Update on Ebola in Uganda

Press Release:

The Ministry of Health declared an outbreak of Ebloa in Kibaale district on Saturday July 28th after receiving confirmatory results from the Uganda Virus Research Institute that the strange disease that had killed 14 people in the district was Ebola Hemorrhagic fever, Sudan strain.

The announcement followed investigations after the Ministry received a report from Kibaale district health authorities on 11th July 2012 about the strange disease that was associated with death in Nyanswiga LCI in Nyamarunda Parish of Nyamarunda subcounty, Kibaale district. 

The report had indicated that the patients presented with the common symptoms of diarrhoea, vomiting and fever. It indicated that by 10th July 2012, despite many of the patients having received treatment from Emesco HCIII, Mugarama HCIII, Kagadi Hospital and St Ambrose, 10 of them had died.

It further indicated that initial samples of blood and stool taken from the sick did not yield any positive findings in the laboratories in Kagadi Hospital and Central Public Health Laboratories of the Ministry of Health, Kampala.

The report also noted that people were delaying to present themselves to seek for treatment, partly because they believed that the cause of the illness was due to “evil spirits”. This caused civil strife among the community requiring Police intervention to quell the animosity.

In response to this report, a team from the Ministry of Health was dispatched to do a quick assessment of the outbreak and give direction for further measures to be taken. The team carried out an eye balling exercise and verbal autopsy on the affected family.

Between the 24th and 25th July 2012, detailed laboratory investigations were conducted at the Uganda Virus Research Institute and confirmed that the “Strange Disease” was Ebola hemorrhagic fever, Sudan. Three samples taken from the dead confirmed Ebola to be present in their biological specimen.

The Ministry of Health wished to inform the public that the index case belonged to a family in Nyanswiga village in Nyamarunda Sub-county in Kibaale district. Nine other members of the family had also succumbed to death. Four other people including a clinical officer who had attended to the dead at Kagadi Hospital also died at Mulago Hospital after she had been referred there. Her three-month-old daughter also died after admission at Kagadi Hospital on July 28th. This brings the total number of dead to 14 as of July 28th.

The ministry of Health and its partners mainly the World Health Organisation, U.S. Centers for Disease Control and Prevention (CDC), MSF and other Health Development Partners convened an emergency meeting to discuss the management of the outbreak. The meeting agreed to embark on the following to contain the situation;
· Started active and sustained tracing and listing of all possible contacts that were exposed to the suspected and confirmed cases since 6th July 2012.

· Dispatched a team of experts from MoH, WHO and CDC to support the response plan

· Mobilized the necessary supplies and logistics for case management from the National Medical Stores

· CDC dispatched Personal Protective Equipment (PPEs) and body Bags to the district.

· World Health Organisation provided an initial supply of PPEs and body bags

· Requested Mulago National Referral Hospital to reactive its isolation camp in readiness for any possible cases detected in the surrounding areas at the hospital.

Yesterday, the Ministry of Health high powered delegation visited the Kibaale district to assess the current situation and build confidence of the healthcare workers. The delegation was led by the National Disease Control Programme Dr. Denis Lwamafa and other Commissioner. Others on the team includd representatives from the World Health Organisation, CDC and other Health Development Partners.

The Ministry of Health assures the public that it is working around the clock with its international partners to rapidly assess the extent of the outbreak and to bring it fully under control as quickly as possible.

Currently, there have been no more deaths recorded since the outbreak of the epidemic in July 28th. The death toll still remains at 14 with only three confirmed to have died of Ebola. There are seven suspect cases admitted at Kagadi District Hospital and are responding well to the treatment being given. Other people who got into contact with the dead have not reported any signs of the disease so far, but continue to be monitored closely.

The Ministry of Health has further set up a temporary Isolation centre at Kagadi Government Hospital to accommodate all people suspected to be infected with the disease. The facility is to be beefed up with medical team from Mulago National Referral Hospital to manage the suspect cases.

A team of experts from CDC and World Health Organization have collected seven more samples from close contacts for further investigations bringing the total number of specimens collected to 11. The samples are being investigated at the Uganda Virus Institute, Entebbe. The Ministry continues to undertake active and sustained tracing and listing of all possible contacts.

Another team of experts is undertaking disinfection control at the wards and the isolation facility at the Hospital. The hospital has set up burial committees to manage burials of people suspected to have died of Ebola. The committee has been oriented on burial procedures and infection prevention and control.This is one of the control measures to control the spread of the highly contiguous disease.

Mulago Hospital is in the process of reactivating its isolation camp to cater for any reported cases in Kampala and neighbouring districts.

The Ministry of Health once again urges the public to take the following measures to avert the spread of the disease.

· Report and immediately take any suspected patient to a nearby health unit

· Avoid direct contact with body fluids of a person suspected to be suffering from Ebola by using protective materials like gloves and masks

· Disinfect the bedding and clothing of an infected person

· Persons who have died of Ebola must be handled with strong protective wear and buried immediately, avoid feasting and funerals

· Avoid eating dead animals especially monkeys

· Avoid public gathering especially in the affected district

· Burial of suspicious community deaths should be done under close supervision of district health workers

· Report all suspicious deaths to the health workers

Once again the Ministry of Health calls upon the public to stay calm as all possible measures are being undertaken to control the situation.

Hillary Clinton Speech at XIX International AIDS conference

Press Release;
Good morning, and – (applause) – now, what would an AIDS conference be without a little protesting? We understand that. (Applause.) Part of the reason we’ve come as far as we have is because so many people all over the world have not been satisfied that we have done enough. And I am here to set a goal for a generation that is free of AIDS. (Applause.) But first, let me say five words we have not been able to say for too long: “Welcome to the United States.” (Applause.) We are so pleased to have you all finally back here.

