Making care available at public health facilities to save citizens from dependence on expensive drugs from private pharmacies or using ineffective herbal concoctions

Debate on the floor of the Parliament of Uganda on October 21, 2021, shifted from politics to health issues when a member moved a motion for a resolution of Parliament urging the Government to provide free drugs to diabetic and hypertensive patients.

Hon. Patience Nkunda, the Woman MP for Kanungu District, said the burden of treating NCDs was becoming unbearable for citizens.

 She said 40% of Uganda’s public health centers do not stock drugs to treat chronic diseases, yet they are too expensive for an average Ugandan to afford.

While seconding the motion, Tororo Municipality MP, Hon. Apolo Yeri Ofwono urged the Government to procure and avail these drugs to the health centers through the National Medical Stores (NMS) instead of forcing citizens to buy them from the private clinics or resorting to herbal concoctions.

While supporting the motion, Butambala Woman MP Hon. Aisha Kabanda narrated what she goes through treating her relatives suffering from cancer and diabetes. She called for extensive research on NCDs to find local solutions.

The MPs requested for the building of capacities at low-level health facilities to tackle NCDs by equipping them with screening machines and training health workers to offer efficient NCD services.

There was also a suggestion to introduce a National Physical Activity policy to address the NCD risk factor of physical inactivity. They said that roads especially in the city need to be modified to cater to cyclists and pedestrians to aid policy enforcement.

NCD is a national burden

NCDs are non-infectious health conditions that result in long-term health consequences and often create a need for long-term treatment and care.

NCDs are one of the leading causes of morbidity, disability-adjusted life years (DALYs), and mortality worldwide. Annually, NCDs kill 41 million people globally. DALYs due to NCDs are reported to have increased by more than 80% between 2000 and 2019. In 2016, over 97, 600 deaths were attributed to NCDs translating into 1 in 3 deaths annually in Uganda [4].

The initial formal priority to NCDs was in 2006 following the establishment of the NCD prevention and control program by the Ministry of Health (MOH). Since then, Uganda has continued to develop NCD policies majorly focusing on preventive measures tackling modifiable risk factors e.g. unhealthy diet, physical inactivity, excessive alcohol consumption, and tobacco use.

In 2010, the National Health Policy prioritized NCDs in the Health Sector Development Plan though there were inadequate resources that constrained the NCD Desk’s ability to coordinate NCDs services effectively.

In 2011, the Parliamentary Forum on NCDs was formed for legislators to take advantage of their legislative, budgeting, and oversight roles for effective national health regulation. Furthermore, the forum’s strategic objectives incorporated the resolutions of the United Nations 19-20 September 2011 Summit in New York; advocating policy formulation, creating awareness of NCDs within parliament, and lobbying for resources to support all functionalities of NCD bodies and agencies in Uganda.

The forum has had several accomplishments such as; enacting a Tobacco Control Act, Alcohol Consumption Bill being drafted, advocating for physical activity facilities at workplaces, sensitizing masses on healthy feeding; shifting from sugar, fats, and salty diets to more fruits and vegetables, advocating early screening for cervical and prostate cancers.

The Tobacco Control Act, enacted in 2015, was to address the risk factor of tobacco use yet the tobacco manufacturing industry has continued to be a threat to the Act.

In 2019, the efforts of MOH working with partners, Uganda NCD Alliance (UNCDA) inclusive, elevated the NCDs Desk to a Department of NCDs and Mental Health with two divisions: lifestyle and mental health and substance abuse. This is expected to increase funding, power, and decision-making capacity to develop and implement NCD programs and policies.

Other policies focusing on preventive measures i.e. physical activity, nutrition labeling, restriction on the marketing of foods and non-alcoholic beverages to children, fiscal measures on sugar-sweetened beverages, and reformulation of foods are underway, thus deserting NCD treatment and palliative care.

Civil Society Organisations have supported and collaborated with the Government in drafting the above policies. UNCDA, in its advocacy work, has supported the introduction of a National Cancer Register and the establishment of an NCD Group in Parliament.

Other Parliamentary proposals

On NCDs awareness, MPs proposed the annual Parliament Health Week to be used as an avenue to educate the public about NCDs. They continued to request for free a radio talk show for health workers to sensitize the public about NCDs.

They called for the strengthening of the existing Multi-Sectoral Health Action Plan for NCDs and several related collaborations with Non-Governmental Organizations and development partners to support the Government in creating public awareness on NCDs.

The legislators also suggested that the existing and amended health policies should be followed up by the leaders to ensure proper enforcement. VHTs were recommended to be utilized to detect these NCDs at the earliest stages and NCDs to be included in the school syllabus.

They insisted that if such proposals are considered, the program of NCDs prevention and control will be uplifted hence reducing the NCDs incidence and mortality in Uganda.

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