Last week, Uganda celebrated 50 years of independence from British rule. However, Uganda’s Minister of Health, Christine Ondoa, missed the nationwide celebration so that she could travel to New York to spread the word about malaria.
While malaria rates drop globally, it continues thrive in Uganda. There, the curable disease is the leading cause of death. Ondoa takes the morbidity to heart. Before being appointed health minister in May 2011, she cared for hundreds of children stricken with the disease as the sole physician at a hospital in Northern Uganda. Powerful treatments and preventative measures for malaria exist, but they are out of reach for many. Ondoa spoke with Nature about her plan to organize a concerted, international effort to change that.
What is your malaria strategy?
In 2008, the non-profit organization Pilgrim Africa achieved a 92% decrease in the incidence of malaria in a small pilot programme with a multi-pronged approach. They screened everyone in the village for malaria parasites and treated those who tested positive; they gave malaria prophylaxis treatments to all pregnant women; they handed out bed nets; and they sprayed houses with insecticide. Most regions currently cannot afford to do all of these things simultaneously, but we hope to raise funds and better coordinate independent efforts so that we can cover at least 80% of Uganda.
We’ll need the equivalent of US$2 billion over five years. If we can achieve this, we will save money in the long-term because healthy adults will be able to work, and healthy children will be able to attend school.
What partners do you hope to attract?
The US President’s Malaria Initiative has agreed to continue spraying households in the northern districts, where we hope to implement the other measures as soon as next year. In January or February, we will have bed nets and malaria treatments provided through The Global Fund to Fight AIDS, Tuberculosis, and Malaria and additional treatments subsidized through the Global Fund’s Affordable Medicines Facility–Malaria (AMFm). We also hope to coordinate with organizations already running malaria initiatives in the country, including the Rotary Club, PATH and World Vision.
Is the Ugandan government committed to this plan?
Yes. The Ugandan government has agreed to put $1.5 million forward, and this is likely to increase over time. This year, our overall health budget increased. It now comprises 7% of the gross domestic product. With the extra money, we have been able to double salaries for doctors in the public sector. (Previously, low salaries provided little incentive for doctors to remain where they were needed most.)
Uganda has been in trouble with international donors because of corruption charges. Is the country’s reputation still damaged?
Since 2009, when the Global Fund froze our grants owing to diverted funds, we have strengthened our internal controls. Also, the government has made the officials who were found guilty of taking grant money, pay it back, and these officials have lost their jobs. The Global Fund has now regained confidence in us, and we will receive about 20 million bed nets from them in the beginning of next year.
Calvin Echodu, chief executive of Pilgrim Africa, adds:
Uganda has been a bad actor in international eyes. I think this is a chance for Uganda to show that we can make progress.