And I want to thank the leaders of the many countries who have joined us. I want to acknowledge my colleagues from the Administration and the Congress who have contributed so much to the fight against AIDS. But mostly, I want to salute all of the people who are here today who do the hard work that has given us the chance to stand here in 2012 and actually imagine a time when we will no longer be afflicted by this terrible epidemic and the great cost and suffering it has imposed for far too long. (Applause.) On behalf of all Americans, we thank you.

But I want to take a step back and think how far we have come since the last time this conference was held in the United States. It was in 1990 in San Francisco. Dr. Eric Goosby, who is now our Global AIDS Ambassador, ran a triage center there for all the HIV-positive people who became sick during the conference. They set up IV drug drips to rehydrate patients. They gave antibiotics to people with AIDS-related pneumonia. Many had to be hospitalized and a few died.

Even at a time when the world’s response to the epidemic was sorely lacking, there were places and people of caring where people with AIDS found support. But tragically, there was so little that could be done medically. And thankfully, that has changed. Caring brought action, and action has made an impact.

The ability to prevent and treat the disease has advanced beyond what many might have reasonably hoped 22 years ago. Yes, AIDS is still incurable, but it no longer has to be a death sentence. That is a tribute to the work of countless people around the world – many of whom are here at this conference, others who are no longer with us but whose contributions live on. And for decades, the United States has played a key role. Starting in the 1990s under the Clinton Administration, we began slowly to make HIV treatment drugs more affordable, we began to face the epidemic in our own country. And then in 2003, President Bush launched PEPFAR with strong bipartisan support from Congress and this country began treating millions of people.

Today under President Obama, we are building on this legacy. PEPFAR is shifting out of emergency mode and starting to build sustainable health systems that will help us finally win this fight and deliver an AIDS-free generation. It’s hard to overstate how sweeping or how crucial this change is. When President Obama took office, we knew that if we were going to win the fight against AIDS we could not keep treating it as an emergency. We had to fundamentally change the way we and our global partners did business.

So we’ve engaged diplomatically with ministers of finance and health, but also with presidents and prime ministers to listen and learn about their priorities and needs in order to chart the best way forward together. Now I will admit that has required difficult conversations about issues that some leaders don’t want to face, like government corruption in the procurement and delivery of drugs or dealing with injecting drug users, but it has been an essential part of helping more countries manage more of their own response to the epidemic.

We’ve also focused on supporting high-impact interventions, making tough decisions driven by science about what we will and will not fund. And we are delivering more results for the American taxpayer’s dollar by taking simple steps – switching to generic drugs, which saved more than $380 million in 2010 alone. (Applause.)

And crucially, we have vastly improved our coordination with the Global Fund. Where we used to work independently of each other, we now sit down together to decide, for example, which of us will fund AIDS treatment somewhere and which of us will fund the delivery of that treatment. That is a new way of working together for both of us, but I think it holds great results for all of us. (Applause.) Now all of these strategic shifts have required a lot of heavy lifting. But it only matters in the end if it means we are saving more lives – and we are.

Since 2009, we have more than doubled the number of people who get treatment that keeps them alive. (Applause.) We are also reaching far more people with prevention, testing, and counseling.

And I want publicly to thank, first and foremost, Dr. Eric Goosby, who has been on the front lines of all this work since the 1980s in San Francisco. (Applause.) He is somewhere in this vast hall, cringing with embarrassment, but more than anyone else, he had a vision for what PEPFAR needed to become and the tenacity to keep working to make it happen. And I want to thank his extraordinary partners here in this Administration, Dr. Tom Frieden at the Centers for Disease Control and Dr. Raj Shah at USAID. (Applause.)

Now, with the progress we are making together, we can look ahead to a historic goal: creating an AIDS-free generation. This is part of President Obama’s call to make fighting global HIV/AIDS at home and abroad a priority for this administration. In July 2010, he launched the first comprehensive National HIV/AIDS Strategy, which has reinvigorated the domestic response to the epidemic – especially important here in Washington D.C., which needs more attention, more resources, and smarter strategies to deal with the epidemic in our nation’s capital.

And last November, at the National Institutes of Health, with my friend Dr. Tony Fauci there, I spoke in depth about the goal of an AIDS-free generation and laid out some of the ways we are advancing it through PEPFAR, USAID, and the CDC. And on World AIDS Day, President Obama announced an ambitious commitment for the United States to reach 6 million people globally with lifesaving treatment. (Applause.)

Now since that time I’ve heard a few voices from people raising questions about America’s commitment to an AIDS-free generation, wondering whether we are really serious about achieving it. Well, I am here today to make it absolutely clear: The United States is committed and will remain committed to achieving an AIDS-free generation. We will not back off, we will not back down, we will fight for the resources necessary to achieve this historic milestone. (Applause.)

I know that many of you share my passion about achieving this goal. In fact, one could say I am preaching to the choir. But right now, I think we need a little preaching to the choir. And we need the choir and the congregation to keep singing, lifting up their voices, and spreading the message to everyone who is still standing outside.

So while I want to reaffirm my government’s commitment, I’m also here to boost yours. This is a fight we can win. We have already come so far – too far to stop now.

I want to describe some of the progress we’ve made toward that goal and some of the work that lies ahead.

Let me begin by defining what we mean by an AIDS-free generation. It is a time when, first of all, virtually no child anywhere will be born with the virus. (Applause.) Secondly, as children and teenagers become adults, they will be at significantly lower risk of ever becoming infected than they would be today no matter where they are living. (Applause.) And third, if someone does acquire HIV, they will have access to treatment that helps prevent them from developing AIDS and passing the virus on to others.

