Friday, December 23, 2011

Uganda children ailing with nodding Disease

It is quite interesting that for several years the nodding disease has been existent in Uganda but very little is known about it in the medical world here. This reminds me of a ‘strange disease’ as described in the media, which was killing especially children only to be discovered as malnutrition.

Uganda has no disease historians, otherwise why would we have a disease running through the community for several years and every time no one knows how to diagnose it. It is a ‘strange disease.’  

According to Wikipedia, ‘Nodding disease or nodding syndrome’ is a new, little-known disease which emerged in Sudan in the 1980s. It is a fatal, mentally and physically disabling disease that only affects young children typically between the ages of 5 and 15.
It is currently restricted to small regions in South Sudan, Tanzania and Uganda says Wikipedia.

This time round, the ‘nodding’ disease initial assessments by the Uganda Ministry of Health, local authorities and Civil society Organisations have found that in 2011, over 2000 children have been infected. Over 60 young of these have died while hundreds have dropped out of school.

With no laboratories to carry out tests in Uganda, samples from children have been sent to Atlanta, USA, the Ministry of Health says. But being a festive season, they are unlikely to be returned on time.

The ripple effect on the family is even bigger. Mothers who are supposed to tend their gardens stay at home to now look after sick children, so food security is threatened at the household level, and they are stigmatized. At the community level, the affected families are shunned so discussion about it is limited.

According to experts, the "nodding disease" causes seizures, and affected children become physically and mentally stunted, which can lead to blindness and even death. It has been linked to Onchocerciasis and epilepsy because it has similar symptoms.

Despite this scenario, the budget for health research for this financial year was reduced and no special provisions have been put into place to ensure additional and necessary medicines and personnel for places affected with ‘nodding disease’.

This year, Uganda has had record economic growth rates and an increasing revenue base over the past decade, yet we find that investment in health as a percentage of the national budget declined during this period and stagnated at around 8 to 9% says the ‘Right to health group’ in Uganda. Per capita investment in health in Uganda today is about 7 US$ per person when the WHO minimum recommended rate is 41 US$.

Press statement on the Ministry’s campaign against the Nodding Syndrome
24th January 2012

Ministry of Health develops Emergency Response Plan to tackle Nodding Syndrome in Northern Uganda

The Ministry of Health has developed a comprehensive Emergency Response Plan to tackle the increasing cases of Nodding Disease in the northern districts of Kitgum, Lamwo and Pader. The Plan provides an integrated response to the disease through a coordinated mechanism that will ultimately identify the cause and control of the disease syndrome to the level where it is no longer of public health importance.
The disease is characterized by head nodding, mental retardation and stunted growth. It was first reported to the Ministry of Health by Kitgum District Health Office in August 2009. Currently, over 3000 children in the northern districts have been affected by the disease. This is not a new disease. Similar cases were also reported in Tanzania and Southern Sudan.
Since 2009, the Ministry of Health has been undertaking a number of measures to control its spread. Among these is the provision of supportive treatment to the children, training of health workers, massive sensitization and conducting research on the cause and control of the disease.   
Initial studies conducted by the Ministry of Health in collaboration with the Centre for Disease Control (CDC) did not indicate any conclusive cause of the disease. However, the new response plan will see an extensive research programme about the cause and spread of the diseases. This research programme will be undertaken by the Ministry of Health, CDC, universities in Uganda and other Health Development Partners.
Initial activation funding has been mobilised from the Ministry of Health budget. The National Taskforce on Epidemic Preparedness and Response chaired by the Ministry of Health is currently in the process of mobilising resources from its partners. The Ministry will in addition submit a Supplementary Budget request to the Ministry of Finance, Planning and Economic Development to support the Response Plan.
The Response Plan that has also been shared with the Acholi Parliamentary Group, provides for the procurement and distribution of medicines and other supplies to affected communities. The medicines will be dispersed to hospitals and health centres that are easily accessible to the affected communities. 
The Ministry will in addition set up screening and treatment centres in affected districts. These centres will be beefed up with supplementary staff consisting of at least a psychiatric clinical officer, psychiatric nurse, nutritionist and counsellor. The designated centres will be opened by end of February. These are; Padibe Health centre IV for Lamwo district, Kitgum Hospital for Kitgum while Pajule Health Centre IV will cater for Padre District. These centres will be supported by monthly outreach programs to the affected communities.
Psychiatry experts shall also be engaged from Mulago and Butabika National Referral Hospitals, as well as other regional hospitals, to train the screening teams at the designated centres.
The Implementation of the Response Plan will be multi-sectoral involving various stakeholders at district and central level. These include; Ministries of; Agriculture, Animal Industry and Fisheries, Gender and Labour, Local Government, Education and Sports and Office of the Prime Minister as well as Universities and Research Institutions. The Ministry of Health has so far sent a request to the Office of the Prime Minister to supply emergency nutritional supplements to the designated screening and treatment centres.
The Ministry is working closely with the affected local governments and political leadership to mobilise communities to seek medical assistance from the designated screening centres. Districts have also been requested to incorporate the activities into their district plans and budgets.
The Minsitry of health is in addition working with a number of Development Partners to implement this plan. These include World health Organisation, Centre for Disease Control (CDC), UNICEF, USAID and MF-Spain.
I appeal to the Members of Parliament and district leaders from the Acoli sub-region to work with the Ministry of Health to ensure proper coordination and implementation of the Response Plan.
I appeal to affected communities to stay calm as we find a lasting solution to this problem.
The Ministry of Health informs the public that it is doing everything in its control to manage the spread of the disease in northern Uganda. I assure the public that we continue our commitment to the prevention and fighting of disease throughout Uganda.
Hon. Christine Ondoa    
Minister of Health 

