Saturday, 27 May 2017

UVRI in the Press


2014

Researchers to investigate Marburg source
November 11   2014
By Emmanuel Ainebyoona

Kampala-
Researchers are to investigate the source of the Marburg virus in Uganda that led to the death of one person in September, according to Prof Pontiano Kaleebu, the Director of Medical Research Council and Uganda Virus Research Institute (MRC/UVRI).
The development follows a confirmed Marburg death involving a medical worker, who died on September 28, this year. Since the 30-year-old’s death, no other person has tested positive of the Marburg virus in the country.

Strange
“We are finding it unusual to have a situation where one person dies from the hemorrhagic fever and source of the virus is not yet known,” Prof Kaleebu said in an interview with the Daily Monitor at an event to celebrate 25 years of MRC/UVRI held at their headquarters in Entebbe last week.

“We need to find out whether the virus exists internally within the population,” Prof Kaleebu said, adding that the entire population needs to be screened. MRC/UVRI was established in 1988 and hosts laboratories where blood tests from suspected Ebola and Marburg patients have been carried out in the country since the first outbreak in early 2000s.

 

Achievements
Commenting on the 25th anniversary, Prof Kaleebu noted that research findings at the unit working with various partners have contributed to the understanding and control of the HIV/Aids epidemic in Uganda and globally.

The research unit is also moving to expand its research into the non-communicable diseases, including diabetes, hypertension, cancers and mental illness, among others

On behalf of the chief guest Prime Minister, Dr Ruhakana Rugunda, the Minister of State for Agriculture, Mr Zerubabel Mijumbi Nyiira, applauded MRC/UVRI for its role in containing the hemorrhagic fever outbreaks in the country.

New clinic opened
Meanwhile, MRC/UVRI also officially opened a Shs4 billion clinic in Mengo- Kisenyi, targeting to offer free antiretroviral treatment (ART), free HIV testing to more than 7,000 low income earning women but mostly sex workers. The clinic construction and equipping was funded by the Center for Disease Control.

 

Uganda declared Marburg free!
11 November 2014
Ministry of Health- Uganda Press Release

Today, the Ministry of Health wishes to inform the Public that the country is officially declared free of the Marburg Virus Epidemic.

The declaration comes after completion of 42 days of the Post Marburg Surveillance countdown period which is a prerequisite of the World Health Organization (WHO) requiring any affected country to monitor the situation of any Viral Hemorrhagic Fever for that period before finally declaring an end to the outbreak.

The outbreak of the epidemic was declared on October 4th 2014 following laboratory tests done at the Uganda Virus Research Institute (UVRI) which confirmed that one person, a health worker, had died of the viral hemorrhagic fever.
The index case was a 30-year-old male Radiographer, who originally was working in Mpigi Health Centre IV, Mpigi Town Council but had been recruited by Mengo Hospital two months before his death on September 28th 2014 at Mengo Hospital.

The Ministry of Health informs the general public that since then, there have been no Marburg cases reported in the country. This implies that the Marburg outbreak in the country has completely been controlled.

Marburg is a highly infectious viral hemorrhagic fever that is spread through direct contact with, body fluids like blood, saliva, vomitus, stool and urine of an infected person. A person suffering from Marburg presents with sudden onset of high fever with any of the following; headache, vomiting blood, joint and muscle pains and bleeding through the body openings like the eyes, nose, gums, ears, anus and the skin.

From 4th October 2014 when the outbreak of Marburg was declared, the National Task Force on epidemics took up the coordination of all interventions geared towards combating the epidemic. Additionally, the district taskforces of Kasese, Mpigi and Ibanda were alerted to trace all people who could have got into contact with the confirmed case. Consequently four isolation centers were set at; Mulago National Referral Hospital, the National Isolation Centre in Entebbe, Mpigi Health Centre IV and in Kagando Hospital in Kasese.

During the period of the outbreak, a total of 197 people were followed up for three weeks in Kampala, Mpigi and Kasese districts. These are people who got into contact with the confirmed case either during his sickness or after death. During this time, eight of these contacts developed symptoms similar to those of Marburg.

However, their results tested negative for the Viral Hemorrhagic Fever at the Uganda Virus Research Institute.

A total of 13 samples were also collected from different parts of the country (Ibanda, Lira, Kitgum, Jinja, Gulu, Luwero and Kampala ) as part of a wider surveillance network during the period. On a good note however, they all tested negative for the Marburg virus.

By 20th November, all the contacts had completed their 21 days of monitoring and apart from the 8 who required laboratory investigation and tested negative; the rest did not develop symptoms which confirms that none contracted the virus. An additional 21 days of surveillance was carried out to make 42 days as a requirement for management and control of viral Haemorrhagic fevers.

The Ministry of Health urges the public to reduce the risk of wildlife-to-human transmission by avoiding contact with fruit bats, reduce the risk of human-to-human transmission in the community in-case of suspected cases reported by avoiding direct or close contact with suspected patients.

We urge the Health workers to wear gloves and appropriate personal protective equipment when taking care of ill patients.

The public is also urged to embrace regular hand washing after visiting patients in hospital, before eating and after using the toilets, to avoid infections.

Finally, the Ministry of Health recognizes the contribution of the different development partners for their support during the outbreak. Special recognition goes to the World Health Organization, the US Center for Disease Control and Prevention, Medicens San Frontiers, UNICEF, USAID (Communication for Healthy Communities), Airtel Uganda, Uganda Red Cross Society, World Vision Uganda, AFENET and the Media.

The Ministry of Health further acknowledges the efforts and contribution of Kampala Capital City Authority towards the control of this out break.

