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Row over money will hurt Uganda’s Ebola response

Saturday November 05 2022
Ebola outbreak in Uganda

As the Ebola outbreak in Uganda stretches into eight weeks, the country is facings a gaping credibility gap. PHOTO | BADRU KATUMBA | AFP

By The EastAfrican

As the Ebola outbreak in Uganda stretches into eight weeks, the country is facings a gaping credibility gap. Hemmed in by one of the longest Covid-19 lockdowns globally that kept learners out of school for a solid two years, the government was slow to impose a quarantine in the six districts where the haemorrhagic fever, confirmed on September 20, first erupted.

The lockdown on the districts only came a month later, after the first case was registered in the capital. Cases traced to a primary school in the capital, have since deepened the government’s dilemma over how not to proceed. With promotional exams in session, and Treasury staring at empty coffers, the trade-offs are steep and money has taken centre-stage.

It is evident that pressure to contain the outbreak has been tempered by fear of spreading unnecessary panic, which anyway, has already hit sectors like tourism. Tour operators have reported a high cancellation rate while there’s a tug of war over whether, international events, previously scheduled in the country should proceed.

Awkward response

The awkward response is somewhat odd for a country that has dealt with Ebola on at least four previous occasions. The first and most deadly outbreak of Ebola in Uganda was in 2000, when 426 cases and 224 deaths, including medical workers were registered.

In contrast, the current outbreak has seen 130 cases and 43 deaths, including six health workers and representing a fatality rate of 33 percent registered by October 31. Despite the lower number of cases, what is alarming is the scope of contacts spread over a large geographical area, including the terminally congested capital, Kampala. More than 2,000 contacts are lined up for follow up as cases pop-up hundreds of kilometres away from the epicentre.

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Experts’ attribute this to a number of factors including better mobility, superstition that has seen some patients visit traditional shrines instead of health facilities and cultural practices in which the dead have been exhumed for pre-burial rituals, nearly wiping out entire families.

Less obvious and hushed up however, is the simmering conflict over resources. Local leaders, seen as essential to mobilising community responses, stood back suspecting they had been locked out of the gravy train that comes with such emergencies.

Clash

Early on in the epidemic, Dr Ruth Aceng, the Minister for Health was reported to have clashed with the Uganda Virus Research Institute, a regional reference laboratory for research into zoonotic diseases, over leadership of the response to the outbreak. Early on, frontline health workers, still owed risk allowances for work during the Covid-19 response, were reluctant to join in the latest emergency.

As the Health ministry made a pitch to parliament for up to Ush 75 billion to fund the response, the US embassy released a statement that it had so far disbursed $22.3 million to support Uganda’s response to Ebola.

Earlier, US ambassador to Uganda Natalie Brown had been quoted as saying that donors had opted for in-kind support after the Ministry of Health failed to account for Covid-19 support funds.

The current epidemic may well be on its way out but it leaves behind a singular lesson. For Uganda to get back on top of the game, it will have to do something about emergency response money or perceptions of it.

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