URN.Dr. Henry Luzze, the Acting Commissioner National Tuberculosis and Leprosy Programme at the health ministry, says Uganda will only become TB free with increased funding for medicines and health education since stigma and discrimination against TB patients is high at 53.7 percent even though detection is at nearly 85 percent. Luzze says the country needs over 46.6million US Dollars, about Shillings 180 billion in 2021 and 2022. However, there is a funding gap of 15.6million US Dollars, about Shillings 60 billion
Medical workers and civil society activists want the government to invest over shillings 20 billion annually in the next 8 years to treat people with Tuberculosis-TB and reduce community transmission.
They made the call on Friday during the National TB Advocacy Meeting held at Imperial Lake Heights Hotel in Entebbe.
Dr. Charles Ayume, the chairperson of the Parliamentary committee on Health, said Parliament doubled government funding for managing TB from shillings 2billion in the previous financial year to Shillings 5 billion in the 2022/2023 financial year.
Uganda is among the 30 high burden TB/ HIV countries according to the World Health Organization-WHO with about 90,000 TB cases. The Ministry of Health figures show that 240 new TB cases occur daily. The government wants to reduce TB incidence by 20 percent from 200 cases in 100,000 people to 160 cases in 100,000 people by 2025.
The highest TB cases are among contacts, tobacco users, uniformed personnel, prisoners, refugees, fisher folk, miners, the mentally ill and diabetics.
Dr. Henry Luzze, the Acting Commissioner National Tuberculosis and Leprosy Programme at the health ministry, says Uganda will only become TB free with increased funding for medicines and health education since stigma and discrimination against TB patients is high at 53.7 percent even though detection is at nearly 85 percent.
As a result, 39 percent of people with TB are not seeking treatment while 20 percent of patients who are diagnosed with TB do not start treatment, which makes it hard to eradicate the killer disease.
Dr. Luzze says the country needs over 46.6million US Dollars, about Shillings 180 billion in 2021 and 2022. However, there is a funding gap of 15.6million US Dollars, about Shillings 60 billion since government and development partners have committed to provide 30.9million US Dollars, which is approximately Shillings 120 billion. Government has committed to provide 4 million US Dollars, about Shillings 15 billion while the rest of the money is expected from the Global Fund, USAID, US Centers for Disease Control-CDC and World Bank.
He therefore called for increased government funding to close the gap which would result in raising awareness, since only 46 percent of the general population has knowledge about TB symptoms, improve TB contact tracing coverage from the current 33 percent and establishing patient feedback mechanisms to improve treatment success rates from the national average of 75 percent to over 90 percent among others. Lango and West Nile regions registered the highest treatment success rates of over 90 percent between April 2021 and Match 2022 while Kigezi region, Kisoro district in particular registered the lowest rates ranging from 42.2 percent to 70.6 percent in the same period.
Dr. Ayume however says the best strategy is to increase funding for health education and promotion for TB and other curable diseases.
Dr. Ayume, who is also the Koboko Municipality MP, says health education and promotion will curb infections and also reduce stigma against TB patients in communities. “We all benefit when TB patients take their medicine on time, eat the prescribed foods and get cured eventually. But those who do not adhere to the treatment requirements are a risk to their contacts and the rest of society since they have not completed treatment.”
He says parliament passed the Public Health (Amendment) Act, 2021 and among others made it mandatory for children to be vaccinated against the diseases such as TB, tetanus which are part of the country’s routine immunization schedule which will help curb TB infections on children.
Also, government for the first time has procured medicines worth shillings 7 billion for TB patients across the country.
Joel Yoweri Ssebikali, the Ntwetwe County MP and vice chairperson of the parliamentary committee on health and the chairperson of the parliamentary Forum on TB prevention, says the government needs to earmark at least shillings 30 billion for TB control annually.
Dr. Ayume and Ssebikali however say the government and private sector players must start thinking of ways to meet the funding requirements because of the anticipated donor fatigue after 2030 for disease control and will most likely channel their funding towards mitigating climate change across the globe.
Dr. Paul Isiko Kawanguzi, the Executive Director Uganda Stop TB Partnership, says nearly 15 people die from TB every day in Uganda. He wants the government to increase funding for TB control and also to mainstream TB in its programmes like the fight against HIV/AIDS and gender based violence.
Dr. Dauda Mugoya, the Medical Superitendent of Iganga Hospital says the facility recorded 313 TB cases in 2020/2021 financial. Though 221 got cured, 40 died, 7 had treatment failures while the hospital failed to follow-up on 27 patients. in 2021/2022, the facility recorded 251 cases of which 215 got cured, 8 died and 7 cases were never followed up. “We need staff and money for adequate monitoring of patients to ensure they complete treatment because some patients die due to poor adherence and poor feeding.”
According to the World Health Organization-WHO, Tuberculosis (TB) is caused by bacteria and affects mostly the lungs. WHO adds that “TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. A person needs to inhale only a few of these germs to become infected”.
In 2020, close to ten million people get I’ll with TB. In the same year, 1.5million people died from TB including 214,000 people with HIV.