Lastly, the Government of Uganda once again reassures the general public that it is committed to protecting the population by ensuring that all measures are in place for early detection and immediate response to all Viral Haemorrhagic fever out breaks.

FOR GOD AND MY COUNTRY

Hon. Sarah Achieng Opendi
Minister of State for Health – Primary Health Care


Marburg: 11 suspects test negative
Publish Date: Oct 07, 2014
Newvision

By John Agaba

ELEVEN suspects whose samples were on Monday taken to the Uganda Virus Research Institute in Entebbe for testing after they developed signs of Marburg, have tested negative for the highly infectious virus.

A total of over eight people who earlier got into contact with Abraham Baluku (who died of Marburg on September 28) were on Monday confirmed to have developed signs of the highly infectious disease creating fear in the country.

About 100 people had been put under surveillance. But results from the Uganda Virus Research Institute indicate that although the suspects had developed signs and symptoms similar to that of the disease, they did not contract the virus. Among those who tested negative include: the brother of the deceased, two suspects (health workers from Mildmay Uganda), seven suspects from Mpigi Health Center IV and two relatives of the deceased who participated in the burial.

Dr. Jane Ruth Aceng, the director general of health services at the ministry, said three suspect cases remain in isolation. Two of these are admitted at the national isolation facility in Entebbe. They were picked from Rubaga Hospital after they showed signs similar to that of the viral haemorrhagic fever. Their samples were on Tuesday taken for analysis at UVRI.

They, however, had no contact with the confirmed case, a statement from the health ministry, said. 

The third suspect, who is admitted at Mpigi Health Center IV isolation ward, is a seven-year-old boy, who is one of the contacts that has been under surveillance for the last three days.  His sample was among those that tested negative. He, however, awaits a re-run of his blood sample after 3 days.

A statement from the health ministry however, said that the suspects will continue to be monitored. Those who continue to have signs, tests will be run again after three days.

 

Eight under surveillance over Marburg
Oct 06, 2014
Newvision

By Vision Reporter

The Ministry of Health has said a total of eight people who earlier got into contact with the Marburg confirmed case have developed signs of the disease.

This follows the death of a 30-year old health worker that was announced Sunday.

The victim had been a radiographer, or X-ray technician, at the Mpigi Health Centre IV, but was recruited two months ago for a similar position at Mengo Hospital.

When he felt ill on September 17, he traveled back to Mpigi for treatment since “he felt more confortable with a facility that he had worked with for a long time.”

Below is the full statement from the Ministry of Health:

A total of eight people who earlier got into contact with the Marburg confirmed case have developed signs of the disease.
The Ministry has taken samples from the eight suspects and are being investigated at the Uganda Virus Research Institute.

Among the suspects are four from Mpigi, two from Kasese and two from Kampala district. Preparations are underway to quarantine the suspects as a preventive measure for the spread of the disease.

To date there is only one laboratory confirmed case that has been reported in the country. This is the first case that was reported at Mengo Hospital and has since died.

The National Taskforce continues to closely monitor all people who got into contact with this confirmed case.

The surveillance team on Monday was able to list an additional 17 people who got into contact with this confirmed case.

These include 16 people from Kampala and one from Kasese. This therefore brings the total number of contacts under surveillance to 97.

The Ministry of Health with support from Medicens San Frontiers (MSF) and the US Center for Disease Control and Prevention, has today trained a total of 103 health workers from Mengo Hospital.

The team was trained in Marburg prevention, treatment and control. Others were trained in sample picking and infection control. A team of experts will tomorrow be dispatched to Kagando Hospital in Kasese district to guide health workers in infection control measures.

With support from MSF, rehabilitation of the Isolation Facility at Mulago National Referral Hospital will commence tomorrow 7th October 2014 and will be ready and operational by Wednesday October 8th 2014.

The facility will in addition to the National Isolation Center in Entebbe attend to all suspect and confirmed cases in Kampala and neighboring districts. The Ministry of Health has today dispatched a total of 300 Personal Protective Equipment (PPEs) to Mpigi Health Center IV and Mengo Hospital.

The Government reassures the general public that the situation is under control as everything is being done to control the spread of this highly infectious disease.

Dr. Alex Opio
FOR: Director General of Health Services

 


Marburg: Five more suspects reported, 97 being monitored

Tuesday, October 7  2014
By Agatha Ayebazibwe
Kampala.

The Ministry of Health yesterday sent five more samples of the suspected Marburg fever to the Uganda Virus Research Institute (UVRI) for more tests after they presented signs of the disease.

On Sunday, the ministry confirmed a health worker had succumbed to the disease following laboratory tests done on September 30.

The ministry is also awaiting results of a sample from the deceased’s brother, who has so far been listed as having developed signs of the deadly disease. He has since been quarantined and isolated for further monitoring.

According to the World Health Organisation country representative, Dr Alemu Wondimagegnehu, the five samples were drawn from people who were in contact with the deceased while at Mpingi Health Centre IV.

“The information we got from the team on the ground is that the five presented with signs of the disease. The samples have been delivered at UVRI and results are expected soon,” Dr Wondimagegnehu told Daily Monitor in an interview.

A temporary isolation centre has been set up at Mpigi Health Centre IV where the suspected cases are being quarantined.

The permanent secretary in the Ministry of Health, Dr Asuman Lukwago, also said another 17 contacts have been identified in Kampala, bringing the total of those who were in contact with the deceased to 97.

“Our teams are still on the ground tracing all the possible contacts. Those who have been identified will be isolated in their homes for at least 21 days. If they show any signs such as fever and headache, then we take their samples for further tests,” Dr Lukwago told Daily Monitor.

He added that results of the six samples are expected in a few hours.