Monday, December 19, 2011

Save and Conserve the Sweet potato

 The Rome-based Global Crop Diversity Trust and the International Potato Center (CIP) in Peru are finalizing a US$1 million five-year renewable grant to support, maintain, conserve and make available sweet potato varieties. 

Sweet potatoes produce more edible energy per hectare per day than wheat, rice or cassava. Research in Uganda has shown that sweet potato is effective in preventing vitamin A deficiency, which is a major cause of sickness and death among young children in Africa. Esther Nakkazi spoke to Dr. Robert Mwanga the sweet potato breeder for sub-Saharan Africa at International Potato Center about it.

1. Why the sweet potato and not another crop for this grant?

Sweet potato is a major food crop yet it has had little funding for research and development compared to other major staples. Its contribution to food and nutrition security in the developing world is increasingly being recognized. Conserving available farmers’ varieties is urgent for exploitation for traits such as drought tolerance in the face of climate change.

2. Will a particular type of sweet potato be promoted in sub-Saharan Africa under the project?

Each active nationals sweet potato program conducts experiments on its sweet potato breeding materials or ‘varieties’ to select the best performing and preferred varieties for farmers, and the market. In general it is desirable for countries to promote high yielding varieties which have advantages for example high in beta-carotene (Vitamin A) to reduce the high prevalence of vitamin deficiency on the continent; varieties with high resistance to weevils, because if weevils are not controlled there will be total loss of storage roots; varieties with resistance to diseases such as sweet potato virus disease and Alternaria blight which can be devastating to the crop, and varieties with drought tolerance to obtain substantial root yields under harsh drought conditions.

3. Sweet potatoes have several flaws like perishability. What sort of technologies will the project develop to address these?

This project addresses constraints to do with conservation of farmers’ varieties and wild relatives of the cultivated sweet potato. Constraints (flaws) such as perishability and processing quality can be addressed indirectly by this project by conserving sweet potato varieties, which have such characteristics, which are important to farmers and consumers. Farmers can use varieties with the desirable characteristics directly as varieties or in breeding by research institutes to produce new improved varieties.

4. What will be the role of local institutions you will work with? Which ones are you targeting in Uganda, Rwanda?

In general with other CIP projects, the local institutions collaborate with CIP as partners to accomplish the goals of the projects. In Uganda on this project, the National Crops Resources Research Institute (NaCRRI) of the National Agricultural Research Organization (NARO) is the partner. In Rwanda, Rwanda Agriculture Board (RAB), Southern Agriculture Zone Division (formerly ISAR at Rubona), hosts our related projects. When activities on this project are extended to Rwanda RAB will be the partner.

5. How will the project enable the smallholder farmers who grow sweet potatoes improve their incomes?

CIP works with national programs to improve the farmers’ varieties in different countries. The national sweet potato programs can access sweet potato varieties from CIP/Lima or the regional Sub-Saharan Africa offices. The national programs can use those varieties directly or use them in their breeding programs to improve their local varieties to produce improved varieties better suited for the market and home consumption or for livestock feed or processing. Improved varieties in terms of nutrition -high beta-carotene or Vitamin A-, and yield can lead to self-sufficiency for food and sell of excess leading to improved nutrition and income.

