Health

In 2016, an estimated 19.5 million infants worldwide were not reached with routine immunization services such as the DTP3 vaccine. According to the WHO’s 2016 epidemiological records, the African region had the highest number of unimmunized and incompletely immunized infants in the world. Unsurprisingly, Africa also accounts for roughly half of global vaccine-preventable deaths (VPDs) for children under five years of age, despite having only about 15 per cent of the world’s population.

To help understand the root causes of under-immunisation of children and vulnerable populations in sub-Saharan Africa, the Uganda National Academy of Sciences in partnership with the Academy of Sciences of South Africa (ASSAf), with support from the South Africa Medical Research Council and the South Africa Department of Science and Technology, was tasked to convene a consensus committee that would identify, review and assess the current state of knowledge the root causes of under immunisation in sub-Saharan Africa. The committee was tasked to develop recommendations for overcoming these barriers based on lessons learnt and contextual priorities.

In 2019 a panel of eleven experts was constituted to undertake this task. These include:

1. Prof Mayanja-Kizza, Co-Chair, Dean, School of Medicine at Makerere University and Fellow of the Uganda National Academy of Sciences (FUNAS)
2. Prof Shabir Madhi (South Africa), Co-chair, Professor of Vaccinology at the University of the Witwatersrand, Member of the Academy of Science of South Africa (MASSAf).
3. Prof Adegbola, Consultant and a Research Professor at the Department of Microbiology at the Nigerian Institute of Medical Research, Lagos, Nigeria.
4. Dr Kiguli is a Senior Lecturer, at the Department of Community Health and Behavioral Sciences at the College of Health Sciences, Makerere University, Uganda.
5. Dr Kisakye, the EPI team leader at the WHO Uganda office, is also the WHO liaison representative on the Uganda National Immunisation Technical Advisory Group (UNITAG).
6. Prof Lulseged, Professor of Paediatrics and Child Health at Addis Ababa University and Senior Associate Research Scientist at Columbia University’s Mailman School of Public Health, New York, USA.
7. Dr Helene Mambu-Ma-Disu, Senior Programme Officer for the Sustainable Immunization Financing Program of the Sabin Vaccine Institute
8. Prof Mphahlele, Vice-President of the South African Medical Research Council (SAMRC) and member of the Academy of Science of South Africa (MASSAf)
9. Ms Diana Kizza Mugenzi, Senior Programme Manager for the Sustainable Health Financing Programme at the Clinton Health Access Initiative (CHAI).
10. Prof Rees, Founder and Executive Director of the Wits Reproductive Health and HIV Institute (WRHI), South Africa, Professor of Obstetrics and Gynaecology at the University of Witwatersrand, South Africa and an Honorary Professor at the London School of Hygiene and Tropical Medicine. She is a Member of the Academy of Science of South Africa (MASSAf).
11. Prof Charles Shey Wiysonge, Director of Cochrane South Africa, the South African Cochrane Centre at the South African Medical Research Council (SAMRC). He is also a Professor of Epidemiology and Biostatistics at Stellenbosch University and a Professor of Public Health at the University of Cape Town, South Africa. He is a Member of the Academy of Science of South Africa (MASSAf).

In January 2019, UNAS partnered with the University of Michigan to convene diverse stakeholders from nursing education to share experience and knowledge, network, and align and act towards a set of common priorities. The critical position of nurses in the provision of primary healthcare motivated the discussion because their quality and number continue to suffer in Uganda. With a more cohesive understanding of the nursing education environment, the possibilities for innovative programme design, delivery, and professionalism in work could be expanded.

To document these discussions, UNAS published a workshop report entitled The Future of Nursing in Uganda: Governing a Shared Vision. The report captured 5 challenges in nursing education:

• Limited financial capital and independence
• Insufficient nursing educators
• Poorly aligned and implemented nursing curricula and national policies
• Inefficient governance structures
• Inaccurate student perceptions

With common consensus on these problems, the attendees developed 10 potential avenues for solutions to the above challenges:

• Collective action and resource pooling
• Increased peer-to-peer learning exchanges
• Increase the number of bachelor-level and higher degrees for nurses
• Enhance research networks and support to graduate level programs
• Reformulate curricula to better reflect demographic and epidemiological trends
• Conduct a national needs assessment
• Establish a national consortium of nursing degree-granting institutions
• Enhance compliance capabilities and coordination
• Incorporate the case for leadership and career progression in nursing education
• Conduct a public relations campaign about the critical role of nurses

Following the completion of this workshop, UNAS supported a rapid national needs assessment for nursing education institutions, setting the stage for ongoing collaboration and discussion between nursing education stakeholders.

Tobacco production, use, and exposure negatively impact the health, environment, and economies of countries. Increasingly, this burden is falling on low- and middle-income countries targeted by the industry for increased consumption and production. Given that Sub-Saharan Africa is still in the early stages of a tobacco epidemic, African countries have a critical window of opportunity to take urgent action to implement and enforce effective tobacco control policies and practices.

Some of the greatest challenges, however, are limited awareness and political commitment to address these negative effects of tobacco.

To this end, eight African Sciences Academies i.e. Uganda, Kenya, Senegal, Ethiopia, Cameroon, Ghana, South Africa, and Nigeria, under the leadership of the Network of African Science Academies (NASAC), with Technical support from the US National Academies (USNAS) partnered together to inform, engage and mobilize high-level African Leadership to prioritize tobacco control for the mitigation of the impending tobacco epidemic in Africa. To achieve these goals, the partnership convened a 16-person expert committee of some of Africa’s top scientists, international tobacco control leaders, and policymakers. The outcome is the consensus report titled “Preventing a Tobacco Epidemic in Africa. A call for effective action to support health, social and economic development.” 