However, some officials have expressed concern over the ministry’s preparedness to handle the crisis, should it become a fully-fledged Marburg outbreak.

“The confirmatory test results were received at the Ministry of Health on September 30, but to date, the ministry has not released any money to facilitate the teams to respond appropriately,” said a source within the ministry who preferred to remain anonymous.

But Dr Lukwago said they are still treating the matter as an emergency, saying those involved can use their money which will be refunded once the ministry gets the money.

“We are aiding them with things such as fuel, cars to enable them move from one place to another. We also expect to have a costed plan for the response in the next 36 hours,” he added.

About the disease

Cause. Marburg Viral Haemorraghic fever is caused by the Marburg virus which belongs to the same family together with the Ebola virus. The incubation period ranges from two to 21 days while the case fatality rates vary from 24 per cent to 88 per cent.

Spread. Fruit bats of the Pteropodidae family are considered to be the hosts of Marburg. The virus spreads among humans through human-to-human transmission by direct contact with wounds and body fluids.

Symptoms. Headache, vomiting blood, joint and muscle pains, bleeding through the body openings, such eyes, nose, gums, ears, anus and the skin.


2013

Shs1 billion released for health staff salary

                                                                        Sunday Monitor, June 9, 2013 
By Patience Ahimbisibwe

In Summary

The delays was a result of under budgeting after the ministry used up its entire wage bill.

Kampala

The government has released Shs1.7 billion supplementary budget to pay health workers who had not received their salaries since April. Dr Samuel Ssenyonga Kyambadde, the ministry’s under secretary, said the money would cater for salaries until the end of the financial year.

Dr Kyambadde said the problem had risen after they paid staff of Uganda National Health Research Organisation (UNHRO) and Uganda Virus Research Institute (UVRI) using the mainstream wage bill. “It was realised that there was under budgeting. However, this was after the ministry had used up its entire wage bill, making government unable to pay the staff for the last two months,” Dr Kyambadde told the Sunday Monitor.

He added: “UNHRO and UVRI staff were supposed to be paid using their account but they continued to withdraw from the mainstream ministry wage leaving theirs intact. We identified the problem and we have got a supplementary budget.”

This is not the first time civil servants are affected. 
Some teachers and tutors in primary teachers’ colleges have endured months of non-payment after it emerged that there was a problem during the budgetary planning process that caused a shortfall of funds for wages.
In a February 22 letter to chief administrative officers and town clerks, the Ministry of Public Service acting Permanent Secretary, Ms Adah K. Muwanga, said tutors in various would not be paid until July.

“It has been established that the funds allocated to the wage bill in respect to the district tertiary institutions for your district local government are insufficient to cover the salary payments from January to June 2013,” the letter reads in part.

“This is to inform you that this ministry (of Public Service) and Ministry of Finance are working closely to ensure that supplementary funding is provided to facilitate payments of the affected staff,” Ms Muwanga said. The health sector has in the recent past been facing various challenges, including blood shortage across the country, blamed on poor blood donation culture and shortage of kits.

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Uganda: Why Aids Is Still a Problem

East African Business Week, February 2, 2013 

By Samuel Nabwiso

Kampala — Uganda was one of the countries in Africa that were recognized for fighting HIV /AIDS, a disease which was discovered in the early 1980s.

The scourge is one of the deadly diseases that have claimed many lives of people in the last three decades. It's because the country has not carried out enough research on how the disease can be controlled as compare to other diseases.

It is what is attributed to the upward trend in the number of Ugandans suffering from HIV/AIDS. At its highest peak, HIV/AIDS prevalence was as high as 30 percent (adult Ugandans who had the virus) tested at some antenatal sites.

This was driven by bad behaviors like having sex with more than two partners, transmission of the virus from mother to children TMTC and many other factors this led the Government to think twice and comes up with strategic interventions aimed at mitigating the spread of the disease

In 1986, President Yoweri Museveni spearheaded a mass education campaign promoting a three-pronged AIDS prevention message: abstinence from sexual activity until marriage; monogamy within marriage; and condoms as a last resort.

The message became commonly known as ABC: Abstinence, be faithful, use a condom if A and B fail. This message also addressed the high rates of concurrency, which refers to the widespread cultural practice of maintaining two or more sexual partners at a time.

Mass media campaigns also targeting this practice included the "Zero-Grazing" and "Love Carefully" public health messages in the 1990s.

This created good environment for the government to fight AIDS in collaboration with other interventions. According to the World Health Organization (WHO), around 41,000 women received Preventing Mother to Child Transmission (PMTCT) services in 2001.

Uganda was the first country to open a Voluntary Counseling and Testing (VCT) clinic in Africa called AIDS Information Centre and pioneered the concept of voluntary HIV testing centers in Sub-Saharan Africa.

"When the Government introduced such preventive mechanism the number of children born with the virus reduced at good rate.

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Uganda: Health Ministry Declares Luweero District Ebola Free

January 16, 2013

By Ronald  Musoke

The health ministry has today (Jan.16) declared an end to the Ebola outbreak that was reported in Luweero District last November.

The announcement follows completion of the mandatory 42 days of the post- Ebola surveillance countdown period which is a prerequisite of the World Health Organization (WHO) requiring any affected country to monitor the Ebola situation for a specific period before finally declaring an end to the outbreak.

An Ebola outbreak was declared on November 14 in the central Uganda district after receiving confirmation from the Uganda Virus Research Institute that two people from the same family in Kakuute village in Nyimba sub-County had died of Ebola.

According to the health ministry statement, the announcement of the outbreak came a month after Uganda had declared an end to the Ebola epidemic in Kibaale District and three weeks after another outbreak of Marburg was confirmed in Kabale and Ibanda districts in western Uganda.

