The health sector in Uganda is very frail. The sector battles with institutional bottlenecks, inadequate funding, and human resource gaps among others. This is further compounded with outbreaks of epidemics amid resource constraints. One such disease that has largely neglected is Hepatitis B. The prevalence rate in Ugandan is (10%) a lot more than HIV/AIDs which is 7.2% (Adult prevalence)
Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV). For some people, hepatitis B infection becomes chronic, meaning it lasts more than six months. Having chronic hepatitis B increases your risk of developing liver failure, liver cancer or cirrhosis — a condition that causes permanent scarring of the liver. A vaccine can prevent hepatitis B, but there’s no cure if you have it. If you’re infected, taking certain precautions can help prevent spreading HBV to others.
This pandemic had been killing people silently with little action from government or development partners.
On 3 July 2014, Hon Ababiku Jessica, Woman MP Adjumani petitioned parliament on the outbreak of Hepatitis B (HBV) in Madi Sub region. It was indicated that between April and July 2014 only 121 cases had been registered in Adjumani hospital alone.
3.5 million Ugandans (10%) are living with chronic hepatitis B, with the highest infection rates in Karamoja (23.9%), Northern Uganda (20%), West Nile(18.5%) and western region (10%). Hepatitis B (HBV) is responsible for 80% of all liver cancers in Mulago hospital.
In the past two years the ministry of health had indicated that funding for fighting the epidemic was an unfunded priority requiring 30 billion shillings. However, the fight received an enormous ally in the members of parliament on the committee on health. In the policy statements for Ministry of health for the FYs 2014/15 and 2015/16, the ministry requires 29.5 bn shillings for emergency response towards mitigating the Hepatitis B outbreak in the country. This is to cover immunization for both children and adults. In the budget for FY 2015/16, 5bn shillings was earmarked for this cause.
The parliamentary committee on health urged parliament and ministry of health to find funds within the budget to address this concern. Members even suggested that unless funds for fighting HBV are made available the budget for health would not be passed. Consequently the budget for HBV was increased from 5 to 10 billion shillings for the FY 2015/16.
In their presentation to the committee on health on 16th July 2015, the ministry of health officials explained how the funds allocated are going to be used to tackle the epidemic. Among these include procuring vaccines, procuring antiviral and lab reagents and programme development and activities. Vaccination is the primary remedy: The goal of vaccination is to reduce the complications of HBV such as liver failure, liver cirrhosis and liver cancer, reduce the socio-economic impact of HBV and reduce community immunity to HBV.
Amid resource constraints and budgets cuts in the health sector, the efforts of parliament and ministry of health to find lasting solutions to the pandemic are commendable. But the challenges still persist especially in regards to funding gaps given the huge demand for the service from the increasingly growing population, limited evidence, experience and expertise nationally and globally, inadequate investments in health services especially human resource, screening and infrastructure and limited donor support.
That withstanding, the efforts being made right now are a step in the right direction, and hopefully in the subsequent budgets similar provisions will be made to ensure that all Ugandans are vaccinated and immune to this dangerous disease.