Thirty-eight LGBT and right-to-health organisations in Uganda have issued an open letter to Uganda’s health minister, Dr Ruth Aceng, expressing deep concern over the decision of the Ministry of Health to start charging Ugandans “an astronomical 240,000 Ugandan shillings” (about US $64) for Covid-19 tests.
By Kikonyogo Kivumbi
In their protest letter, the activists contend that charging such a high fee to a poor population would be “suicidal” because it would discourage testing and allow the unchecked spread of the killer virus.
Such an approach also negates the human rights-based approach to health care, they said.
Mr. Kenneth Mwehonge, the programmes manager at the Coalition for Health and Social Promotion (HEPS-Uganda), who delivered the letter to the minister, said many Ugandans cannot afford that price for Covid-19 tests.
All activists that endorsed the letter want the government to use the already mobilised resources from Uganda’s well wishers and friendly countries to pay expenses of Covid-19 testing, Mwehonge said.
The letter stated:
” … we are alive to the sizable amount of resources that have been mobilized from the World Bank, International Monetary Fund, African Development Bank, the US Government, the European Union, the Global Fund, and other institutional and individual in and outside Uganda to support Uganda’s response to Covid-19.
“We strongly urge Government of Uganda to use these and other aid resources and resources from the National Treasury to fund an effective national response to COVID-19 – including the transparent, cost-effective and optimal procurement and use of test kits – to enable as many Ugandans as possible to access free Corona Virus testing services.”
The activists’ letter is reproduced verbatim below:
OPEN LETTER TO MINISTRY OF HEALTH:
CALL FOR IMMEDIATE REVERSAL OF POLICY TO CHARGE USER FEES FOR COVID-19 TESTS
Your undersigned petitioning organizations and individuals are deeply concerned by the decision of the Ministry of Health to start charging Ugandans an astronomical UGX 240,000 for Corona Virus tests.
As the COVID-19 pandemic ravages the world and infections are yet to peak in Uganda, the policy to begin charging this so-called “cost recovery fee” is not only misconceived and mistimed but negates the human rights-based approach to health care.
We understand that the cost of testing for the new Corona Virus is very high and is straining national resources, which has posed a challenge for Ministry of Health to roll-out the much-needed mass testing. However, we are alive to the sizeable amount of resources that have been mobilized from the World Bank, International Monetary Fund, African Development Bank, the US Government, the European Union, the Global Fund, and other institutional and individual in and outside Uganda to support Uganda’s response to COVID-19.
We strongly urge Government of Uganda to use these and other aid resources and resources from the National Treasury fund an effective national response to COVID-19 – including the transparent, cost-effective and optimal procurement and use of test kits – to enable as many Ugandans as possible to access free Corona Virus testing services.
Before the advent of COVID-19, out-of-pocket expenditure on health has already been catastrophic for the majority of Ugandans and many poor households have sunk deeper into lifelong poverty and misery by just having one member suffer a serious health condition. In the short while that COVID-19 has been with us, this situation has been worsened as attention has turned away from pre-existing killer conditions.
It is important to remember that COVID-19 mitigation measures have already severely stressed the population financially for more than six months as movements were restricted, businesses closed, and livelihoods lost. The COVID-19 public health preventive measures such as face masks, hand-washing, sanitization, social distancing, curfews, isolation, quarantine and other “standard operating procedures” have come at a painful cost to Ugandans – and more so to the majority of Ugandans who live a hand-to-mouth lifestyle.
A human rights-based approach to public health generally, and to COVID-19 in particular, naturally means that Ministry of Health and Government of Uganda must avoid passing additional costs of health care to the population. It should be recalled that cost-sharing was officially abolished in the public health sector and has helped improve uptake of services. In addition, given the infectiousness of the new Corona Virus, the public benefits of paying for prevention and care far out-weigh the private benefits, which simply means that the national response must come from the public purse (not private pockets).
Introducing user fees also contravenes the technical normative guidance of the World Health Organization (WHO) that user fees have no role in an effective COVID-19 response.
While we recognize that the user fees are a Government response to the higher demand for tests, many ordinary Ugandans will not afford it (especially that it is not a one-off test) and testing only the rich who can afford will not help anyone in the end.
Based on the Ministry of Health circular issued on 27th August 2020, the new user fees include groups with high rates of COVID-19, such as people at exit and entry ports. This fee will deter people from testing, which is dangerous and counterproductive.
We therefore strongly call upon the Ministry of Health and Government of Uganda in general to immediately reverse this counter-productive policy before it backfires and it becomes too late to handle its obviously suicidal implications.
List of organisations who participated in the UCEAM meeting
1. Alliance of Women Advocating for Change (AWAC)
2. ACTs 101 Uganda
3. AIDS Health Care Foundation (AHF Uganda)
4. Center for Participatory Research and Development (CEPARD)
5. Coalition for Health Promotion and Social Development (HEPS Uganda)
6. Action Group for Health, Human Rights and HIV/AIDS Uganda (AGHA)
7. Centre for Health Human Rights and Development (CEHURD)
8. Positive Men’s Union (POMU)
9. National Forum for People Living with HIV/AIDS (NAFOPHANU)
10. Uganda Health Sciences Press Association (UHSPA)
11. Health Rights Action Group (HAG)
12. Mama’s Club
13. Mariam foundation
14. Makerere Women Development Association (MAWDA)
15. Global Coalition of Women against AIDS in Uganda (GCOWAU)
16. Uganda Network of AIDS Services Organization (UNASO)
17. Uganda Young Positives (UYP)
18. Uganda Cares
19. Human Rights Awareness and Promotion Forum (HRAPF)
20. International Community of Women Living with HIV Eastern Africa (ICWEA)
21. Initiative for Prisoners Health Rights (IPHR)
22. National Community of Women Living with HIV
23. Health Global Access Project (Health GAP)
25. Uganda’s young positive networks (UNYPA)
26. Uganda Key Populations Consortium (UKPC)
27. Sexual Minorities Uganda (SMUG)
28. Human Rights Research Documentation Centre (HURIC)
29. Centre for Health, Human Rights and Development (CEHURD)
30. Preventive Care International (PCI)
31. National Community of Women Living with HIV/AIDS (NACWOLA)
32. Uganda National Health Consumer Organisation (UNHCO)
33. Uganda Network of key population service organisation(UNESO)
34. Uganda Network on Law Ethics and HIV/AIDS (UGANET)
35. SAMASHA Medical Foundation
36. Kampala District Forum of PLHIV Networks (KADFO)
37. Southern and Eastern African Trade Information and Negotiations Institute (SEATINI)
38. Women Probono Initiative
Kikonyogo Kivumbi, the author of this article, is the executive director of the Uganda Health and Science Press Association.