During the Luweero outbreak, seven cases were reported in which nearly 90% of the victims were relatives living in the same sub-County as the index case.

Dr. Christine Ondoa, the health minister said during the function to declare the end of the outbreak all structures previously set up to contain outbreaks in various districts were still operational to combat any potential risks.

She said the trained health workers are still actively watching the situation, the laboratory system at the UVRI is still operational while the national and district taskforces are all on the alert to watch out for any emerging threats.

The statement noted that the ministry's close working relationship with other partners was crucial in the containment of the epidemic because of the effective leadership and coordination of the response activities by the national and district task force.

The WHO country representative, Dr. Joaquin Saweka, said WHO is fully committed to supporting the ministry to conduct a comprehensive evaluation of the recent viral haemorrhagic fever outbreaks that will inform response to future outbreaks.

 

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Ebola suspected in Mubende district

The New Vision, January 11, 2013

By Francis Kagolo 

MUBENDE - Health state minister Sarah Opendi and other senior ministry officials dashed to Mubende hospital Friday morning following suspicions of an Ebola outbreak in the area. 

Mubende district health officer (DHO), Dr. Wilson Mubiru said two five-year-old children were admitted on Thursday night while vomiting blood – a symptom that was hurriedly linked to Ebola. 
The children were from different families.
Earlier rumours had put the number of patients admitted at the hospital to four and that three had died on spot. 
However, Mubiru and the hospital director Dr. Edward Nkrunziza told New Vision online that there were only two patients. 
Besides, the doctors have since called for calm, saying that it was unlikely for the patients to be Ebola cases. 

“We have forwarded blood tests to the Uganda Virus Research Institute (UVRI) in Entebbe. Although we are yet to get the results, we highly doubt whether this is Ebola,” said Dr. Mubiru. 
Save for vomiting, Mubiru said the patients showed no other Ebola-like symptoms. 
Dr. Nkrunziza also explained that the patients’ condition had “significantly improved” at around 10am on Friday. 
The development comes as the health ministry is preparing to declare Luweero district Ebola-free on January 16, if no new cases are registered in the area. 
About five people died of Ebola in Luweero late last year. 
The declaration will follow the completion of the 42 days countdown period since the last patient was discharged from the isolation Centre.
The ministry has also just declared Kabale and Ibanda districts free of Marburg, another infectious viral disease. 
Health ministry Permanent Secretary Asuman Lukwago said his ministry is working with the Environment and Wildlife ministries to ensure that the animals and birds that spread both Ebola and Marburg disease are wiped out.

 

 

2012

Curbing rampant viruses with ‘one health’

The Observer, November 20, 2012

By Racheal Ninsiima

Barely a month after the World Health Organization (WHO), declared Uganda Ebola-free, scores of people in Luweero have been isolated following another outbreak. The outbreak was confirmed by the Uganda Virus Research Institute (UVRI) after two people belonging to the same family and a health worker died in Sombwe parish, Nyimbwa sub-county, Luweero district.

Currently, there are five suspects closely monitored by the ministry of Health surveillance team. This outbreak comes on the heels of a Marburg outbreak in Uganda that left over five people dead in south-western Uganda. However, with the country’s on-and-off attacks, no drug has been approved to treat the Ebola or Marburg viruses. People diagnosed with Ebola or Marburg simply receive supportive care and treatment for complications.

WHO’s revised international health regulations require that countries establish core capacities to address such emergencies at national, sub-national, health facility and community level, as well as at border crossings. In effect, health experts have approved a “one-health approach” which integrates human, animal and environmental health in curbing such outbreaks.

“Previously, different professionals responded to disease outbreaks differently and in isolation but a one-health approach will promote integration of these sectors to ensure holistic and exhaustive management of the diseases,” Dr David Mukanga, the executive director of the African Epidemiology Network (AFENET), says.
He adds that the approach is necessary since 60% of the infectious diseases affecting humans like Ebola, Marburg, anthrax and brucellosis originate from animals. A case in point where the approach has proven effective is in the prevention of tuberculosis and scabies in Bwindi.

However, implementation of the concept requires a new calibre of professionals with skills to monitor, detect, report, manage and prevent diseases which cut across the three sectors. Dr Thomas Easley, the country coordinator for the Emerging Pandemic Threats (EPT) programme says  such a solution must centre on  education. Government and its stakeholders must train professionals in the one-health approach.

 

“It is clear that no one discipline has enough knowledge to prevent the emergence or re-emergence of diseases,” he said. “Only by breaking down the barriers among agencies, individuals and specialties can we unleash the innovation and expertise needed to meet the integrity of eco systems.” In June this year, AFENET graduated six professionals trained in one-health approach.

 

Ebola

Ebola haemorrhagic fever may be caused by any of four of the five known Ebola viruses, namely:  the Zaire Ebola Virus, the Sudan Ebola Virus, the Taï Forest virus, more commonly called Côte d’Ivoire Ebola Virus and more recently the Bundibugyo Ebola Virus. The Zaire virus has the highest fatality rate (up to 90% in some epidemics.) There have been more outbreaks of Zaire Ebola virus than of any other species. Transmission has been attributed to reuse of unsterilized needles and close personal contact. On 24 November 2007, the Uganda ministry of Health confirmed an outbreak of Ebola Virus in the Bundibugyo district and this time it is being contained in Luweero district, Bombo and Mulago hospital.