6. What will this project add to cancer research on the sweet potato?

This project is not directly working on cancer research. Sweet potato, particularly varieties with purple-fleshed roots are a rich source of compounds called anthocyanins, which have medicinal value as anti-oxidants and cancer preventing agents. Linkage of this project to any potential project on cancer research would be to provide appropriate sweet potato germplasm if required.

7. What challenges do you envisage with this project?

Collection of sweet potato varieties from countries where there are unique farmers’ varieties, but resources are limiting for those countries to collect those varieties for long-term conservation. Some countries may not have realized the threat of loss of sweet potato varieties due to different factors such wars, floods, drought and climate change, so may not see the urgency of conservation, especially long term conservation.

Also published on Africa STI


Mama Great Lakes leaves peace and security abound

Ambassador Liberata Mulamula (Mama Great Lakes) is the outgoing Executive Secretary of the International Conference of the Great Lakes Region (ICGLR). She was in Kampala to attend the 4th ordinary Summit of the Heads of State and Forum of Parliaments for the eleven member States. Esther Nakkazi spoke to her about her five-year term at the helm of ICGLR and how she realized the goal of keeping peace and security in the region.

QN: What has been most challenging in your job at ICGLR?
I was the first Executive Secretary of ICGLR and I had to establish it from scratch. I have seen it grow within its mandate of establishing peace and security.

QN 2; What were your achievements during your five-year tenure in office? The region was very unstable, there was rebellion in Burundi, guns in the Democratic Republic of Congo but we have seen some of this end like Burundi is stable and they had elections. Through this framework we were also able to contain rebel leaders like Congolese rebel leader Laurent Nkunda.
In my tenure, nine countries have undergone elections under the last two years. I had to deploy election observers because as ICGLR we had to see to it that elections are held in a peaceful manner, we bring in politicians and engage all the parties prior.

We have deployed former leaders like Olusegun Obasanjo of Nigeria and Benjamin Mkapa of Tanzania. We deploy different people depending on the mandate but people identify themselves with past leaders and they also mobilize political will. Even if we still have challenges of armed groups; what we have achieved so far has given me a lot of satisfaction.

QN 3: What makes ICGLR different from other similar organisations?
The convening power and the ability to address issues which are unique to the Great Lakes region. By convening power, I mean, the Conference brings together everybody; civil society sits on the same table as government; women and youth play an equal role. No body can cry that they are left out.

QN 4. There are concerns that the resolutions you make may not be legally binding. What should be done to enforce them?
We have legally binding resolutions since we operate under a pact but implementation of the commitments is lacking in the sense that Heads of State take decisions but when they go back, it is left to the secretariat to push for implementation.
We also need implementation at the institutional level. There are weaknesses of follow up. For instance we talk about Sexual and Gender Based Violence but there are places with no police stations. Women are raped and they cannot report it. There is a vacuum.
You also need a lot of political will. I have seen it. To get it you have to do a lot and get the political leaders to commit and make resources available so that we implement whatever decision is taken.

QN: How are member states performing in terms of funding ICGLR?
We have had 80 percent contribution, so member States are doing very well and they fund most of our operations. With other funding, partners are earmarked for specific activities.
You know ICGLR is on good track. Countries are here because they believe in corporation, integration, consensus building, dialogue and good relations. It brings me hope that as we continue like this, it will bring us peace and stability in the region.

QN: Isn’t there duplication of efforts with other agencies like IGAD, the East African Community to which member States also belong?
We have a specific mandate as ICGLR, which is peace and stability to enable economic growth for communities. Usually, however, our roles are complementary although that is not what the public see. There is no duplication as such but what happens is organizations make competing decisions, which is where we find problems. Fortunately, we have signed Memorandum of Understandings with other regional organizations.
QN: How have you managed all of this with your family?
It is a balancing act as a mother and wife I have responsibilities. There is also so much sacrifice. You have no life of your own. By now I should be planning a birthday party for my son but I am here. There is a lot of understanding from my two children and my husband.
But my father modeled us in this way. In terms of leadership, he said, you have to be respected but live to your commitments and integrity.