So yes, HIV may be with us into the future until we finally achieve a cure, a vaccine, but the disease that HIV causes need not be with us. (Applause.)

As of last fall, every agency in the United States Government involved in this effort is working together to get us on that path to an AIDS-free generation. We’re focusing on what we call combination prevention. Our strategy includes condoms, counseling and testing, and places special emphasis on three other interventions: treatment as prevention, voluntary medical male circumcision, and stopping the transmission of HIV from mothers to children.

Since November, we have elevated combination prevention in all our HIV/AIDS work –including right here in Washington, which still has the highest HIV rate of any large city in our country. And globally, we have supported our partner countries shifting their investments toward the specific mix of prevention tools that will have the greatest impact for their people. For example, Haiti is scaling up its efforts to prevent mother-to-child transmission, including full treatment for mothers with HIV, which will in turn, of course, prevent new infections. And for the first time, the Haitian Ministry of Health is committing its own funding to provide antiretroviral treatment. (Applause.)

We’re also making notable progress on the three pillars of our combination-prevention strategy. On treatment as prevention, the United States has added funding for nearly 600,000 more people since September, which means we are reaching nearly 4.5 million people now and closing in on our national goal of 6 million by the end of next year. That is our contribution to the global effort to reach universal coverage.

On male circumcision, we’ve supported more than 400,000 procedures since last December alone. And I’m pleased to announce that PEPFAR will provide an additional $40 million to support South Africa’s plans to provide voluntary medical circumcisions for almost half a million boys and men in the coming year. (Applause.) You know and we want the world to know that this procedure reduces the risk of female-to-male transmission by more than 60 percent and for the rest of the man’s life, so the impact can be phenomenal.

In Kenya and Tanzania, mothers asked for circumcision campaigns during school vacations so their teenage sons could participate. In Zimbabwe, some male lawmakers wanted to show their constituents how safe and virtually painless the procedure is, so they went to a mobile clinic and got circumcised. That’s the kind of leadership we welcome. And we are also seeing the development of new tools that would allow people to perform the procedure with less training and equipment than they need today without compromising safety. And when such a device is approved by the World Health Organization, PEPFAR is ready to support it right away. (Applause.)

And on mother-to-child transmission, we are committed to eliminating it by 2015, getting the number to zero. Over the years – (applause) – we’ve invested more than $1 billion for this effort. In the first half of this fiscal year, we reached more than 370,000 women globally, and we are on track to hit PEPFAR’s target of reaching an additional 1.5 million women by next year. We are also setting out to overcome one of the biggest hurdles in getting to zero. When women are identified as HIV-positive and eligible for treatment, they are often referred to another clinic, one that may be too far away for them to reach. As a result too many women never start treatment.

Today, I am announcing that the United States will invest an additional $80 million to fill this gap. These funds – (applause) – will support innovative approaches to ensure that HIV-positive pregnant women get the treatment they need to protect themselves, their babies, and their partners. So let there be no mistake, the United States is accelerating its work on all three of these fronts in the effort to create an AIDS-free generation and look at how all these elements come together to make a historic impact.

In Zambia, we’re supporting the government as they step up their efforts to prevent mother-to-child transmission. Between 2009 and 2011, the number of new infections went down by more than half. And we are just getting started. Together, we’re going to keep up our momentum on mother-to-child transmission. In addition, we will help many more Zambians get on treatment and support a massive scale-up of male circumcision as well, two steps that, according to our models, will drive down the number of new sexually transmitted infections there by more than 25 percent over the next 5 years. So as the number of new infections in Zambia goes down, it will be possible to treat more people than are becoming infected each year. So we will, for the first time, get ahead of the pandemic there. And eventually, an AIDS-free generation of Zambians will be in sight.

Think of the lives we will touch in Zambia alone – all the mothers and fathers and children who will never have their lives ripped apart by this disease. And now, multiply that across the many other countries we are working with. In fact, if you’re not getting excited about this, please raise your hand and I will send somebody to check your pulse. (Laughter and applause.)

But I know that creating an AIDS-free generation takes more than the right tools, as important as they are. Ultimately, it’s about people – the people who have the most to contribute to this goal and the most to gain from it. That means embracing the essential role that communities play – especially people living with HIV – and the critical work of faith-based organizations. We need to make sure we’re looking out for orphans and vulnerable children who are too often still overlooked in this epidemic. (Applause.)

And it will be no surprise to you to hear me say I want to highlight the particular role that women play. (Applause.) In Sub-Saharan Africa today, women account for 60 percent of those living with HIV. Women want to protect themselves from HIV and they want access to adequate health care. And we need to answer their call. PEPFAR is part of our comprehensive effort to meet the health needs of women and girls, working across United States Government and with our partners on HIV, maternal and child health, and reproductive health, including voluntary family planning and our newly launched Child Survival Call to Action.

Every woman should be able to decide when and whether to have children. This is true whether she is HIV-positive or not. (Applause.) And I agree with the strong message that came out of the London Summit on Family Planning earlier this month. There should be no controversy about this. None at all. (Applause.)

And across all of our health and development work, the United States is emphasizing gender equality because women need and deserve a voice in the decisions that affect their lives. (Applause.) And we are working to prevent and respond to gender-based violence, which puts women at higher risk for contracting the virus. And because women need more ways to protect themselves from HIV infection, last year we invested more than $90 million in research on microbicides. All these efforts will help close the health gap between women and men and lead to healthier families, communities, and nations as well.