 

Marburg

Marburg haemorrhagic  fever is a severe illness caused by the Marburg virus. It was first described in 1967 during outbreaks in Germany and the former Yugoslavia that were linked to monkeys imported from Uganda. The largest Marburg outbreak recorded to date began in late 1998 in north-eastern Democratic Republic of the Congo (DRC). The natural reservoir for the Marburg virus remains unknown, although it is presumed to be of animal origin. “Primary transmission of the virus from the natural reservoir appears to occur only in sub-Saharan Africa and is sometimes followed by secondary person-to-person transmission in both community and health facility settings,” Dr Ambrose Talisuna, former head of the Epidemiology and Surveillance Division at the ministry of Health, says.

  

Two more test positive for Ebola

 The Monitor, November 16, 2012  

By Dan Wandera
Blood Samples sent to the Uganda Virus Research Institute in Entebbe have confirmed two more Ebola positive patients, bringing the number of patients to four, including the two who died last week. 

Luweero District Health Officer, Dr Joseph Okware, says blood samples for a patient admitted at Bombo Army General Hospital on Monday have tested positive for the Ebola Sudan strain, while another patient who was in close contact with one of the deceased Ebola cases, and now admitted at Mulago National Referral Hospital, have tested positive for Ebola.

"We have 2 more results confirmed positive by UVRI bringing the number of confirmed cases to 4 for the Ebola Sudan Strain,” Dr Okware said.

“We are also sending more blood samples for 5 people whom we suspect came in contact with some of the victims.” Medical personnel at various health centres in Luweero told this newspaper that their units have not received protective gear. "We are increasingly getting worried because some of our units do not have protective gear. It would be very important that the lives of the health workers are also secure because our units have not closed", a nurse at Bamunanika Health Centre III told this reporter. However, Dr Okware says that focus, for now, is on the facilities at Bombo Military Hospital, Kasana Health Centre IV and Nyimbwa Health Centre, and other health units will be catered to later.

 

Uganda: Fresh Ebola Outbreak Burdens Health System

IRIN, November 15, 2012

Opinion

Kampala — Uganda's Ministry of Health says a fresh outbreak of Ebola haemorrhagic fever - the second in the country this year - is straining an already over-stretched health system. "An outbreak of this nature poses a serious financial and human resource challenge. Our resources have been strained since July. We need additional resources to handle the current outbreak. What we have at hand is not enough," Dennis Lwamafa, the acting director-general of health Services at the Ministry of Health, told IRIN.

"With the increasing epidemic outbreaks and their frequencies, we are further constrained... The costs to manage this outbreak cause a distortion... We had not planned for it." As of 12 November, three people - all members of the same family - were suspected to have died from Ebola in Luwero District, 50km northwest of Kampala. Five people who had close contact with the deceased are also suspected to have contracted the disease; two of these are in an isolation unit at Mulago National Referral Hospital in the capital, Kampala, two in health centres in Luwero and one at Bombo Military Hospital, 30km north of the capital. The Ministry of Health has begun tracing people who may have had contact with the deceased and those infected.

On 15 November, Uganda's Daily Monitor newspaper reported the death of a man who had presented with symptoms characteristic of Ebola at a health centre in the northwestern district of Koboko.

 

Sudan strain

The outbreak comes less than two months after the country was declared Ebola-free following an outbreak in July that killed 17 people in the western district of Kibaale. The virus in Luwero is the same strain - Ebola Sudan - as the Kibaale outbreak, according to the Uganda Virus Research Institute (UVRI). The Sudan strain was responsible for an outbreak that infected more than 400 and killed some 220 people in Uganda in 2000 and one person in Luwero in May 2011. The country is also battling an outbreak of Marburg - a viral haemorrhagic fever similar to Ebola - which has killed eight people in the southwest.

Ebola, which causes fever and bleeding from orifices, can cause death within days. There is no cure or vaccine for it, so efforts are concentrated on stopping its spread.

"We need more financial resources to put [in place] optimal response plans to contain this highly infectious disease," Lwamafa said. "We need doctors, nurses to manage isolation units, surveillance teams to list, monitor and track the contacts, laboratory technicians to take the specimens for testing, burial, mobilization teams and psychosocial support teams to handle trauma."

 

The UN World Health Organization (WHO) in Uganda has dispatched a team of experts to Luwero to help in surveillance, case management, health education, epidemiology, laboratory, infection control and psychosocial services, according to Miriam Nanyunja, WHO's adviser on disease prevention and control.

"The response is being mounted to effectively contain the outbreak," she told IRIN. 

Christine Ondoa, Uganda's minister of health, has appealed to the public to remain calm, take precautions to prevent contracting the virus and avoid public gatherings in the affected district.

[ This report does not necessarily reflect the views of the United Nations. ]

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Uganda: Govt Hires Experts for Marburg Outbreak

The Independent, October 30, 2012 

By Julius Odeke

Ministry of Health and its partners have hired ten technical experts to handle and contain the spread of Marburg cases in the identified districts.

The ministry of health says the death toll of both the probable and confirmed cases stands at eight, with the latest being a case that died at the isolation facility at Rushoroza Health Centre III on October 27.

 The Minister Dr Christine Ondoa clarified that since the onset of the outbreak, her ministry has collected a total of 45 samples of which nine were confirmed positive; five in Kabale, two in Kampala and two from Ibanda.

She says that working closely with the US Center for Disease Control and Prevention (CDC), whereby the ministry has set up a field diagnostic laboratory at Kabale Regional Referral Hospital. "All samples from the affected neighbouring districts will hence be taken to this laboratory for quick diagnostics. This will shorten the time when we get results to three hours from the original 24 hours due to distance. Further serological testing will be undertaken at the Uganda Virus Research Institute (UVRI)," Ondoa said.

