a robust and durable vaccine for the disease.

“The world needs a vaccine to help prevent or mitigate future Ebola outbreaks, and ideally it should provide sustained protection for at-risk populations,” said Paul Stoffels, M.D., Chief Scientific Officer, Johnson & Johnson in a press release.

Janssen’s investigational Ebola vaccine regimen was developed in collaboration with the National Institutes of Health (NIH). The regimen is based on Janssen’s AdVac® technology and MVA-BN®technology from Bavarian Nordic A/S. Johnson & Johnson’s partners in the Ebola program also include Europe’s Innovative Medicines Initiative, the London School of Hygiene & Tropical Medicine, Inserm, and BARDA.

In the Phase 1 study, led by the Oxford Vaccine Group at the University of Oxford, UK, healthy volunteers were given one vaccine dose to prime their immune system and the alternative vaccine to boost their immune response.

The Phase 1 study enrolled healthy participants aged 18 to 50 years. Of 75 active vaccine recipients, 64 attended follow-up at day 360, the latest time point analyzed. No vaccine-associated serious adverse events were observed from day 240 to day 360. All of the active vaccine recipients maintained Ebola virus-specific antibody (immunoglobulin G) responses from the first post-vaccination analysis conducted through to day 360. 

Dr Matthew Snape, Chief Investigator of the study reported that this is the longest duration follow-up for any heterologous prime-boost Ebola vaccine regimen yet published. 

Phase 1, 2 and 3 studies are ongoing to confirm these findings.

A total of 10 clinical studies are being conducted on a parallel track across the U.S., Europe and Africa in support of potential eventual registration for the Ebola vaccine regimen. The first study of the vaccine regimen in a West African country affected by the recent Ebola outbreak began in Sierra Leone in October 2015.

In September 2016, Janssen completed a submission to the World Health Organization (WHO) for Emergency Use Assessment and Listing (EUAL) for the investigational preventive Ebola prime-boost vaccine regimen. 

Janssen in partnership with Bavarian Nordic rapidly scaled up production of the vaccine regimen and now has approximately 1,800,000 regimens available, with the capacity to produce several million regimens if needed.
ends

EU funding to combat illegal fishing on Lake Victoria

Fisheries Managers from Uganda, Kenya and Tanzania



















By Esther Nakkazi
The European Union (EU) will contribute 100,000 Euros to improve monitoring, control and surveillance of Lake Victoria to combat illegal, unreported and unregulated fishing. More funds are expected from partner states.

The EU funds to be available for eight months from April to November 2017, will be managed by the Lake Victoria Fisheries Organisation (LFVO) and given to SmartFish one of the largest regional Programmes for fisheries in Africa.

At a regional consultative meeting held in Entebbe (28-29th March), fisheries managers from three partner states that share Lake Victoria of Uganda, Kenya and Tanzania agreed on a joint action plan.

The fisheries managers agreed to carry out joint patrol activities, registration of fishers, enforcement and support to comply with licensing, marking licensed fishing boats as well as to create awareness and encourage voluntary surrender of illegal fishing gears.

“Pooling of assets, information and knowledge between different countries enables countries to share surveillance and control of fishing,” said Fanjanirina Jérômine, IOC-SmartFish monitoring, control and surveillance (MCS) Assistant.

Patrick Kimani the Kenya regional representative IOC-SmartFish said there is need to sustain MCS activities being undertaken although inspite of these illegal fishing on Lake Victoria persists.

Paul Okware the acting assistant commissioner in charge of regulation and control at the Uganda Ministry of Agriculture, Animal industry and Fisheries commented on how illegal users are increasingly using strange illegal methods and gears.

And while these have also increased catching and trading in immature fish,  harmonising all agencies in enforcement for all partner states has become a nightmare, he said.

Fisheries situation in Uganda:

Lake Victoria partner states currently have different standards. This is true especially after Uganda in November 2015, suspended all operations of Fisheries Officers, Beach Management Units (BMUs) and police - these are pending reforms.

But prior to this there was harmony as fisheries management in Uganda, Kenya and Tanzania was on a single spine command as by 2004, co-management, BMUs and other institutions were in place and harmonised.