QN: What about as a woman working with Heads of State and rebel leaders- has training and experience helped?
I am a political scientist by training and I have a Masters degree in Governance. I have worked in the Ministry of Foreign Affairs in Tanzania and Foreign Service.
My relationship with Heads of States has been extremely good, they were all ready for my engagements and there is no single country in the region whose Head, I have not met in their own capital.
I helped build confidence with some rebel leaders. For instance I went to see Nkunda and he listened. When such people see me, they see themselves in me. They said I am not intimidating, they see mama who can listen and carry their message. This has helped build confidence. That is why they call me ‘mama Great Lakes’.

QN: Any departing words as executive secretary?
I am leaving a foundation for achieving peace and stability in this region.

Wednesday, December 7, 2011

Museveni dry HIV messages incapable of revamping public response

By Esther Nakkazi

Civil society and People living with HIV in Uganda want the Uganda AIDS Commission (UAC) and Ministry of Health to jointly launch a costed national strategy for rolling out a comprehensive HIV prevention and treatment response and correctly advise on messages to the public.

They want the response to have concrete deliverable by 2015 like getting at least 80% male circumcision coverage among adult men, rapid and strategic scale up of ARV treatment to all people with HIV with CD4 cells greater than 350 but even earlier for serodiscordant couples, pregnant women, and other key populations.

The government should increase domestic funding and available funds should be accounted for transparently to ensure that funding is not wasted, diverted, abused or stolen as well as strategic implementation of pre-exposure prophylaxis project in vulnerable populations.

“President Obama just put forward a powerful down payment toward the end of the AIDS crisis,” said Lillian Mworeko, the Executive Director of the International Community of Women Living with HIV East Africa. “But we are deeply concerned that Uganda will not seize this opportunity—Government should also double its investments in life saving treatment to turn the tide of HIV in Uganda.”

U.S. President Barack Obama on World AIDS Day announced that the U.S. would scale up treatment access to reach a total of 6 million people on antiretroviral treatment by 2013 through the President’s Emergency Plan for AIDS Relief (PEPFAR)—doubling the pace of scale up for the programme. Obama committed the U.S. to using emerging science to “begin to end” the global AIDS crisis—a concept unimaginable just a few years ago.

Uganda activists also say, although there is various proven new research showing that expanding access is essential to getting ahead of the epidemic the president, Yoweri Museveni has not been advised correctly, accurately and based on scientific evidence.

For instance Museveni’s World AIDS Day message was negative, inaccurate, harmful and showed the continued lack of political will to revamp the national response to the HIV/AIDS crisis that has gone completely off track.

Ultimately, the message did not promote use of the new approaches to HIV prevention and treatment that scientists and policymakers are describing as key to bringing about an end to the AIDS pandemic, the activists said.

In his 1 December 2011 speech, delivered by Vice President Hon. Edward Ssekandi, the President argued that the country should be “careful” of implementing “new medical tools” against HIV, because such innovations “can lead to laxity in behavior.”

The President argued that “eliminating negative sexual behaviors” should be the fundamental priority in the country. Activists say this message is not only inaccurate but also harmful, and

“Of course reaching communities, particularly most at risk populations, with accurate and high impact behavior-change interventions is important—but it is just not enough,” said Leonard Okello of the International HIV/AIDS Alliance in Uganda. “We want a prevention and treatment revolution.”

Unprecedented new research findings have shown that antiretroviral treatment for HIV not only saves lives, but it also reduces the risk of sexual transmission by 96%-, making HIV treatment an incredibly powerful HIV prevention tool.

The “Partners PrEP” study, conducted in Uganda and Kenya, also found that antiretroviral drugs reduced the risk of infection by as much as 73% when taken by HIV-negative people in serodiscordant relationships

Safe medical male circumcision, and access to ARV treatment for HIV positive pregnant women are other crucial biomedical prevention interventions that urgently need to be taken to national scale in Uganda. Expanding investments in these interventions will not only save lives—they will also substantially reduce the costs of the AIDS response over time, according to experts.

“These data have provided hope that through accelerated scale up of treatment, as well as other proven prevention and treatment strategies, the end of AIDS could be possible,” says Richard Hasunira, Coordinator of Uganda Civil Society HIV Prevention Working Group.

According to the activists, technical experts in the Ministry of Health are supportive of these new approaches—but the backward-looking message from the President appeared designed by advisors who are not keen on expanding government investments in the fight against the HIV epidemic.