Dr Ondoa says due to the presence of cases in other districts, the ministry of health has established temporary isolation facilities to accommodate the suspected and confirmed cases. In Ibanda, a temporary isolation ward has been created at Ibanda Hospital, while plans are underway to set up a proper isolation facility by tomorrow.

She says at Mbarara Regional Referral Hospital, a separate temporary has been designated for the suspect Marburg cases. A triage has also been set up at the causality ward. 

We have assembled a team of experts to work in the newly established isolation facilities and they are expected in these districts today. We also plan to undertake infection control procedures in these facilities as safety measures for the workers and the admitted patients.

Dr Ondoa says there are seven suspect cases (student nurses) quarantined at Ibanda. These cases attended to the confirmed case that later died at Mbarara Regional Referral Hospital on October 24. Other health workers who attended to the patient are closely being monitored.

Dr Ondoa dispelled rumours that, "Dr. Sheila Ndyanabangi, the head of the Mental Health Unit Division, had contracted Marburg and had been isolated. Dr. Ndyanabangi has not been isolated but has been advised to exercise social distancing. She is one of the contacts who are being monitored. She has not developed any signs or symptoms of the disease and therefore cannot be isolated from the community. She is due to complete the 21 days of observation."

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East Africa: Marburg Contained - Health Ministry  

East African Business Week, October 29, 2012 

By Eriosi Nantaba

Kampala — The Ministry of Health has urged the public to remain calm and avoid contact with victims of Marburg or report any suspected cases with the outbreak of the epidemic anywhere.

According to the Minister for health Hon. Christine Ondoa, The ministry has developed a response plan for the Marburg control, surveillance, and procurement of protective gear amounting to Ushs 2.3 billion(US$900,000). "The ministry of health surveillance team has listed up a total of 196 contacts for the close monitoring so individuals are called upon to be calm for all possible measures are undertaken to control the situation," said Ondoa during a press briefing in Kampala recently.

The ministry declared an outbreak of Marburg in Kabale District (Western Uganda) on October 19th 2012 after receiving laboratory results from the Uganda Virus Institute (UVRI) confirming that the two family members had died of the highly infectious viral hemorrhagic fever. According to the reports, patients presented with symptoms of diarrhea, vomiting, fever, headache, dizziness and generalized convulsions. "Marburg and Ebola have similar control mechanisms and since the outbreak of Marburg fever in the country, the ministry took the initiatives to alert all the medical workers to ensure that they disease is handled," explained Ondoa. "Six people have already been confirmed dead and other cases are also confirmed with one being suspected." Dr. Joaquim Saweka, Uganda WHO Country Representative alerted that Marburg is highly inflectional and kills in a short time but can be prevented. 

"Marburg is spread through direct contact with body fluids like blood, saliva, vomitus, stool and urine of an infected person," warned Seweka. "The public is told to continue accessing Mulago hospital and Kabale hospital without any fear despite the outbreak of Marburg in the country." 

Ondoa noted that the ministry continues to monitor 196 people who are suspected to have contacted with the dead. 

The last outbreak of Marburg in Uganda came in 2007 and killed two miners in the country's west. The Marburg outbreak in Uganda comes just after the World Health Organization had just declared an end of the Ebola outbreak.

 

An effective Aids vaccine is in sight at last, thanks to the efforts of African scientists
The East African: October 20,  2012 

By Pontiano Kaleebu & Omu Anzala

Researchers from around the world recently converged on Boston for a scientific conference dedicated to one of the most pressing challenges of our time 

Researchers from around the world recently converged on Boston for a scientific conference dedicated to one of the most pressing challenges of our time: The development of safe and effective vaccines for the prevention of HIV, the virus that causes Aids. They had much to discuss, given the extraordinary progress in this area of research, much of which has been widely reported in the press. 

What is less well known, perhaps, is how much that progress stems from the contributions of scientists in Africa, who continue to work with thousands of volunteers to find solutions to the Aids crisis. With steadfast support from governments and civil society organisations across Africa, scientists on the continent have played key roles in everything from the basic science that underlies vaccine design to the clinical evaluation of Aids vaccine candidates. 

Much of this work has been conducted in partnership with Western government agencies, such as the United States Agency for International Development and its counterparts in Europe, as well as an array of international and regional HIV care and research organisations — including the Centre for HIV/AIDS Vaccine Immunology (CHAVI) of the US National Institutes of Health (NIH), the Collaboration for AIDS Vaccine Discovery (CAVD) supported by the Bill & Melinda Gates Foundation, the International Aids Vaccine Initiative (IAVI) and the European and Developing Countries Clinical Trials Partnership. But African scientists have been front and centre, and their governments have backed their efforts. African researchers have helped establish proof of concept for other HIV prevention strategies as well, most notably for microbicides against HIV, medical male circumcision and the prophylactic use of antiretroviral drugs.

Research in this arena has also helped build the technical capacity essential to seeding medical and biotechnological innovation. We have witnessed nothing less than a silent revolution in African science over the past several years. If sustained, this revolution could have very positive implications for both the public health and, in time, the economies of the region. Take, for example, the evolution of the Kenya AIDS Vaccine Initiative. KAVI was launched a little more than a decade ago, the brainchild of a small band of prominent HIV researchers in Nairobi. Established as a partnership between UK’s Medical Research Council MRC-UK), IAVI and the Kenyan government, KAVI’s goal was to test HIV vaccines devised to prevent the subtypes of HIV prevalent in East Africa.