If we’re going to create an AIDS-free generation, we also must address the needs of the people who are at the highest risk of contracting HIV. One recent study of female sex workers and those trafficked into prostitution in low and middle income-countries found that, on average, 12 percent of them were HIV-positive, far above the rates for women at large. And people who use injecting drugs account for about one third of all the people who acquire HIV outside of Sub-Saharan Africa. And in low-and middle income countries, studies suggest that HIV prevalence among men who have sex with male partners could be up to 19 times higher than among the general population.

Now over the years, I have seen and experienced how difficult it can be to talk about a disease that is transmitted the way that AIDS is. But if we’re going to beat AIDS, we can’t afford to avoid sensitive conversations, and we can’t fail to reach the people who are at the highest risk. (Applause.)

Unfortunately, today very few countries monitor the quality of services delivered to these high-risk key populations. Fewer still rigorously assess whether the services provided actually prevent transmission or do anything to ensure that HIV-positive people in these groups get the care and treatment they need. Even worse, some take actions that, rather than discouraging risky behavior, actually drives more people into the shadows, where the epidemic is that much harder to fight.

And the consequences are devastating for the people themselves and for the fight against HIV because when key groups are marginalized, the virus spreads rapidly within those groups and then also into the lower-risk general population. We are seeing this happen right now in Eastern Europe and Southeast Asia. Humans might discriminate, but viruses do not.

And there is an old saying that goes: “Why rob banks? Because that’s where the money is.” If we want to save more lives, we need to go where the virus is and get there as quickly as possible. (Applause.)

And that means science should guide our efforts. So today I am announcing three new efforts by the United States Government to reach key populations. We will invest $15 million in implementation research to identify the specific interventions that are most effective for each key population. We are also launching a $20 million challenge fund that will support country-led plans to expand services for key populations. And finally, through the Robert Carr Civil Society Network Fund, we will invest $2 million to bolster the efforts of civil society groups to reach key populations. (Applause.)

Now Americans are rightly proud of the leading role that our country plays in the fight against HIV/AIDS. And the world has learned a great deal through PEPFAR about what works and why. And we’ve also learned a great deal about the needs that are not being met and how everyone can and must work together to meet those needs.

For our part, PEPFAR will remain at the center of America’s commitment to an AIDS-free generation. I have asked Ambassador Dr. Goosby to take the lead on developing and sharing our blueprint of the goals and objectives for the next phase of our effort and to release this blueprint by World AIDS Day this year. We want the next Congress, the next Secretary of State, and all of our partners here at home and around the world to have a clear picture of everything we’ve learned and a roadmap that shows what we will contribute to achieving an AIDS-free generation.

Reaching this goal is a shared responsibility. It begins with what we can all do to help break the chain of mother-to-child transmission. And this takes leadership at every level – from investing in health care workers to removing the registration fees that discourage women from seeking care. And we need community and family leaders from grandmothers to religious leaders to encourage women to get tested and to demand treatment if they need it.

We also all have a shared responsibility to support multilateral institutions like the Global Fund. In recent months, as the United States has stepped up our commitment, so have Saudi Arabia, Japan, Germany, the Gates Foundation, and others. I encourage other donors, especially in emerging economies, to increase their contributions to this essential organization.

And then finally, we all have a shared responsibility to get serious about promoting country ownership – the end state where a nation’s efforts are led, implemented, and eventually paid for by its government, its communities, its civil society, its private sector.

I spoke earlier about how the United States is supporting country ownership, but we also look to our partner countries and donors to do their part. They can follow the example of the last few years in South Africa, Namibia, Botswana, India, and other countries who are able to provide more and better care for their own people because they are committing more of their own resources to HIV/AIDS. (Applause.) And partner countries also need to take steps like fighting corruption and making sure their systems for approving drugs are as efficient as possible.

I began today by recalling the last time this conference was held here in the United States, and I want to close by recalling another symbol of our cause, the AIDS Memorial Quilt. For a quarter-century, this quilt has been a source of solace and comfort for people around the world, a visible way to honor and remember, to mourn husbands and wives, brothers and sisters, sons and daughters, partners and friends.

Some of you have seen the parts of the quilt that are on view in Washington this week. I well remember the moment in 1996 when Bill and I went to the National Mall to see the quilt for ourselves. I had sent word ahead that I wanted to know where the names of friends I had lost were placed so that I could be sure to find them. When we saw how enormous the quilt was covering acres of ground, stretching from the Capitol building to the Washington Monument, it was devastating. And in the months and years that followed, the quilt kept growing. In fact, back in 1996 was the last time it could be displayed all at once. It just got too big. Too many people kept dying.

We are all here today because we want to bring about that moment when we stop adding names, when we can come to a gathering like this one and not talk about the fight against AIDS, but instead commemorate the birth of a generation that is free of AIDS.

Now, that moment is still in the distance, but we know what road we need to take. We are closer to that destination than we’ve ever been, and as we continue on this journey together, we should be encouraged and inspired by the knowledge of how far we’ve already come. So today and throughout this week let us restore our own faith and renew our own purpose so we may together reach that goal of an AIDS-free generation and truly honor all of those who have been lost.

Thank you all very much. (Applause.)

Research that shows child survival progress in developing countries

Press Release

Summary of some of the latest research on child health in developing countries (Uganda): evidence derived from all the randomized trials published over the last year. It is hoped that such information will be helpful in reviewing treatment guidelines, clinical practice and public health approaches, and in teaching about paediatrics and evidence-based medicine.