In this report, the committee assessed the evidence on the state of tobacco use and production in Africa and the resulting detrimental health, economic and environmental effects. The committee also reviewed the efforts currently underway to prevent and control tobacco use, including the status of adoption and ratification of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC).  Based on this evidence, the committee reached a consensus on the actions that African leaders and other stakeholders should take to combat this growing threat.

This report clearly outlines the strong scientific evidence on which the recommendations are based, and is a powerful tool for use by stakeholders such as government ministries of health, finance, gender, labor, and social development, legislative bodies like Parliament, Advocacy groups like CSOs, and NGOs, Development Partners, Multilateral agencies and media houses; in sharing the responsibility of protecting those most vulnerable to misleading and deceitful messaging by the tobacco industry. 

Indeed, this report was a key tool used in the parliamentary debate in drafting the Uganda Tobacco Control Act 2015.

Malaria kills more than 400,000 people a year worldwide and causes illness in tens of millions more, with most deaths occurring among young children living in sub-Saharan Africa. Uganda has the sixth highest number of annual deaths from malaria in Africa, as well as some of the highest reported malaria transmission rates in the world, with approximately 16 million cases reported in 2013 and over 10,500 deaths annually

In order to plan ahead for the decision on a possible malaria vaccine, the Uganda National Academy of Sciences (UNAS) with support from the Programme for Appropriate Technology in Health (PATH)’s Malaria Vaccine Initiative (MVI) initiated a process to prepare the malaria vaccine decision-making framework (DMF) for Uganda. An inception meeting that was attended by stakeholders with diverse expertise in 2010 recommended the setting up of a Standing Committee that would ensure that the necessary data is available ahead of time to enable decision makers to make evidence-based decisions on vaccine introduction. The Malaria Vaccine Committee (MVC) was formally launched in April 2011 with initial funding for from PATH.

At its inception, the Malaria Vaccines Committee was tasked to perform the following specific roles:

1. Review the existing DMF to understand the data requirements and identify amendments to it that help to contextualize it to Uganda.
2. Carry out a review of available evidence to identify reliable data that can be used for the DMF and to identify data gaps that need to be addressed.

iii.        Identify key sources of appropriate data that are needed for the DMF and engage with the sources to see that current and new data are availed to the committee for its work.

1. Identify ways to fill in key data gaps for the DMF which will include liaising with people, groups or organizations and mobilizing resources for special studies to be commissioned.
2. Carry out an assessment of the institutional policy decision-making process to determine how the DMF can best fit and determine the key stakeholders that influence the process.
3. Set up time-limited subcommittees as the need arises to take on specific tasks. The committee can co-opt individuals who are subject matter experts to serve on these sub-committees. On a case by case basis, key resource persons shall be invited to participate in meetings of the Committee or its sub-committees.

vii.       Use data that accrues to simulate the decision-making process for any malaria vaccines that have the potential to be introduced as a public health intervention within the next five years.

viii.      Participate in networking and advocacy activities that can highlight the value of the DMF and the work of the committee.

1. Participate in documenting and disseminating the outputs of the work of the committee which will include but not limited to reports, newspaper articles and journal publications.

The Malaria Vaccine Committee Membership 2011-2018

Dr. James K. Tibenderana, Global Technical Director, Malaria Consortium, FUNAS

Dr. Sabrina Bakeera-Kitaka, Senior Lecturer, Paediatrics and Adolescent Medicine/Infectious Diseases Makerere College of Health Sciences, FUNAS

Dr. Myers Lugemwa, Team Leader(M&E and Research), National  Malaria Control Program, Ministry of Health

Ms. Christine Rebecca Mubiru, Former Principal Policy Analyst, Ministry of Health

Dr. Evans K. Tusubira, Clinical Trial officer, National Drug Authority

Dr. Ambrose Talisuna, Regional Scientific Director, Worldwide Antimalarial Resistance Network(WWRN)

Prof Fred Kironde, Senior Lecturer, Department of Biochemistry, Makrere University College of Health Sciences and Principal Investigator, GMZ-2 Malaria vaccine trial

Prof. George William Lubega, Professor in the Department of Veterinary Parasitology and Microbiology, College of Veterinary Medicine, Animal Resources and Biosecurity at Makerere University, FUNAS

Dr. Flavia Mpanga, Health Specialist, UNICEF, Uganda

Dr. Charles Katureebe, Country Advisor/Malari, WHO-Uganda Country Office Afro

Dr. Immaculate Ampaire, Senior Program Officer, EPI, Ministry of Health

Dr. Phionah Atuhebwe, Senior Program Officer, PATH

Achievements

The Malaria Vaccine committee collected and documented all data deemed relevant to enabling the Government of Uganda evaluate the Malaria Vaccine candidates available globally with the view of helping speed up the decision making process for its introduction in Uganda.

The developed a decision making framework for the Malaria Vaccine following a stakeholder consultative workshop (link to workshop report) frequently asked questions booklet (link to FAQ publication) summarizing answers to questions on the RTS,S Malaria Vaccine Candidate.

The convened the East and Southern Africa Regional Meeting of Malaria Vaccines committees in 2014, hosted an Academic Round Table Meeting to discuss the RTS,S Malaria Vaccine Candidate in 2015.

By 2020, the malaria vaccine had not yet been introduced in Uganda, but some countries in Africa including Malawi and Kenya had introduced it in their immunization progams.

For news and updates on the Malaria vaccine see link here https://www.malariavaccine.org/news-and-events