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World Business Journal talks to Dr Diana Atwine, Permanent Secretary, Ministry of Health, about the progress made in increasing medical infrastructure and access and the outstanding challenges, such as ramping up home production of vital medical supplies.

What notable changes have marked the healthcare sector’s progress in the last five years?

The health sector has undergone substantial development in recent years. We upgraded more than 300 facilities, which reduced healthcare distance, putting 91% of the population within a 5km reach. The ongoing plan involves establishing basic health centres in every sub-county and constituency.

In the tertiary medical services domain, two specialised hospitals—Pediatric Surgical Hospital in Entebbe and Women’s Hospital—now serve as regional centres of excellence. Additionally, legal frameworks for organ transplants are in place, with two facilities ready for bone marrow transplants and a kidney transplant unit in Mulago.

Our Cancer Institute, the East African Center of Excellence for Oncology, has expanded to regional centres in Gulu and Mbarara. We’re enhancing cardiac care by establishing a standalone heart hospital in Naguru, which will be completed within two years.

We’ve established one of the largest medicine warehouses in Africa, the National Medical Stores.

Delivery indicators show significant progress: maternal mortality nearly halved from 336 to 189, under-five mortality and neonatal mortality reduced, and access to family planning and healthcare increased.

In the context of epidemics, especially with COVID and Ebola, we’ve demonstrated a robust capacity for effective response. The mobile lab quickly and efficiently processed samples, and a streamlined government structure, from local to national task forces, played a pivotal role in our overall success. Despite initial challenges, Uganda’s swift containment of Ebola within 90 days highlights the effectiveness of our established systems.

How have e-health and digitalisation influenced the health sector in Uganda?

We’ve been at the forefront of the digital health rollout, recognising E-health’s efficiency and real-time access benefits. Telemedicine facilitated through a telecenter in Mulago, has enabled consultations and advice from specialists, enhancing productivity and quality of care. Digitalisation is also crucial for efficient responses to epidemics, with our Emergency Operating Center receiving minute-by-minute information.

Our commitment to digitalisation extends to regional referral hospitals, with an ambitious target to fully digitise the health sector in the next five years. Strong regulations, including the recently passed Patient Data Protection and Privacy Law, assure data security. With a well-established Ministry of ICT, NITA-U as a digital regulator, and comprehensive policies on E-governance, the framework, structure, and laws are in place to drive and support our digitisation efforts.

What strategies could Uganda employ to lessen its reliance on imported essential medicines and health supplies?

About five years ago, we initiated engagements with potential manufacturers in the UK, collaborating with the government there and partnering with the Ministry of Finance to develop this sector. There are local manufacturers, but approximately 78% of the medicines used in the country are still imported. To support local manufacturers, the National Drug Authority charges only a 3% verification fee for locally produced medicines meeting standards, compared to a 12% fee for imported counterparts.

Recently, we secured land in Kisozi for a designated industrial park for pharmaceutical companies, working with the Ministry of Finance to ensure its full development. Once completed, we anticipate this industrial park, operational in the next 12-24 months, to be a significant incentive for manufacturers. Additionally, the government offers free land to manufacturers, further enhancing the favourable environment for investors interested in pharmaceutical manufacturing.

Where do you identify the most promising opportunities for pharmaceutical investors?

Our critical need is anticancer drugs, as we import all cancer medications. While we produce some antibiotics, there’s a gap in the entire range. Similarly, we don’t manufacture any vaccines, relying entirely on imports. Specialised care items such as kidney transplant commodities, including dialysis, IV medicines, antibiotics, immunotherapy, and supportive drugs, are all imported.

Currently, our local production covers under 30% of medicines and supplies needed. Investment opportunities exist in essential medical equipment, such as blood pressure machines, glucometers, and cholesterol monitoring devices, which are currently imported. Our goal is to support local manufacturers in producing point-of-care equipment and fostering self-sufficiency in healthcare resources beyond medicines.

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