However, in Uganda, with time these did not function well as parallel and uncoordinated enforcement systems and officers emerged who pushed the technical officers and BMUs to the side lines thus causing a gap for fisheries illegalities to escalate.

In 2015, Uganda's suspension of BMUs was announced by President Yoweri Museveni who also issued a directive requiring fisheries to form a Fish Protection Unit (FPU) led by an officer from the Presidents office. To that effect a Memorandum of Understanding (MoU) was prepared and in the long run the Fish Bill incorporating reforms will be passed.

BMUs helped to; improve sanitation to meet Fish Quality Assurance and safety requirements, maintain and update registers of BMUs and vet fishers to be licensed, provide fisheries catch and marketing data, implement fisheries regulations and management measures at landing sites as well as develop local fisheries management plans.

Museveni also directed that special courts for fisheries be introduced. He abolished importation of fishing gears and announced imprisonment of 7 years for fisheries offenders. According to Okware, after Museveni's announcement over 300 illegal gears were impounded in 2015/2016.

In the meantime, only 0.3% vessels are licensed in Uganda waters, however, if all vessels were licensed and a formidable enforcement was in place, Uganda would collect Ushs 5 billion annually.

Godfrey Monor, the executive secretary LVFO said it was awkward that only 0.3 vessels are licensed by Uganda because it creates a situation of ‘free for all’ which is not healthy for an ecosystem.

But the meeting heard that licensing in Uganda is also used as a management tool, more like, the less the licensing the more the fish stocks will grow.

Uganda has also introduced a mobile licensing system and TradeMark East Africa will soon train fisheries people on e-licensing system.

Kenya and Tanzania Monitoring, Control and Surveillance status report;

In the Kenya waters, according to the 2016 frame survey, gill-nets increased by 2% from 188,984 in 2014 to 192,987 in 2016 of these about 40% are undersize or illegal; monofilaments increased from 58 in 2004 to 20,842 in 2016; beach seines increased by 24% from 724 in 2014 to 901 in 2016.

The number of fishers increased by 9% from 40,133 in 2014 to 43,799 in 2016; boats increased by 7% from 13,402 in 2014 to 14365 in 2016. Over 300 illegal gears were impounded in 2015/2016 and Kenya fisheries are in the process of boat registration to give specific identities to crafts for licensing to commence.

This comes at the backdrop that Kenya since the inception of the devolved system of governance no meaningful MCS has been done as well there is little information exchange between counties and national governments.

Meanwhile, Tanzania has the highest MCS activities compared to Uganda and Kenya on Lake Victoria. For instance for the period January 2016 to March 2017, Tanzania patrols resulted into confiscation of 19,250 beach seines, 3,171 undersize gill-nets, 9,459 monofilaments, 44 dagaa nets, 84,140 kgs of immature fish and apprehension of 777 culprits.

In Tanzania, fishing vessel licensing is done by a competent authority in collaboration with BMUs. According to the frame survey report 2016, the total number of fishing crafts operating in Tanzanian waters were 31,773.

A total of 18,452 or 58.07% of the total Fishing Crafts are registered and licensed, the highest number on Lake Victoria.

Way forward for MCS on Lake Victoria;


The meeting heard that inspite of all activities including joint regional patrols by partners states on Lake Victoria there is increased illegal fishing as well as catching and trading in immature fish.

Susan Imende deputy Director at Ministry of Fisheries Development Kenya said fisheries managers have to think ‘outside the box’ as illegal users are ahead of them, which is pushing down fish stocks and while joint regional patrols could be effective and are a normal procedure the arrested fishers say they are being harassed.

Samson Abura the LVFO Communication Director said this time it should be ‘ business unusual’ and suggested a data base for MCS operations and IUUs to be set up as well as a good plan to show partner governments what is being done.

However, Monor from LVFO was skeptical about sustainability and if suggested activities would create any change. “We have done many activities but get the same results. We shall first increase the appetite of illegal fisheries but what happens after November?,” he asked after the EU funds are used up.

“This is like a ‘knee jack reaction’ because the funds are available. Will it be sustainable and have effective outcomes?” wondered Monor.

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