On Friday 10th December 2004, Hon. Kirunda Kivejjinja, Minister for the Presidency represented His Excellency Yoweri Museveni at the official launching of the new Uganda Stop TB Partnership. The colourful ceremony marked by the unveiling of the Partnership Logo was attended by, among others, Senior Staff of the Ministry of Health, representatives of the District Councils of all 56 Districts of Uganda, all District Directors of Health Services, District TB/Leprosy Supervisors and Medical Superintendents of regional referral Hospitals. Other important guests included Dr Paula Fujiwara of the International Union Against TB and Lung Diseases, Dr Ger Steenbergen representing Executive Secretary of the Global Stop TB Partnership and Dr G. Gargioni from WHO in Geneva.
The Uganda Stop TB Partnership (USTP) is the national equivalent of a Global partnership to Stop TB. The latter was formed in 2000 with the aim of amalgamating the efforts of major players in TB Control to accelerate efforts against the Global TB Epidemic.
The launching ceremony was preceded by a half day National Conference on Tuberculosis. Opening the Conference, the Director General of Health Services, represented by the Director Clinical and Community Health, Dr. Sam Zaramba, emphasized the need for all districts to include TB control activities in the District Work plans and to allocate necessary resources for their implementation. A presentation by the national programme manager highlighted the TB burden of Uganda. An estimated 80,000 new cases of Tuberculosis occur in the Country every year. Just about half of these are at the moment picked up by the health system.
The Tuberculosis problem is compounded by the HIV/AIDS epidemic as indeed about 50% of all TB patients are also infected with HIV. Dr. Adatu, the National TB/leprosy Programme manager also described the strategy adopted by Ministry of Health for fighting TB: Community Based TB care with DOTS. In this strategy, the Community partners with the health services in ensuring that TB patients can take their full course of treatment on a regular basis in the comfort of their own homes. It assumes a high level of political commitment, a network of laboratory services to diagnose new cases of TB, a regular supply of good quality anti TB drugs, supervision of the daily swallowing of tablets and a system for recording and reporting the outcome of treatment. Out of 56 Districts, 54 are already implementing the DOTS Strategy.
Dr. Martin Okot-Nwang, a Senior Consultant Chest physician at Mulago Hospital described the challenges posed by the clinical care of TB patients. Among others, he pointed out the challenge of giving good quality care in the face of the huge number of patients and limited facilities. He also lamented the lack of progress in the area of developing more user friendly tools for detecting TB and of new drugs to treat it.
The Director of the Traditional and Modern Health Practitioners and traditional healers united against HIVAIDS (THETA), Dr Dorothy Balaba, presented the important role Traditional Healers can play to compliment the conventional health services against TB. She reported that THETA had demonstrated in several districts that it is possible to establish a referral system between the Traditional healers and Biomedical Service Provider (the conventional).
A presentation by the Private Sector Coordinating Entity, (a private sector core group to fight HIV/AIDS, TB and Malaria), Mr. Alex Menyha revealed the important role of the Private and corporate sector in the TB control services. He described the opportunities to recognize and treat TB in the work place setting.
All in all the presentations illustrated clearly that TB control is not the exclusive responsibility of the ministry of Health or the Public Sector. The Uganda Stop TB partnership was formed by a core group of stake holders in the struggle against TB in Uganda. These include: The World Health Organization (WHO), The International Union Against Tuberculosis and Lung Disease (IUATLD), The National Tuberculosis/Leprosy Programme of the Ministry of Health (NTLP), Doctors with Africa (CUAMM), German Leprosy and TB Relief Association (GLRA), Traditional and Modern Health Practitioners Together Against AIDS (THETA) and The AIDS Support Organization (TASO).
Others are: AIDS/HIV Integrated Model District Programme (AIM), JSI-DELIVER, The Unites States Agency for International Development (USAID), Centres for Disease Control and prevention (CDC), Italian Association for Solidarity among people (AISPO), AIDS Information center(AIC), Uganda Peoples Defense Forces (UPDF), Uganda
Prisons Services, Uganda Police Force, Makerere University Medical School, International Service Volunteers’ Association (AVSI), The Uganda Private Medical Practitioners’ Association (UPMPA), The Italian Cooperation, International Medical Corps and Malaria Consortium- East and Southern Africa. Representatives of these core partners were introduced to the guest of honor with a brief description of their existing and/or potential roles in the TB control programme. The introductions covered in addition, representatives of people treated for Tuberculosis and the Uganda Business Coalition on HIV/AIDS. One of the main objectives of the national coalition is to provide a platform for coordination of agencies and stakeholders to contribute to the fight against TB. While partners retain their identity, they contribute to the overall thrust of the partnership with the strength of their identity. During their presentations, Dr Rosamunde Lewis, on behalf of the WHO Country Representative, Dr Oladapo Walker, and the Executive Secretary of the Global Stop TB partnership congratulated Uganda for being the first country to launch a Stop TB partnership on the African content and one of the few in the whole world. In the speech read for him by the Hon. Kirunda Kivejjinja, the President acknowledged the high TB burden in Uganda, its social economic implications and the important relationship between TB and HIV/AIDS. He reaffirmed Uganda’s commitment to achieve not only the targets set for end of 2005 but also the Millennium Development Goals. The President paid glowing tribute to the development and other partners that are supporting Uganda in this area. He saluted the Ministry of Health for honoring the pledge to facilitate the development of a national response against TB. The instruments of the artnership i.e. the logo and the Terms of reference were received from the guest of honor on behalf of the artnership by the Interim Executive Secretary, Dr. Herman Joseph Kawuma, the country Medical Adviser of the German Leprosy and Tuberculosis Relief Association (GLRA). The name has been associated with the formation of the National Tuberculosis/Leprosy Programme especially in the areas of training of district level TB/Leprosy Focal Persons and the success story of the Leprosy Control Programme in Uganda.
Uganda Stop TB Partnership will be housed in the Country Office of the World Health Organization but will operate from there as an autonomous body. The partners will utilize this platform to bridge human resource and other gaps in the TB control programmes at District level and to maintain a relationship with the Global Stop TB Partnership. They also expect to play the continuing role of providing the Ugandan public with accurate information about TB and the fight against it.
Going by the theme of the launching ceremony getting TB on the Agenda, a role for all, it is expected that many other agencies both from the health service and the corporate sector will join the partnership and help Uganda to mount a truly national response to the TB problem.