To accomplish that task, however, researchers at Kenyatta National Hospital had to first train their staff to conduct research with the rigour required to win regulatory approval for a future vaccine. With the support of IAVI, they ensured that their staff technicians, scientists and research physicians were trained in Good Clinical Practices, and that their labs obtained certification for compliance with Good Clinical Laboratory Practice (GCLP), a stringent, internationally recognised badge of laboratory quality. Throughout the past decade, KAVI researchers have spread those skills to colleagues across sub-Saharan Africa, even as they have tested a series of Aids vaccine candidates in clinical trials.

 

KAVI recently obtained a grant from the Canadian government to help develop biomedical research labs across the region, help them earn GCLP accreditation, and to build its own capacity to conduct cutting edge research in the subfield of mucosal immunology. Further, as a member of the Networks of Excellence programme run by the European and Developing Countries Clinical Trials Partnership (EDCTP), KAVI is today deeply engaged in building capacity for the conduct of clinical trials in East Africa. On the strength of its experience in clinical research, KAVI has also begun to branch out to assess treatments for other ailments, including tuberculosis. It is only fair to note that none of this would be possible without the active — and proud — support of the Kenyan government, which has consistently made resources and personnel available for these and many other HIV prevention projects.

 

Similarly, since Ugandan scientists completed the first Aids vaccine trial on the continent more than a decade ago, they have become major players in HIV prevention research. In fact, the Uganda Virus Research Institute in Entebbe was selected as a central laboratory by CAVD, which co-ordinates a global programme in Aids vaccine development. It is also a co-ordinating centre for EDCTP’s East African Networks of Excellence and, through its partnership with MRC-UK, was a key participant in the NIH-funded CHAVI. UVRI researchers contributed to the development and standardisation of experimental methods employed to assess immune responses to Aids vaccine candidates and conduct relevant basic research. Today, the technical capacity of UVRI and other research facilities in the country is increasingly being applied to support advanced research in vaccinology, virology and the immunology of HIV infection.

 

South African scientists have put their nation on the map in HIV prevention research as well, and not just for HIV vaccine development, in which they have played a leading role in both the design and clinical evaluation of candidates. A team led by scientists affiliated with the NIH-funded Centre for the Aids Programme of Research in South Africa provided the first evidence, in 2010, that a microbicide—in this case, a vaginal gel infused with an ARV—can prevent HIV transmission. Further, a South African biotechnology company, Elevation Biotech, has participated in the complex business of HIV vaccine design with funding from IAVI and BMGF. Now South Africa has launched a research programme in partnership with the government of India to design and develop vaccines against HIV, probably the first instance of South-South collaboration in HIV vaccine design. It is only right that researchers in sub-Saharan Africa focus as much as they do on the HIV crisis. After all, no other part of the world has been quite as severely affected by the pandemic. Though that pandemic remains far from contained, the good news is that the contributions of African scientists are making a tangible difference to the development of new HIV prevention technologies. Indeed, African participation in such research is now a proud tradition, one we expect will continue unabated until the day we have in hand a safe and effective Aids vaccine. 

Prof Pontiano Kaleebu is director of the Medical Research Council at the Uganda Virus Research Institute Unit on Aids and cofounder of the African Aids Vaccine Programme. Prof Omu Anzala is principal investigator, Kenya Aids Vaccine Initiative and current chair of the Department of Medical Microbiology at the University of Nairobi. 

 

Health Ministry warns on Marburg outbreak

The New Vision, October 19, 2012

By Vision Reporter

The Ministry of Health has warned the general public of an outbreak of a deadly Marburg virus in Kitumba sub-county, Kabale district in western Uganda. 
A statement issued Friday afternoon said laboratory tests done at the Uganda Virus Research Institute (UVRI) confirmed three samples positive of the highly infectious viral hemorrhagic fever.  
Preliminary reports from the district indicate that four other people had allegedly died of a strange disease since October 4th. This strange disease has now been confirmed as Marburg. Investigations indicate that all the cases occurred among members of the same family in Kiyonjo parish in Kitumba sub-county. Marburg is a killer disease caused by a virus and is spread through direct contact with wounds, body fluids like blood, saliva, vomitus, stool and urine of an infected person. 
A person suffering from Marburg presents with sudden onset of high fever with any of the following; headache, vomiting blood, joint and muscle pains and bleeding through the body openings, i.e. eyes, nose, gums, ears, anus and the skin. 

Marburg is a highly contagious disease and kills in a short time but can easily be prevented. The Ministry of Health is working with stakeholders and other development partners to contain the spread of this disease. 
The following measures have been put in place in order to limit the spread of this highly infectious disease; 
•     A team of experts has been dispatched to the district to support both clinical and public health investigations   
•    The National Taskforce has reactivated its rapid response committees to quickly act to any emergencies
•   The surveillance team has commenced the active tracing and listing of all possible contacts that were exposed to the suspects and confirmed cases.
•   The Kabale District Taskforce has been reactivated to effectively coordinate programs in the district
The Ministry of Health urges the general public to observe the following protective measures;
•     Report any suspected patient to a nearby health unit 
•    Avoid direct contact with body fluids of a person suffering from Marburg by using protective materials like gloves and masks 
•   Avoid unnecessary public gatherings  
The Ministry of Health calls upon the public to stay calm as all possible measures are being undertaken to control the situation.
 For more information and reports of any cases, please contact the Ministry hotline on +256750996034.  The country will be kept informed further on the outcome of this health emergency

 

 

 

Deadly Marburg Virus Breaks Out In Kabale

The Red Pepper, October 19, 2012 

Three people have tested positive to the Marburg virus in Kabale district. The Kabale district director of health services Dr. Patrick Tusiime confirmed that tests carried out by Uganda Virus Research Insititute (UVRI) Entebbe on Thursday had turned out positive.