Uganda’s response to HIV is faltering badly, according to experts. Uganda is one of the few countries in the world with rising HIV infection rates, with an estimated 132,500 infections annually. More than 50% of Ugandans in urgent need of HIV treatment currently do not have access to treatment to save their lives and prevent new infections. One in five new HIV infections in Uganda are from mother to child.

“We have no time for equivocation as a country,” said Dr. Stephen Watiti, Board Chair of NAFOPHANU. “Our people are dying; incidence rates are rising. Shaming people with talk of negative sexual behaviors is not helpful at all, since as we all know many people are getting infected without practicing what the President calls ‘negative sexual behavior.’

At this critical time, no one should be talking as if they have the moral high ground; it is not helpful. Moreover, all Ugandans need access to effective prevention and treatment services—not stigma and exclusion.”

Activists also expressed concern that Uganda was not making use of public health flexibilities that would make it easier for Uganda to gain access to low-cost, generic medicines, particularly in the future.

“Uganda needs to be forward looking—instead of making excuses, the government should take advantage of flexibilities other countries are already using to reduce the price of essential medicines,” said Moses Mulumba, Executive Director of Centre for Health, Human Rights and Development (CEHURD).

Thursday, December 1, 2011

Mobile phones use could spur access to contraception among youth

By Esther Nakkazi

Access to mobile phones across the world is expanding and so is their use in bridging the gap in service delivery and education for family planning for over 215 million women who have no access.

Through innovative new programs, clinics in Tanzania are using mobile phones to track family planning supplies and avoid stockouts and in Nigeria, over 300,000 text messages were sent by youth about reproductive health to experts to inquire about contraceptives.

Increasingly, young people are utilizing mobile technologies to meet their sexual and reproductive health needs wherever they are, whenever they need help according to case studies in east and west Africa.

In Uganda, software programmers working in the ‘cloud’ were able to solve coding challenges for building the text message quiz functionality. Family planning supervisors in low resources organizations are now able to download the resulting platform, FrontlineSMS for use for free.

In Kenya and Tanzania, the M4RH -mobile for reproductive health- text message program provides basic information about nine different family planning methods as well as the locations of clinics where services are offered. 

Respondents in the study said they used m4RH so they could make informed decisions about reproductive health and learn about contraception to prevent unwanted pregnancies. 

These are some of the mobile phone technologies being presented at the international family planning conference in Dakar, Senegal, which prove the innovative ways of how mobile phones are being used for family planning awareness and education.

These case studies bring into focus the nascent but promising role of mobile technologies to foster behavior change in Family Planning for providers, clients, and program implementers said researchers.

The technologies are especially helpful for reaching the ‘mobile generation’ in the developed world that give birth before 20 years, basically because they have low access to reproductive health information, supplies and education.

In one of the case studies in Tanzania and Kenya, ‘Family planning in a Digital world: Using Technology to promote family planning among young people’ it says mobile phones are regarded as a “high-impact practice” that can support the provision of family planning services and they offer a new mechanism for delivering health information in a highly relevant, private, and cost-effective manner.

In the Nigeria case study, since the launch in 2007 of ‘Learning about living’ analyses of more than 300,000 ‘screen hits’ showed that the most frequently accessed topic was natural family planning, followed by information about condoms, implants, and emergency contraception.

According to the researchers, it demonstrated that emerging technologies could provide a simple, cost-effective way to reach young people in developing countries with sensitive information they need and want.

They concluded that technology provides an anonymous way to address difficult subjects and engages young people more than traditional communication methods. The social nature of these tools also encourages the rapid spread of accurate, positive sexual and reproductive health messages.

With the use of mobile phones, Tanzania has been able to deliver family planning commodities to service delivery points in a timely manner. This was proven in a six month pilot study ‘Improving family planning commodity availability using mHealth technologies,’ that ended mid 2011 in four districts which were initially consistent with stock outs for commodities.

In the 75 Tanzania facilities, at scheduled time intervals, facility staff used their personal mobile phones to send text messages to report stock on hand, losses and adjustments of ten essential medicines- Copper T IUD, Depo-Provera, implants, condoms, Microgynon and Microvial - supervision frequency, delivery of goods, and report and request submissions.

The facility staff sent text messages to a toll-free short code, data was merged and displayed on an interactive web-based interfaced that prompted decision-making. Monthly reports were also emailed to decision makers at all levels.