This year trials reported significant reductions in child mortality: the Uganda studies

• In Uganda a trial of zinc in the treatment of severe pneumonia showed a significant reduction in deaths in the zinc treated group. This is the first trial of zinc treatment in pneumonia with the power to show a mortality difference. The effect was especially strong in children with HIV. Two other trials this year – from India and Nepal - did not show a significant beneficial effect of zinc on resolution of pneumonia signs. 
• In 6 African countries initiation of HIV treatment in children who had no prior exposure to nevirapine, ART with zidovudine, lamivudine, and ‘ritonavir-boosted lopinavir’ resulted in lower virological failure than zidovudine, lamivudine and nevirapine. Nevirapine resistance was a common feature of treatment failure. 
• In 7 African countries in a phase III trial the RTS,S/AS01 malaria vaccine provided protection against both clinical and severe malaria in African children, with vaccine efficacies of 50% for first episode of malaria, and 35% against severe malaria. Another study from 3 African countries in a phase II trial showed similar efficacy (53% and 59%) against the first episode of malaria and all malaria episodes, respectively, when children were followed up at 19 months. A third study of seroresponse in children in Mozambique showed protective anti-circumsporozoite antibodies at 42 months. The RTS,S/AS02 vaccine also induced high levels of anti-hepatitis B surface antigen antibodies. 
• In a large study in Uganda involving over 100,000 children with suspected malaria, use of rapid diagnostic tests (RDT), compared with presumptive diagnosis, significantly reduced the prescribing of artemether-lumefantrine. However 23% of children with negative RDT were still prescribed antimalarials. Compared with microscopy, RDTs reduced waiting time and were considered more convenient for patients and health workers. 
• In Lao , China , and Uganda trials of albendazole and mebendazole for the treatment of worm infestation showed that albendazole is more efficacious than mebendazole for hookworm. However single-dose albendazole had low efficacy against hookworm, and treatment daily for 3 days (in Lo and China ), or 2 doses 8 hours apart (in Uganda ) was better. Albendazole had lower efficacy than mebedazole against Trichuris trichiura, where 3 days of treatment (or 2 doses in the one day) was optimal for cure. 

This is the tenth edition of this booklet. It is part of a project supported by WHO, AusAID and many international partners, which critically appraises the evidence behind WHO's treatment guidelines. Previous editions (2003-2011) and further reviews of WHO guidelines are available at www.ichrc.org.au 

www.ichrc.org
www.rch.org.au/cich

Malaria Consortium Welcomes Clinton-Museveni Pledge to Eliminate Diarrhoeal Deaths in Uganda

Press Release
Entebbe, Uganda 20 July 2012: Malaria Consortium welcomes the pledge by President Bill Clinton and President Yoweri Museveni today to increase support to reduce the 14,000 annual childhood deaths caused by diarrhoea in Uganda. At this critical time for achieving the Millennium Development Goals and reducing child mortality by 2015, scaling up high impact health interventions must be a priority.

Malaria Consortium, an international NGO working in Uganda was invited to participate in the “Scale-Up Diarrhea Treatment – Cut Down Child Mortality” event hosted by the National Medical Stores, the Uganda Ministry of Health and the Clinton Health Access Initiative in Entebbe today.

Ministry of Health policy in Uganda is to treat diarrhoea using Oral Rehydration Solution and Zinc; however patients still fail to use this potentially life-saving treatment. Malaria Consortium, at the event, committed to conducting much needed research on understanding community perceptions and behaviour concerning diarrhoea as a health problem. The data gathered from this research will support the Ministry of Health and partners to improve diarrhoea prevention and treatment communication campaigns, and diarrhoea treatment approaches.

‘Malaria Consortium is happy to see that diarrhoeal deaths are receiving global, and now, national attention with political commitment,’ says Malaria Consortium Uganda Country Director Dr. Godfrey Magumba, who met with decision-makers before the event. ‘We are working to save children’s lives in Uganda, and treating diarrhoea as part of an integrated approach is a key strategy for achieving this.’

In Uganda, 40% of all deaths in children under five are caused by diarrhoea, pneumonia and malaria. Children often show more than one symptom and need to be treated with antimalarials, antibiotics for pneumonia and Oral rehydration solution for diarrhoea.

In an effort to reduce these easily preventable deaths, Malaria Consortium is working with the Government of Uganda to implement a holistic approach to childhood disease control called Integrated Community Case Management, diagnosing and treating children at community level to achieve maximum impact. 


 The Ministry of Health programme trains and supports volunteer community health workers, called Village Health Team members, to conduct health promotion activities, diagnose and treat diarrhoea, pneumonia and malaria, recognise danger signs in newborns and under-fives and refer to nearest health facility. This strategy is expected to reduce childhood deaths from these diseases by 65 per cent, bringing diagnosis and treatment closer to home, where, in the past, poverty and distance limited access to quality health services.


“Continuing with business as usual is not an option if we want to achieve the Millenium Development Goals in Uganda in the near future,” says Dr. Karin Källander, who coordinates a Malaria Consortium project conducting research to support the scale up of quality Integrated Community Case Management in Uganda. “Scaling up coverage of essential medicines to sick children to 80 percent through the ICCM strategy could lead to 20,000 lives saved; it can make a huge difference.”

UNESCO’s Shameful Award

Press Release
Legal Questions, Human Rights Concerns Surround Obiang Prize

(Paris, July 16, 2012) – UNESCO’s decision to issue a controversial prize sponsored by President Teodoro Obiang Nguema Mbasogo of Equatorial Guinea is disappointing and irresponsible, seven civil society groups said today. A ceremony to award the prize is scheduled for July 17, 2012, in Paris. Obiang, in power for 33 years, leads a government known for corruption and repression.

In a divisive 33-18 vote with 6 abstentions, UNESCO’s governing Executive Board approved a renamed prize on March 8 under the name UNESCO-Equatorial Guinea International Prize for Research in the Life Sciences and pressed UNESCO’s Director-General, Irina Bokova, to move quickly to award it. 

