By Enatu Steven
The Hepatitis Aid Organization has urged the Ugandan government, specifically through the Ministry of Health, to consider increasing the budget allocation dedicated to the eradication of hepatitis in Uganda.
Emmanuel Lutamaguzi, the Executive Director of the Hepatitis Aid Organization and an individual living with hepatitis B, made this plea at this year’s Hepatitis B celebration in Kumi.
Lutamaguzi highlighted that the funding allocated to the fight against hepatitis in Uganda has remained at 10 billion shillings since 2015 which is approximately USD 3m, despite the escalating burden within the community. “In 2019, we had the first African hepatitis summit and we made a commitment to support hepatitis C through the Egyptian government. As a civil society person, I would really push that we do something about the program; hepatitis C is curable. With the budget cuts, we need to do advocacy for increased budgetary allocation towards hepatitis. The last funding allocated has been the same for close to 10 years now,” Lutamaguzi appealed.
He said achieving the UN commitment of eliminating hepatitis by 2030 will be undermined if domestic funding is limited.
Uganda currently has 1.1 million hepatitis B patients and 356,000 cases of hepatitis C. Prior to the event, Kumi tested 7,110 community members, and out of this, 300 tested positive for hepatitis B. This indicates a prevalence of 4.1%.
Dr. Emmanuel Ongala, the District Health Officer of Kumi District, said the number is distributed throughout the district, and samples have been taken to the central public health laboratory in Kampala to determine who qualifies to be enrolled in treatment.
“We base it on several tests like viral load; if it’s high, we enroll you in treatment. We also compare your blood count and liver function. We calculate if you meet certain figures, we enroll you in treatment,” he explained.
Some hepatitis patients have mild symptoms that their body can fight, and they become normal, according to scientists. “We are also receiving supplies very soon from NMS to ensure all our clients are tested. So, as a district, we shall continue with interventions geared at eliminating hepatitis. One of them is ensuring that all our newborn children receive the hepatitis vaccine at birth,” he said.
Dr. Ongala said that it’s been proven that infection at birth is more severe and can lead to cancer in the future. The screening of children shall be enrolled at all health centers. He called upon the community in the area to embrace testing for hepatitis as the district has over 30,000 kits for carrying out tests.
Dr. Charles Olaro, the Director of Curative Care at the Ministry of Health, noted that the number is concerning since the country launched the vaccination in 2016. In 2000, the government also launched the vaccination for newborns. With this, Dr. Olaro noted that they wouldn’t expect such statistics in Uganda.
Prof. Dr. Ponsiano Acama attributed the high prevalence of hepatitis in the region to high alcohol consumption and cultural practices. He said the effects of alcohol on the liver are similar to the effects of viral hepatitis. In his keynote address, he said some people’s deaths are a result of alcohol-related hepatitis rather than viral hepatitis. Viral hepatitis is caused by five types: A, B, C, D, and E.
Hepatitis A and E are transmitted in the same way cholera spreads—through eating contaminated food and drinks. The two cause acute infection but are not chronic to the level of damaging the liver. Whereas B, C, and D cause chronic diseases and are transmitted in the same way HIV/AIDS is spread—through sexual intercourse, sharing sharp objects, and blood transfusion, which is rare in Uganda.
A person with hepatitis B may end up with cirrhosis, leading to liver cancer or liver failure and death. However, hepatitis B and D are intertwined, and D survives on B.
In the greater northeastern region, cultural and traditional norms are common ways through which hepatitis B is spread, according to Prof. Dr. Ocama. Practices like the traditional mode of treatment in childhood, when a child gets what is termed the first episode of diarrhea, involve a traditionalist removing the burning tool and using the same instrument on another child. If one child has hepatitis B, then it will be spread to the other.
Another form of cultural practice is the treatment of pneumonia in children, where a traditionalist removes fat globin in the child’s chest, allegedly the cause of pneumonia, and uses the same object on another child. If one child had hepatitis B in this process, it means the infection will spread. Tribal marking among some tribes like the Karamojongs also contributes. He strongly condemned these cultural practices.
Yesterday’s commemoration of World Hepatitis Day in Uganda, held at Kumi Boma Grounds, also marked a significant stride in the fight against hepatitis. The National Viral Hepatitis Prevention and Control Strategic Plan was launched during the event, which was presided over by the State Minister for General Duties at the Ministry of Health, Hannifah Kawoya, and the Director of Curative Care at the Ministry of Health, Dr. Charles Olaro, among others.
The plan articulates what the government intends to do both at the central and district levels, with much emphasis on prevention and treatment. The treatment of hepatitis is similar to that of HIV/AIDS. World Hepatitis Day was held under the theme “Eliminating Hepatitis: Hepatitis Can’t Wait, It’s Time for Action.”