Reviewing our Strategy

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Thank you to all who have helped raise more than £210,000 over the last five years to  support the work of International Medical Foundation in Uganda.

Our founder and chairman, Kevin Duffy, recently returned to the UK and so we are taking this opportunity to review those programmes that Suubi Trust has been supporting, before deciding our strategy for the coming year.

GoU Plans Forced HIV Test for All Patients

I read in today’s Monitor that the Government of Uganda is planning to require all those who attend a health centre or hospital to have an HIV test. Whilst I understand why some will support such a policy, there will be others who will resist it, especially from a human rights perspective.

It is very important that we all have regular HIV tests and that we know our own status and that of our partner(s). Usually this is done on a voluntary basis in which we rely on an individual coming forward for counselling and testing, VCT. Sometimes counselling and testing is initiated by a health service provider, PITC, e.g. when women attend ante-natal or a man comes forward for safe male circumcision.

A policy which mandates testing will need to be carefully planned and we will need sufficient time to allow for wide and full discussions regarding the issues that will follow.

  • Is it right for the GoU to ask health workers to enforce such a policy, especially if the patient is refusing?
  • Are there enough, adequately trained, and skilled, counsellors to ensure that patients receive all relevant information to enable informed consent?
  • Will we be able to enrol all those that test positive onto the necessary care and treatment programmes, ART?

HIV prevalence is on the increase in Uganda and more people are becoming infected than the number of those that are started on treatment, so yes we need to improve Prevention. Testing accompanied with enrolment onto treatment programmes is an essential prevention measure, I’m just not convinced making it compulsory will work here and the backlash may in itself prove detrimental to other prevention campaigns.

World AIDS Day 2012

WAD RibbonAs we celebrate another World AIDS Day, these data may make a sobering read:

  • 1 person dies of an HIV/AIDS related illness every 18 seconds.
  • 1 person becomes infected with HIV every 14 seconds.
  • The number of those infected with HIV grows by 1 every 56 seconds, that’s 563,142 per year.

We need better Prevention.

Africa Radi-Aid for Norway

People don’t ignore starving people, so why should we ignore cold people?
Frostbite kills too.

Imagine if every person in Africa saw the “Africa for Norway” video and this was the only information they ever got about Norway. What would they think about Norway?

If we say Africa, what do you think about? Hunger, poverty, crime or AIDS? No wonder, because in fundraising campaigns and media that’s mainly what you hear about.

The pictures we usually see in fundraisers are of poor African children. Hunger and poverty is ugly, and it calls for action. But while these images can engage people in the short term, we are concerned that many people simply give up because it seems like nothing is getting better. Africa should not just be something that people either give to, or give up on.

The truth is that there are many positive developments in African countries, and we want these to become known. We need to change the simplistic explanations of problems in Africa. We need to educate ourselves on the complex issues and get more focus on how western countries have a negative impact on Africa’s development. If we want to address the problems the world is facing we need to do it based on knowledge and respect.

The video is made by The Norwegian Students’ and Academics’ International Assistance Fund (www.saih.no). With the cooperation of Operation Day’s Work (www.od.no). With funding from The Norwegian Agency for Development Cooperation (Norad) and The Norwegian Children and Youth Council (LNU). Music by Wathiq Hoosain. Lyrics by Bretton Woods (www.developingcountry.org). Video by Ikind Productions (www.ikindmedia.com)

Radi-Aid: Norway for Africa.

20,000 HIV Infections Averted

SMC Small LogoThe SMC Programme in Uganda started in the second half of 2010. In the twelve months October 2010 to September 2011, a total of 40,000 SMCs were performed. From October 2011 to September 30th, 2012, PEPFAR reports a total of 348,000; which is a significant year-on-year increase. So, to date, the SMC programme in Uganda has reached a total of 388,000.