That vote disregarded the advice of UNESCO’s legal office, which said that the prize could not be implemented, according to the organization’s own rules, due to discrepancies surrounding the source of the funding.

“It is shameful and utterly irresponsible for UNESCO to award this prize, given the litany of serious legal and ethical problems surrounding it,” said Tutu Alicante, director of the human rights group EG Justice. “Beyond letting itself be used to polish the sullied image of Obiang, UNESCO also risks ruining its own credibility.”

In a July 12 letter to delegates opposed to the prize, Bokova said that a legal opinion issued following the Board vote concluded that concerns remained but that she is nevertheless required to adhere to the Executive Board’s decision and implement the prize. In a July 13 response, the delegates protested that “UNESCO has a legal and fiduciary duty” to fully resolve the funding questions “so that there is no cloud of illegality hanging over the prize.”

It remains unclear if Obiang, who has pushed this prize as part of a major effort to improve his global standing, will attend the award ceremony, as foreseen in the program for the event. The prize was first approved in 2008 as the “UNESCO-Obiang prize.” His name was dropped from the award in the face of outrage from prominent African and Latin American intellectuals, writers, journalists, Nobel Prize Laureates, scientists, health professionals, and civil society groups who criticized the president’s poor human rights record and alleged involvement in money laundering.

Ongoing corruption investigations of members of the Obiang family in France, Spain, and the United Statescontribute to questions over the source of the prize’s funding. On March 5, Association SHERPA and Transparency International France requested that French judges extend France’s corruption investigation to include Obiang’s $3 million donation for this prize.

Serious allegations of corruption and money-laundering on a grand scale by the president or his family and close associates are now being examined by multiple judicial bodies internationally. 

Obiang’s eldest son and presumed successor, Teodoro Nguema Obiang Mangue, known as Teodorín, is wanted under an international arrest warrantissued by French judges on July 10 in connection with the case in France. 

In a move that may have been an attempt to grant Teodorín immunity from prosecution, Obiang appointed his son to be Equatorial Guinea’s deputy permanent delegate to UNESCO in October 2011. 

In May, Obiang also named Teodorín to be Equatorial Guinea’s second vice president, a post not foreseen under the country’s constitution. Teodorin’s lawyer in France contends that the arrest warrant “is null and void because of Mr. Obiang's status” as second vice president.

French authorities have twice raided a lavish residence used by the Obiang family in Paris and seized large quantities of luxury goods valued at tens of millions of Euros belonging to Teodorín.

In a separate investigation, the United States Department of Justice has filed complaints that provide detailed allegations that Teodorín abused his prior government post as Minister of Agriculture and Forestry to extort and launder money to finance more than $300 million in high-end purchases between 2000 and 2011, including properties in Brazil, France, South Africa, and the United States with a total value of US$133 million, and $45 million in art by Renoir and other master painters.

Lawyers for Teodorín in France and the US have disputed the claims against their client.
Teodorín’s lifestyle and the prize’s stated goal of “contributing to improving the quality of human life” contrast sharply with conditions in oil-rich Equatorial Guinea, where poverty, human rights abuses, and corruption are widespread and social services are inadequate, the civil society groups said.

In contrast to UNESCO’s core mandate to protect and promote media freedom and information sharing, free expression and press freedom are routinely curtailed in Equatorial Guinea. The government also fails to publish basic information related to government budgets and spending.

“Ordinary people in Equatorial Guinea have never shared in the country’s wealth or their leaders’ fancy lifestyles,” Alicante said. “If they celebrate anything as they languish in poverty, it won’t be the UNESCO prize. It will be Teodorín’s arrest warrant.”

The statement was issued by the following organizations:
Association SHERPA
Committee to Protect Journalists
Corruption Watch
EG Justice
Global Witness
Human Rights Watch
ONE
For more EG Justice reporting on Equatorial Guinea, please visit:http://www.egjustice.org

Used cooking oil to fuel your car

By Esther Nakkazi

Imagine using waste cooking oil blended with diesel to fuel your car?

Pure fuels East Africa Ltd, a pioneer producer of biodiesel in the region based in Mombasa has switched to waste cooking oil from Jatropha to offer a cheap, environmentally friendly and renewable alternative that will keep East African economies green.

“We stopped using Jatropha because it proved expensive to transport from Arusha and to remain profitable, so we have focused on used cooking oil which we are collecting from hotels and restaurants,” said Daniel Mugenga, managing director, Pure Fuels (E.A) Ltd.

In its new marketing strategy, Pure Fuels (E.A) now focuses on production of the biodiesel through engaging sub-contractors who are encouraged to buy their GXP-200 processor and collect waste cooking oil from hotels and restaurants.

Since its inception in 2008, the company has been processing biodiesel and has used its experience to develop a simple and efficient multi-feedstock processor the GXP-200, which can process vegetable oils, animal fat, used cooking oils or a mixture of them all.

It processes 200 litres of biodiesel per 8 hours and sub-contractors are encouraged to produce a minimum of 200 litres per week, which has been calculated to enable them break even in less than 6 months and also grow the market with increased biodiesel output.

The GXP-200 costs Kshs.99, 000 inclusive of VAT and although it is an easy to use technology, one of the challenges the team faces is people thinking it is complicated because to most of them ‘it is the first time ever they have heard of biodiesel and its production’ said an employee from Pure Fuels E.A.

But fortunately, the target market is fairly informed about the product and is growing demand. For instance last month, the company had further success after acquiring a contract with a leading bus shuttle service that operates within the Nairobi central business district as well as an independent fuel station chain in Mombasa, which are buying 130,000 Liters of biodiesel for a start.

