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several manufactures can now bid for the supply of LLINs under the Global Fund facility and enable the purchase of the total amount of LLINs the country needs to achieve the 2010 targets.
Secondly it was agreed that both polyester and polyethylene LLINs be procured as long as they have been approved by WHO Pesticide Evaluation Scheme (WHOPES). This use of the two types side by side in Uganda means that now, big quantities of LLINs will be available to meet the numbers that are required by the country.
Thirdly, in order to quicken procurement it was agreed that the Voluntary Pooled Procurement (VPP) will be used as a temporary measure to purchase the nets while the national procurement system is strengthened to take on the task. The VPP will apply for both the nets and ACTs.
Lastly, the Delegation pledged to support local production of ACTs that are to be of high quality, affordable and efficacious. In that regard local manufactures of ACTs are required to submit data and information that will satisfy the independent reviewers as is required internationally and by WHO regulations and standards for pre-qualification. On behalf of WHO, Dr Chan promised to assist the local manufactures to expedite that process.
The Delegation also noted that while Uganda and other African countries have more than their fair share of disease burden, they do not have a fair share of resources both financial and materials to tackle the problem. This greatly constrains the malaria control efforts and the delegates pledged to leverage with donors such as the Global Fund to increase timely funding to countries.
The Delegation noted with satisfaction the excellent work done by the Community Drug Distributors and advised government and other health workers to always keep in constant dialogue with them to boost their morale and commitment as health volunteers. They also called for the scaling of CMDs/VHTs to cover the whole country.
On Indoor Residual Spraying using DDT, Ministry of Health officials reported dramatic drop in malaria cases in areas where the exercise had been tried out and reported that only a recent litigation by some environmentalist halted the expansion of the exercise to other district. To this, WHO Director General called for caution pointing out that DDT should only be used in special circumstances, under strict supervision and following WHO guidelines, to avoid damage to the environment. She also noted that to avoid development of resistance, DDT should be used alongside other insecticides like the pyrethroids. Dr Chan promised to assist government work with the President’s Malaria Initiative (PMI) and other partners to gather evidence and information by conducting insecticide susceptibility mapping studies so as to support any decisions that may be taken by government on the insecticide to be used for IRS in the different sites.
Turning to malaria drug stock-outs, the Delegation promised to use their influence, contacts and power to leverage with the Global Fund for quick procurement of ACTs for Uganda.
In general, the Delegation and Uganda Government officials noted that no one strategy can work alone to tackle the malaria problem. It will have to be a three pronged approach of use of LLINs, indoor residual spraying (IRS) and effective treatment using artemesinin combinations therapy (ACTs). This should of course be combined with social mobilization for behavior change.
In the meeting with the Speaker of Parliament Honourable Edward Ssekandi and members of the Parliament Social Services Committee, the importance of political commitment and support was emphasized. The Delegation noted that while some components of the malaria control strategy such as a comprehensive National Malaria Plan and funding can be handled by experts and donors, the issue of political support can only be handled by governments and parliaments.
The Delegation noted that if all agreed measures are implemented, it will be possible to achieve the universal coverage whereby every Ugandan will sleep under an ITN by the end of 2010, reduce to near zero malaria deaths by 2015 and to achieve the malaria related MDG targets by 2015. They promised to come back to Uganda at the end of 2010 to check on the progress and successes Uganda will have attained.
During the visit, the Delegation held talks with the Vice President of Uganda His Excellency Professor Gilbert Bukenya, the Speaker of Parliament Mr Edward Ssekandi and members of the Social Services Committee, the Minster of Health Hon. Stephen Mallinga, UN Head of Agencies, Malaria and Health Development Partners and senior editors from the local and foreign media houses. They also visited the Quality Chemical Industries Ltd plant and Wakiso District to interact with Community Medicine Distributors. They also visited a Health Center III and a private drug shop.
For more information please contact Benjamin Sensasi, Health Information and Promotion Officer, WHO Country Office Tel 256-41-4334400 Email: sensasib@ug.afro.who.int
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