Tuesday, May 19, 2009

Corruption-Uganda's perspective -Part 5

Malaria Deaths overwhelming!!!!!!
Your article on health: “Anti Malarial-Saying Bye to the Bitter Tablet” The New Vision, Monday, November 10 attracted attention because it is part of the good news that will help save about 110,000 Ugandan children who die annually due to malaria. Again on Saturday November 22, The New Vision ran an article about ‘Malaria Drugs running out’. The article pointed out that Uganda was running out of malaria drugs in public hospitals, after having lost funding from the Global Fund over accountability problems. In our Anti-corruption Week campaign of 2007, it was revealed that leakages of essential medicines is up to 73% and since the drugs are meant for the rural and peri-urban poor, such leakages have only led to increased mortality rates for the vulnerable groups, mainly children and women. If the accessibility of this drug is enhanced, it means that we can control malaria mortality to a figure of about 30 children per day compared to the current disquieting figure of 329 per day on average. Since it is clear that the Government has branded these medicines-thanks to the Ministry of Health, the President, the National Medical Stores and National Drug Authority — what is left is to roll out the said branded medicines to lower health centres and to ensure proper use. As a national coalition in the week ending November 16, we moved around the country and the truth is that nothing has changed in terms of costs for essential drugs like Coartem (when obtained legally or illegally). However, there is some level of readiness in our regional coalitions in Teso, Kigezi, Rwenzori, Apac, northern Uganda, West Nile and Bunyoro regions to follow and monitor distribution of essential drugs to ensure better service delivery in this sector that has had its share of corruption. According to statistics from the health ministry, as quoted by the Sustainable Development Centre Makerere University, malaria, acute respiratory infections, diarrhoea and malnutrition contribute to over 70% of overall child mortality in Uganda, in particular malaria is known to account for 25% of mortality among children who are less than five years of age while pneumonia and diarrhoea account for 19% and 17% respectively. This being the case, however, in 2005, the proportion of children under five years with fever, diarrhoea and pneumonia seeking care within 24 hours of illness was 30%, but this only rose to 54% in 2006/7. Similarly, the proportion of children under five with acute diarrhoea receiving oral rehydration therapy increased dismally from 37% to 43% in the same period; the proportion of children under five with pneumonia receiving appropriate antibiotic treatment increased modestly from 30% to 47%. Against this background, the health ministry, in its mid-term review 2007/8 has set target of 60%, 80% and 80% respectively for these indicators by the year 2009/10. The national drug policy emphasises providing essential medicine that is to say those that are required for the treatment of the most common conditions in the majority of the population. They should be availed in all health units at all times. Essential drugs for children that the health ministry supplies under the essential drugs are Arteminisinin Combination Therapy (ACT) for example Coartem and Duact, and Quinine for malaria; Oral Rehydration Salts, Cotrimoxazole tablets, Amoxicillin, de-worming tablets (Mebendazole and Albendazole)”. It is the leakage in malaria drugs that needs to be followed if the situation of the children noted above is to be reversed and the goals set by the Government in the context that development goals are to be achieved and a reduction of child morbidity and mortality will happen. In this regard, we are aware of the child survival strategy for Uganda that has been formulated by the health ministry. The strategy is to work within the framework of development goals to guide the actions for scaling up effective and affordable interventions to reduce child mortality and morbidity to achieve the Millennium Development Goal 4; and to contribute to the achievement of Poverty eradication targets during the period of 2007/8-2014/15. The above shows that within 12 weeks, we have lost 1094 Ugandans due to malaria out of 2,384,330 reported cases. If you estimate an average cost of sh5,000 per reported case (as treatment fees), then about sh11.9m has been used in such a short time by poor patients. The solution lies in Coartem with a success rate of over 95%. Coartem, as one of the Artemisinin- based combination therapy. A fixed dose that has been approved for treatment of malaria is a welcome initiative and since the Government has reduced it from an average of sh15,000 to sh14,000 for children dose and sh18,000 for adult dose as current market prices) to sh400 in a government facility and 800 in a private facility respectively. Our appeal is that an effective scheme is taking long to be implemented and the average malaria deaths per day have not decreased since this was announced in September 2008. Let us translate words into action and our nation will have better services especially in the social sectors Health, Education, Water, Agriculture as we grapple on the way to handle grand corruption that seems official. Only then can we say there is hope for the poor rural folks.

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