The Fight against He­pati­tis B: Fi­nally there is light at the end of the tun­nel

By: Reagan Wamajji

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.