In 2011, DMPPT modelling for Uganda showed that in order to reach the target 80% prevalence of adult males circumcised by 2015, it needed to perform 4.25m circumcisions and an additional 2.1m in the years 2016 to 2025 to maintain that degree of prevalence. The total discounted cost of doing so was estimated at just over $350m. The number of SMCs required to avert one future infection varies from country to country; this modelling indicated that Uganda needs 19. This suggests that such a programme would avert 350,000 new infections, 25% of the total expected over that 14 year period, at a cost of $1,408 for each HIA, which in turn would generate future savings of $5,992.

In summary, 6.35m SMCs over the years 2011 – 2025, at a discounted cost of $350m, could generate total future savings of $1.52 billion.

The country still has a long way to go in the national scale-up of the programme. It has set a challenging target of 1m SMCs for the 12 months to the end of September 2013, a 250% increase in the current rate of output.

The good news is that these 388,000 SMCs may potentially avert some 20,000 new HIV infections, saving the country more than $100m in the cost of future treatments.

SMC is not an invisible condom, it is only partially protective against infection (60%) and men must continue to be serious about protecting themselves and their partner(s).

Recent Tweets

I know that many of you, okay most of you, are not Twitter users. So I thought it might be interesting to post some of my recent tweets here.

Enjoy…

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It’s less than 1% of budget but need to ensure cost effectiveness > RT@EGPAF Bono to urge USA not to cut aid programs: http://reut.rs/RT98BQ

Yes improve access but also influence behaviour > RT@gatesfoundation 200m worldwide don’t have access to contraception: http://no-controversy.com

RT @malonebarry: On reports #Uganda dropped $2.3m on two cars for Museveni, Ugandans have just started hashtag #ThingsMusevenisBenzCanDo

Do babies in UK die as result of diarrhoea? They do in Africa. > @DHgovuk: Rotavirus vaccine planned to protect babies http://ow.ly/fa3OZ

Worthy of support > @targettb in 2011: 1 cause, 5 countries, 11 partners, 15 projects, 360 donors, 85,924 lives touched http://ow.ly/f7nUp

Good update on SMC programme in Uganda > RT@GdnDevelopment Mixed progress in male circumcision campaign to combat Aids http://gu.com/p/3bjhf/tw

I read this in The Independent, sad and annoying, fat cats eating. Museveni adopts new tactics in corruption fight: http://bit.ly/RwgVa8

Having more money for health may not solve all probs > RT @DailyMonitor Editorial: When will we deal with healthcare? http://www.monitor.co.ug/OpEd/Editorial/When+will+we+deal+with+healthcare+/-/689360/1609776/-/144lvtw/-/index.html …

Safe Male Circumcision not an ‘invisible condom’. It is part of comprehensive prevention package that includes condoms and behaviour change.

The number infected with HIV increases by one every 56 seconds, that’s 563,142 pa. We need better Prevention: http://bit.ly/QWFev0

Whilst many are busy tweeting about Andrew Marr’s History of the World, I’ve been watching History of Modern Britain, people are fascinating

I’ve just updated my professional profile on LinkedIn. Connect with me and view my profile. http://lnkd.in/565yy7

Gaming the System

There seems to be no end to people’s ingenuity when it comes to gaming a system. Donors funding the national safe male circumcision programme ask partners to provide lists of names and contact details for those that they have circumcised, before payment is made. I know some donors then check these randomly by calling and asking how the individual is healing, what they thought of the service provided, were they asked to pay etc.. Earlier today I heard that some are paying up to UGX 20,000 ($8) for a name, telephone number and agreement by that person that they will say they have been circumcised.

6,172 Health Workers to be Recruited

It seems that the Government of Uganda has agreed the need to recruit more healthcare workers. That’s really good news and something that should be positively received. The Ministry of Health will need to make sure that matters affecting morale are also tackled; salaries are too low, health centres are often in a poor state of repair lacking equipment and medical supplies. These issues all contribute to poor morale and staff seeking alternative opportunities. These extra six thousand will not be sufficient to bring the numbers of healthcare workers to the levels that WHO suggest are required, or even to the average in the Africa region. If all 6,172 new recruits are doctors (very unlikely), Uganda would have 1.8 per 10,000 citizens; the average in the Africa region is 2.2.