This was on top of existing customers whose demand is the entire stock of 20,000-30,000 Liters per month. In the out-grower model they are using now, sub-producers are key but these have to buy the GXP-200 processor, source their own used cooking oil, seed oil or animal fat as the company supplies you with the know-how and chemicals.

It has also partnered with the Equity Bank, Bank of Africa to offer financing to prospective sub-contractors.

The current price for the finished biodiesel is between Kshs.64-70 per litre depending on the quantities supplied. For now the company is only offering a buyback guarantee for Kenya sub-producers but will expand soon to Uganda.

“At least through this model are able to know the profitability of collecting that particular diesel other than traveling over 50 kms expecting 1000 litres of used cooking oil only to find that only 200 litres of it is available,” said Mugenga.

And it is not only this uncertainty that has made the company change its strategy. At its inception, Pure Fuels targeted the use of Jatropha, which it was importing from Tanzania but it proved too expensive to meet their target of 10-20 percent less than the price of conventional fuel. 

The idea was to have a 20:80 ratio of diesel and biodiesel in the blend.

Now switching to cooking oil, Pure Fuels targeted the youth to become sub-contractors in an effort to reduce unemployment among the youth, women and people with disabilities.

“We assumed the youth would readily jump on board but our biggest market has come from middle aged individuals with established careers who use it a second income earner,” said Mugenga.
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Uganda Scientists 'Peanuts' salary rise

By Esther Nakkazi

Uganda’s President Yoweri Museveni this time fulfilled his promise to increase scientists’ salaries to motivate them and keep them home.

In the 2012/13 Budget, all scientists received a 10-30 percent salary increment including science teachers in Universities and post-primary institutions in a total amount of 290 billion ($II5 million) to be dispensed.

Studies done so far, have indicated that Uganda is currently experiencing high levels of brain drain as critical personnel, especially scientists seek for greener pastures not only in developed countries but also in other African countries mostly to Rwanda.

And the World Bank Migration and Remittance fact book 2011 confirms that there are about 750,000 Ugandans working abroad.

Scientists in Uganda blame the exodus of their colleagues on the lack of a good working environment, poor research infrastructure, unavailability of long-term benefits and opportunities for promotion. They accuse the government of insensitivity to their needs and failing to provide sufficient salaries.

This time round Museveni made his promise come true. During the State of the Nation Address ahead of the Budget he said, 'scientists are the only public servants that deserve higher pay because they contribute decisively to the economy and their contribution is unique. We cannot replace nor replicate them.'

According to Museveni, Uganda scientists who have finally woken up from a ‘long slumber’ are needed for a knowledge-based economy such as making cars, making computers, adding value to agricultural products and fabricating machines.

But scientists have called the increment ‘peanuts’ and wondered if this time the promise would manifest on their bank accounts since this is not the first time Museveni has talked about an increment.

“The president has many times promised us a pay rise. This is a group of people that can help the economy generate more revenue,” said Peter Ndemere Executive Director of Uganda National Council for Science and Technology.

It is the first time that the pay rise will be honored, if it is, after a million times of Museveni declaring a rise for the scientists. Immediately, he came to power in 1986 he pledged to raise scientists pay and even though the past two budgets speeches of 2010 and 2011 he was at it.

During all the innovations launches, his signature speech is a pay rise for scientists with the most recent during the launch of the Makerere University’s pioneer electric car, Kiira EV.

“I highly welcome the idea but this government is known for backtracking on its promises. I will only celebrate if the long-awaited increment is finally reflected on my pay cheque”, said Ninsiima Daniel a young research assistant at Makerere University Agriculture Research Institute Kabanyolo.

“Everything is theoretical. You forego a lot of things while training to become a scientist only to earn peanuts,” said Professor Eriabu Lugujjo head of Department of Electrical Engineering at Makerere University.

Professor Lugujjo said he manages to get by “.....digging. I engaged in farming long ago, because I know that if you solve the basic needs you can read sensibly.”

But Museveni has since warned that Uganda is not like Europe advising that many public servants have land at home and can grow food to supplement the now small salaries until the situation improves.
“When we build the base of our economy, we shall all be better off,” he said. “I still await patriotic offers about the voluntary salary cuts.”

One of the reasons the implementation of the pay rise delayed, was because 'he' was facing a lot of ‘resistance’ in the Government as officials still wanted salaries to be based on protocol and not one’s profession and contribution to the economy'.

Ministry of Finance officials argued that the scientists pay rise should be based on how important they are to the growth of the economy. So ultimately the scientists will get wages depending on their productivity. What have Ugandan scientists produced? There are no innovations!, remarked an official in Finance ministry.

But the Association for Strengthening Agricultural Research in East and Central Africa (ASARECA) officials said Uganda has a lot of innovations and products from scientists. The varieties of maize, beans, banana, cassava, sweet potato, cowpea, potato, groundnuts currently being grown in Uganda have been developed - courtesy of the efforts of Uganda scientists.

They said Uganda would also have very little milk and beef in the country if disease and pest control packages including nutritional packages developed by scientists were not available.

“This tendency to take scientists efforts for granted is an issue that requires a total reboot of the minds of our policymakers,” said Dr. Charles Mugoya, the head of Biotechnology and Biosafety program at ASARECA.

“We should not confuse and equate the inadequate capacity in the country to upscale locally developed technologies and innovations developed by scientists to lack of scientific innovations,” he said.

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Biotechnology Crop Development in Africa

Press Release: African Agricultural Technology Foundation

Dr Denis T Kyetere, the Executive Director at the African Agricultural Technology Foundation (AATF), today said that improved seeds and other farm technologies are best bet for enhanced agricultural productivity in Sub-Saharan Africa (SSA) where smallholder farmers make up 70 percent of people that depend solely on agriculture for livelihood and suffer most challenging farming problems. 