It was found that mobile phone technology using cheap and readily available cell phones offers a possible sustainable solution to making quality logistics data for decision-making readily available in real-time.

All the users also indicated they preferred SMS based reporting compared to the paper-based system, they improved their reporting rates and adherence on reporting which in turn improved their timeliness of ordering and stock management.

Mobile phones successfully reduced stockouts of family planning commodities; improved the frequency and quality of supervision provided by supervisors at all levels; and improved the timeliness and accuracy of ordering and reporting deliveries to health facilities.


Minus Global funds Uganda may at last raise own HIV funding

By Esther Nakkazi

Cancelation of the Global Fund funding may finally achieve what the Uganda government has for long failed to do -increase its funding for HIV activities.

Two weeks ago, (22nd November) the Global Fund Board cancelled Round 11 after some donors failed to honor their pledges so that funding amounted to only half of the anticipated $1.6 billion for this Round.

In a country were HIV activities are 90 percent donor funded and Round 11 was particularly meant to fund HIV activities, activists say this is a wake up call to Ugandans that they should pay for their HIV medicines. 

The Uganda Aids Commission says it has already prepared a position paper to start a levy on some items like beer, but Uganda has to start treating its people.

Dr. Lydia Mungherera an HIV activist says Uganda has been relying on donor funding for a long time, but now is the time for the government to start treating and investing in its own people.

“During the World Aids Day the message should be definite that our people are going to die. The donors are already sending a straight message which we ought to heed to,” said Dr. Mungherera.

“We have been warning our government, donors are unreliable and that they are jumping out is not new. Government should find the money or prepare to deal with a national disaster,” said Richard Hasunira an advocate for HIV prevention and health rights.

A statement released after the Global Fund Board meeting in Ghana two weeks ago said that with no money for Round 11, the next opportunity for countries to apply for new grants would be during the 2014-2016 period.

IT further said that countries would now apply for grants using a new funding model developed under a different strategy. The GF supports globally programs on malaria, TB and HIV as well as strengthening the national health systems through free grants.

Since the establishment of the Global Fund, Uganda has successfully applied for eight grants from the Global Fund For Aids, Tuberculosis and Malaria (GFATM) all totaling US$ 426,763,257.

But in regards to HIV/Aids, Uganda has unsuccessfully submitted requests to the Global Fund several times including rounds 4,5,6,9 and most recently 10 where the country appealed against the TPR decision without success.

Before Round 11 was cancelled, Uganda was busy drafting its application, whose funds were exclusively for HIV. And, the Uganda Aids Commission says they are going ahead to write the proposal, mainly to give ‘clear numbers’ for the funding gap.

Prof Vinand Nantulya, the chairman of the Uganda Country Coordinating Mechanism (CCM) ScieGirl that they were suspecting that Round 11 would either be delayed or it would not take place.

However, in the meantime Uganda has the necessary resources to buffer interventions in the areas of malaria, Tuberculosis, HIV/Aids and health systems strengthening for the next 3-4 years, said the Uganda Global Fund secretariat.

According to the CCM secretariat, Uganda has over $300 million to intervene in the four disease problem areas but activists and civil society insist it should come up with alternative funding other than donors funding HIV activities.

“I think we may need a supplementary budget but most importantly we need to come up with other funding sources. We cannot expect the donors to do everything for us. I mean Mugabe has done something,” said Dr. Mungherera.

In 1999, Zimbabwe introduced an AIDS levy consisting of a 3 percent tax deducted from salaries of formally employed workers and companies to compensate for the declining donor support.

“It is unfortunate that Round was cancelled but we have to try to mobilize domestic resources,” said Prof. Nantulya also the Chairman of Uganda Aids Commission (UAC). The plan for mobilization of domestic resources is already under way for Uganda. So far, a position paper on alternative avenues of domestic funding has been developed and is under scrutiny by the ministry of Finance.

“We may come up with a levy on items like beer, soda e.t.c. We have examined everything and given the options to the Ministry of Finance,” said Prof Nantulya.

The initiative to impose an AIDS levy on some items could be the only way out for funding Uganda’s HIV/AIDS activities amidst the declining donor support. But it is an initiative for the long term.
With a low tax base and a high burden on the taxpayers, the CCM requires mobilization, education and public support, the only means out of a tight rope.

“It is going to be a long, meticulous process and a public good. But we shall put in place what works,” said Prof. Nantulya. “We hope to explore every possible way to get treatment.”