In May 2023, the World Health Organization (WHO) declared that Covid-19 was nolonger a public health emergency of international concern. The declaration however did not mean that Covid-19 is over as a global health threat.
Since 30th January 2020, when WHO declared the pandemic outbreak, Covid-19 turned world upside down – killing over 7 million people, disrupted health systems, caused severe economic upheaval, disrupted travel and trade, shuttered businesses, and plunged millions into poverty.
In the 3 years, the pandemic exposed and exacerbated health system weaknesses especially in the global south – bringing global health security to the top of the post-pandemic agenda.
In Uganda, apart from Covid-19, the country’s health system has in recent years been strained by the outbreak of Ebola Virus Disease, Marburg, rift valley fever, among others and this has exposed system and structural weaknesses and highlighted the fact that the country must be prepared for health emergencies through proper planning, resource allocation, accountability, multi-stakeholder involvement, political commitment, and surveillance.
Health experts observe that pandemics, health emergencies and weak health systems not only cost lives but pose some of the greatest risks to the global economy and security.
According to Kenneth Mwehonge – the Executive Director HEPS-Uganda, emphasis at country, regional and global level should now be on preparedness and health systems strengthening.
“The COVID-19 pandemic demonstrated that the world was not well prepared to respond to global health security threats of such magnitude. Countries across all socioeconomic and development categories struggled to implement effective national responses. In this post Covid-19 era, governments especially in the global south must commit funds to support the development of country capacities to prevent, detect & respond to both existing & emerging global health security threats,” Mwehonge explains.
Jackson Tusiime; a public health specialist observes that “health security is not just a health issue, but a whole economy issue,” adding that when health security threats like epidemics and pandemics breakout, they affect every sphere of the economy. “However, allocation of funds in country budgets for health security strengthens health systems and the ability to cope when outbreaks occur,” he explains.
During the 3rd annual International Conference on Public Health in Africa, Dr. Merawi Aragaw Tegegne Head of Surveillance and Disease Intelligence at Africa CDC underscored the need for health security financing. “In order to prepare for the next pandemic, Africa must have dedicated and increased financial investment in preparedness and sustain innovations started during Covid-19,” he noted during the November 27-30th summit in Lusaka Zambia where Pandemic Preparedness and Resilient Financing Mechanisms for Africa was one of the thematic areas.
According to Uganda’s Ministry of Health, the country registered 170,255 cases and 3,632 deaths. Also, available data shows that by end of May 2023, a total of 26.4 million doses of Covid-19 vaccines had been administered in Uganda. Vaccination, and general Covid-19 response in Uganda was largely donor funded – just as it has been with other outbreaks like the Ebola Virus Disease that ravaged the country especially Mubende and Kasanda districts between September and December last year. To health experts, this is a trajectory that Uganda must reverse.
“Donor priorities are changing more often than ever. Government of Uganda – just like all other African governments must commit and allocate funds in the country budget for health security. Over reliance on donors is not sustainable, and the Covid-19 pandemic clearly highlighted this,” explains Nathan Byamukama – the Executive Director of the Regional Centre for Human Security – Great Lakes Region. According to Byamukama, domestic financing for health security and systems strengthening is possible even without expanding Uganda’s resource envelope. “In a country like Uganda with limited financial resources, the practical simple way of raising resources is to eliminate wastage. We must cut unnecessary and consumption expenditure like on travels and meetings, end corruption and misuse of public funds and this would save huge amounts of money that can be allocated to the health sector,” he explains.
Corruption remains a big problem in Uganda. At the peak of the pandemic, the Auditor-General unearthed mismanagement of close to 2 trillion shillings appropriated by Parliament to manage the COVID-19 pandemic. According to the audit report for the financial year 2020/2021, these funds were disbursed to government Ministries, Departments and Agencies.
Also, a forensic investigation into the Covid-19 funds expended in financial years 2019/2020 and 2020/2021 by the auditor general among others highlights corruption and funds accountability gaps. For example, the report indicates that out of 4.485 billion Shillings transferred to Regional Referral Hospitals for management of covid-19 related activities, 614 million remained unaccounted for as of 30th June 2021.
What is Global Health Security?
The World Health Organization defines global health security as the activities required, both proactive and reactive, to minimize the danger and impact of acute public health events that endanger people’s health across geographical regions and international boundaries.