Speaking at the 2012 ‘Bio International Convention: the Global Event for Biotechnology’ in Boston, MA, USA, Dr Kyetere also said that smallholder farms also have lowest farm production costs and any investment will be visible and impactful. The use of improved technologies will result in higher and better yields, labour savings and will also allow for possible crop diversification and address production constraints such as insect and weed pests, drought, diseases, and soil degradation and protection of the environment. ‘I believe the greatest impact, benefit and return on investment will be realised at smallholder level,’ he said.

However, while agricultural biotechnology advances rapidly in the developed world, developing countries are struggling to keep pace for various reasons including human and institutional capacity challenges, lack of familiarity with the biotech product development process, and difficulties in navigating cumbersome regulatory processes.

‘We are calling on the private sector to partner with the public sector to contribute to the development and delivery of biotechnology tools to smallholder farmers in Sub-Saharan Africa to help overcome some of these challenges. The private sector can contribute their technologies, knowhow and even funding. Other key areas include capacity strengthening in areas such as stewardship, product development and deployment and participating in policy development debates where they can share their experience with governments.’ Dr Kyetere added.

Despite these challenges, there is increased and encouraging biotech activity in Africa. Awareness on the potential of modern agricultural biotechnology in the region is on the increase with various countries already applying various tools. South Africa, Burkina Faso and Egypt already have developed commercialised genetically modified (GM) crops. In addition, six countries have enabling biosafety laws in place that allow the safe development and commercialisation of GM products.

The 2011 Global Status of Commercialized Biotech/GM Crops produced by the International Service for the Application of Agri-biotech Applications indicates that there is increased biotech research around important staples in Africa such as cowpea, cooking banana, rice, maize, cassava, sorghum, and sweet potato. There is also greater attention and interest towards intelligent crops that can utilise natural resources to ensure environmental conservation; produce enough food – such as water use efficiency, nitrogen use efficiency, tolerance to stress such as salt, drought and heat.

In addition to the above, resolutions and actions have been taken at continental, sub-regional and country levels to provide general direction, support policy decisions and action and contribute to R&D activities. This activity has also recognised biotechnology as offering options to food security.

‘However, there are immediate challenges to overcome so as to advance biotechnology development in SSA – these includeemerging regulatory/biosafety frameworks that may delay smallholder farmers from accessing the tools of biotechnology and prevent them from enjoying the benefits that this may bring to their farming productivity,’ said Dr Kyetere. Some biosafety policies could serve as a disincentive to introducing technologies to smallholder farmers.

Dr Kyetere also noted that misinformation and controversy regarding biotech is a hindrance to public acceptance of biotech in the region. The process of bringing biotech to SSA is also riddled with trust issues as skepticism of private sector involvement in humanitarian projects through public private partnerships (PPPs) is expressed. Further, insufficient government funding for research contributes to slow growth of biotechnology on the continent.

‘In order to support biotech crop development in less developed markets like Sub-Saharan Africa there is need to nurture and initiate efforts that contribute towards creation of an enabling policy environment for the development of such innovative technologies,’ said Dr Kyetere, adding that biotech research programmes benefit from enabling activities that deal with intellectual property, licensing, technology stewardship, regulatory science, communication and issues management, market linkages and research, and development management and coordination.

Currently working in 8 countries in SSA, AATF facilitates access and delivery of affordable agricultural technologies for use by smallholder farmers in Africa. Priority areas for the Foundation include addressing targeted agricultural constraints facing these farmers which include the impact of climate change in agriculture; pest management; soil management, nutrient enhancement in foods; improved breeding methods; and mechanisation. These are addressed through the access, development and deployment of accessible, transferable, adaptable and proven technologies.

Projects that AATF currently participates in include: Striga control in maize; development of insect-resistant cowpea; improvement of banana for resistance to banana bacterial wilt; biological control of aflatoxin; development of drought tolerance in maize; and development of nitrogen-use efficient, water-use efficient and salt tolerant rice varieties for use by smallholder farmers in SSA.

East African ICT Budget Allocations and Priorities for 2012/2013

CIPESA Press Release Information and Communication Technology, a sector recognised as crucial to social and economic development by the East African Community (EAC), received meagre budget allocations for 2012/2013 in most of the regional grouping’s five member countries - Burundi, Kenya, Rwanda, Tanzania and Uganda. East Africa is a leader in adoption of mobiles, and, led by Kenya, in adoption of mobile money and a string of technological innovations. The figures allocated by the different states, and the (non)-mentions of the ICT sectors in the spending blueprints for the coming year, seem to indicate that most EAC governments have surrendered the role of developing the ICT sector to private players - if they ever quite had the baton. The Rwanda government, taking notable strides in promoting ICT infrastructure investments and enabling usage by citizens, put no figure to the sector's portion of its US$ 2.32 billion budget. Uganda's US$ 6.4 million ICT sector allocation is the highest in the last three years but represents a mere 0.13% of the budget. Among the priorities for Kenya’s more than US $17 billion budget were implementing the new public sector reforms and the country’s new (2010) constitution, and funding the upcoming general elections. But it still made, by regional standards, a far larger allocation to ICT. Tanzania, one of the region’s top misers as far as allocation to the ICT sector is concerned, increased duty on mobile telephone airtime, taking it to a league Uganda has for long dominated, where telephone services are taxed steeply. In this June 2012 briefing paper, the Collaboration on International ICT Policy for East and Southern Africa (CIPESA) takes a peek into the East African ICT budget allocations and priorities for 2012/2013. Read the full brief here http://bit.ly/LrSZlA