On Saturday June 26, Uganda’s Permanent Secretary in the Ministry of Health, Dian Atwine, appeared on the “Big Talk” talk-show on NBS, a local television channel, to explain her government’s response on covid 19. She was an hour late, was very agitated and frustrated. She spent the next hour quarrelling and accusing the media and the general public of branding her corrupt.
The following day, President Yoweri Museveni while opening the regional World Health Summit conducted virtually, was also agitated and frustrated. He insulted his officials for being incompetent and ignoring his advice to procure hospital beds, adequate oxygen and personal protection equipment yet he had given them the requisite money. He was also angry with them for ignoring his advice to invest in manufacturing local vaccines.
To a keen observer, government officials are in disarray and don’t seem upto the task to efficiently manage the second wave of the covid 19 pandemic.
As government labours to identify people to feed politicians are blaming technocrats for incompetence while technocrats are blaming politicians for having ignored the covid 19 standard operating procedures during elections leading to community infections.
Meanwhile security personnel are on rampage torturing ordinary people on the wrong side of covid 19 measures and extorting money from them.
There seems no clear plan on how to get out of this quagmire. And this is motivating the opposition led by Dr Kizza Besigye to mobilize citizens to defy the lockdown measures and go back to work. Besigye, who has four times competed with President Yoweri Museveni for state power, has given government an ultimatum of a week to come up a clear plan on covid 19 management.
Only President Museveni, however, appears to have clarity of mind on how to save his people in the short term. His philosophy in response to the pandemic if effectively implemented could completely wipe out coronavirus and its effects.
Mr Museveni has instructed his people to use herbal medicine having failed to secure the necessary vaccines in time. He has also locked down the country to disrupt the spread of coronavirus and reduce positivity rate from 17 to below five percent.
No one in government, however, has a detailed list of vulnerable people to be fed. Neither does government have clear bail out plans for the business community. Instead the revenue authority is mounting pressure on the business community to pay taxes even though people are locked in their homes.
Government borrowed close to $800m between March and December last year to manage the pandemic. Those funds were either misappropriated or misallocated.
Today, Mr Museveni’s government is unable to borrow again because its books of accounts are in red—the debt to GDP ratio has skyrocketed to over 51.9 percent.
In addition, government projects to lose two trillion shillings in revenue collection in the financial year starting this July. Analysts estimate the covid 19 effects will continue hurting the economy for another four years.
So the only hope is on the $1bn (3.5 trillion shillings) IMF loan of which $258m has been disbursed so far.
The Ministry of Finance has also decided to suppress 44.7 trillion shillings budget, to raise 600 billion shillings for covid 19 emergencies (372 billion shillings) to increase bed capacities; buy more oxygen; pay allowances for medical personnel; recruit more doctors and nurses and empower village health teams and local councils to raise awareness on the pandemic.
Out of the budget suppression, 54 billion shillings is to feed the vulnerable poor that live by hand to mouth, whose work was disrupted by the lockdown.
Of the relief package only 500,000 households in urban areas throughout the country yet Kampala city alone has 1.7 million residents. Each family is to get 100,000/= for the entire 42 days of the lockdown. But even getting statistics of the vulnerable has taken government three weeks even though they provided food relief in the first lockdown.
“This is tokenism. We should have locked down the country in a cascaded manner,” Leader of Opposition, Matthias Mpuuga, said on NBS talk-show on July 3.
However, covid 19 patients continue to die as a result of lack of oxygen and prohibited medical charges. Worse, hospitals are detaining dead bodies to recover their money.
The population is getting frustrated. Youth have resorted to drug abuse (14% increment during covid 19, according to police statistics). While infected people have resorted to all kinds of concoctions to save their lives.
Ms Diana Atwine, the Health Ministry Permanent Secretary, has upto now failed to explain why she failed to procure the require beds, personal protection equipment, oxygen and pay medical personnel (for 10 months they haven’t been paid).
At the start of the lockdown the president instructed his officials prepare for 42,000 beds but Atwine says they have been banking on local manufacturers who have yet to deliver. So far, she says, only 400 beds have been supplied, and the next batch arrives in the next eight months.
Dr Atwine told local media that while they had planned for procurement of an oxygen plant and other supplies, the global demand is overwhelming the manufacturers, leading to delays in deliveries.
“Right now we are supposed to procure oxygen plants, but all the manufacturers are fully booked. Countries like India have booked all those machines with fully paid up-front. Now I must order manufacturing of those machines and wait. Now when the things come a little late, am I at fault? Why must I be lambasted for the delays by [the] manufacturer when there are too many orders?” she questioned.
Dr Atwine also blamed the cumbersome procurement and public finance management laws in the country for delays to respond to emergencies.
Atwine said her ministry is being unfairly criticised over Covid-19 management and instead blames Ugandans for refusing to heed to the advice of the ministry predicting a second wave.
“But I have heard people out of ignorance, out lack of knowledge shouting… How can we work in this kind of hostile environment? Isn’t that unfair to us? We who never take leave even on Sundays and are always in office working, even on Christmas and Easter, isn’t that really unfair?” she questioned.
The Auditor-General’s 2019/2020 financial year report states that procurements were delivered before being approved by the contracts committee or signing contracts with suppliers. In some cases, procurements were started without the availability of funds, funds were diverted and often unaccounted for.
The report also highlights instances where the health ministry delayed issuing appointment or deployment letters to engaged staff, and to pay staff allowances to individuals.
Parliament that would have saved the situation has gone on recess. The legislture, a key institution that must approve and monitor funding for covid 19, was ordered to shut down beginning on June 28 after more than 200 MPs and Parliament staff tested positive for coronavirus.
Unconfirmed reports indicate that the Parliament Speaker Rt Hon Jacob Oulanyah was flown out of the country very ill.
Seventeen ministers also missed the swearing-in ceremony recently largely because they got in contact with people who tested positive for Covid-19. Some ministers admitted that some people close to them had tested positive and were in self-isolation for 14 days as the rules require.
Although covid 19 is choking Uganda the pandemic has become lucrative business for some people. Hospitals hiked patient charges to prohibitive costs (between 1 to 10 million shillings a day). It is also mandatory that relatives procure services funeral service companies to pick dead bodies from mortuaries and bury them at a cost of about five million shillings.
As a result people with influence resorted to stealing vaccines and other crucial drugs to sell on the market to desperate Ugandans.
Desperate Ugandans holding onto life in the wake of Covid 19 have resorted to all measures to survive as health care facilities fail to cope with the rising cases. This has left many underprivileged Ugandans worried about their own livelihoods. This has led to fear and panic within the population with some using untested herbal concoctions to try to beat Covid-19. Some are unsure about what to eat.
According to the Senior Presidential Advisor of Epidemics, Dr Monica Musenero, an epidemiologist by training, Uganda lost control of the Covid-19 pandemic in August 2020 after the government opted to re-open certain sectors that had been closed, failed to trace contacts and rolled out a political campaign that resulted in community infections.
Dr Henry Mwebesa, the Director-General of Health Services equally acknowledged that it is hard to tell the number of people on home-based care since many patients are not reporting to health facilities.
Worse still, Uganda has failed to secure vaccines although government says they are developing their own vaccines. Out of a target of 22 million Ugandans to be vaccinated only about 1.3 million have been vaccinated.
The cost of Oxford-AstraZeneca vaccine dose has increased from $8 (Shs28,456) to $40 (Shs142,249) per dose.
President Museveni says they will continue engaging with India to secure Astrazneca; the USA for the Johnson-Johnson vaccine, China, Russia and Cuba.
In the meantime, Uganda has approved use of Covidex, herbal medicine, as supportive treatment.
Covidex is a new drug locally-manufactured by our medical personnel at Mbarara (University of Science and Technology) that is yet to undergo clinical trials.
Although covidex gives hope to majority of Ugandans the unanswered question is; how do they go back to work after losing their jobs and businesses?
The IMF estimates four percent growth, but Ramadhan Ggoobi, an economist and lecturer at Makarere Business School, says the second wave is likely to shrink Uganda’s GDP by 10 percentage points hitting badly sectors likely, tourism, retail trade, manufacturing, transport and agriculture.
He argues that government can only get out of the crisis by creating an SME recovery fund of about 200 billion shillings to jumpstart the economy. He also says commercial banks should be de-risked so that money is available for lending.
It is important to first keep people alive and then work on recovery of businesses, Ggoobi says.