The Marburg virus was last reported in Uganda in 2008. According to the World Health Organization, Marburg is a severe and highly fatal disease caused by a virus from the same family as the one that causes Ebola hemorrhagic fever.

According to the global health body, the illness caused by Marburg virus begins abruptly, with severe headache and severe malaise. Case fatality rates have varied greatly, from 25 percent in the initial laboratory-associated outbreak in 1967, to more than 80 percent in the Democratic Republic of Congo from 1998-2000, to even higher in the outbreak that began in Angola in late 2004.

Marburg virus was first noticed and described during small epidemics in the German cities of Marburg and Frankfurt and the Yugoslavian capital Belgrade in the 1960s. Workers were accidentally exposed to tissues of infected grivets (Chlorocebus aethiops) at the city’s former main industrial plant, the Behringwerke, then part of Hoechst, and today of CSL Behring. During these outbreaks, 31 people became infected and seven of them died.

  

Uganda Is Ebola Free

East African Business Week, October 14, 2012

By Eriosi Nantaba

Kampala, Uganda — The Ugandan Ministry of Health officially declared the country free from Ebola outbreak that broke out in the country in July.

According to the press statement by the Ministry, the announcement follows completion of 42 days of the post Ebola surveillance countdown period. "As you may recall, the Ministry of Health declared an outbreak of Ebola in Kibaale district on July 28th after receiving confirmatory results from the Uganda Virus Research Institute (UVRI) that the strange disease that had killed 14 people in the district was Ebola Hemorrhagic fever, Sudan strain," Health Minister Christine Ondoa

She revealed that the Post Ebola Surveillance countdown period is a prerequisite of the World Health Organization (WHO) which requires any affected country to monitor the Ebola situation for a period of 42 days after the last discharged patient case before finally declaring that the outbreak is over. The last patient in Kibaale was allowed to go home on 24th August.

 

The outbreak, which was reported to have occurred in Luwero district (47 miles north of Kampala city), had remained a mystery until a 12-year-old girl from Luwero district died at a Military Hospital on May 12. 

However the outbreak of Ebola has left Ugandan Muslims barred from taking part in this year's pilgrimage following delays in clearing the group over Ebola fears. This is the second time in 12 years Ugandan pilgrims are barred from travelling to Saudi Arabia over Ebola, the first being in 2001 when the deadly disease struck Gulu District.  A total of 900 pilgrims had registered for pilgrimage this year.

  

Uganda Declared Ebola-free

The Red Pepper, October 6, 2012 

By Jane Kamanzi

Uganda has been declared Ebola-free according to a press statement signed by Health Minister Dr. Christine Ondoa. While addressing journalists this morning on the launch of Ministry of Health and the Uganda Peoples’ Defence Forces (UPDF) Ugandan Golden jubilee activities, Ondoa said the deadly disease was no more. “As you may recall, the Ministry of Health declared an outbreak of Ebola in Kibaale district on July 28th after receiving confirmatory results from the Uganda Virus Research Institute (UVRI) that the strange disease that had killed 14 people in the district was Ebola Hemorrhagic fever, Sudan strain. The index cases were reported from Nyanswiga LCI in Nyamarunda Parish of Nyamarunda sub-county. On October 4th, the Ministry will declare an end to the outbreak after completing 42 days of the post Ebola surveillance phase,” she announced.

She revealed that the Post Ebola Surveillance countdown period is a prerequisite of the World Health Organization (WHO) which requires any affected country to monitor the Ebola situation for a period of 42 days after the last discharged patient case before finally declaring that the outbreak is over.  The last patient in Kibaale was allowed to go home on 24th August. In addition to the good news, Dr. Andoa announced that the Ministry of Health and the Uganda Peoples’ Defence Forces (UPDF) are partnering to undertake a series of activities as a climax to the Independence Day celebrations.
 

Fight against Ebola in Uganda

Uganda is celebrating 50 years of independence on October 9th and various institutions as well as individual Ugandans have planned different commemorative activities. The Central Bank announced earlier this week that it would issue a shs. 1000 commemorative coin “This initiative came as a result of realizing that the two partners play a critical role in protecting the lives of people through different ways. It is for this reason that the two groups have joined hands to take health services closer to the people,” said Ondoa. In collaboration with the UPDF, the Ministry of Health will hold a national event at Hoima Regional Referral Hospital tomorrow (29th September) to flag off the activities. This will signify the beginning of a series of social mobilization and service provision activities in the five districts.

 

At the national level, the Ministry of Health and the UPDF will conduct a cleaning exercise of all the 14 regional hospitals throughout the country. This will be done in a bid to improve on the sanitation of these facilities as Uganda marks 50 years of independence. The hospitals are Moroto, Mbarara, Mbale, Soroti, Hoima, Mubende, Gulu, Arua Lira, Fort Portal, Masaka, Kabale, Jinja and Kawolo.

 

Uganda declares end of Ebola outbreak

CNN, October 6, 2012

 By the CNN Wire Staff 

Researchers work at U.S. Center for Disease Control and Prevention, after Ebola outbreak in Uganda.

 

STORY HIGHLIGHTS

  • 17 people died in Uganda's Ebola outbreak
  • The last patient was released on August 24
  • The initial announcement of the outbreak caused panic and sent patients fleeing
  • At least 10 more died in a separate outbreak in the Democratic Republic of Congo

 

(CNN) -- Ugandan health officials are declaring the country free of an Ebola outbreak blamed for 17 deaths since late July.The last patient with a confirmed infection was released on August 24, the World Health Organization said in a statement. "WHO does not recommend that any travel or trade restrictions be applied to Uganda with respect to this event," it said. The outbreak's initial confirmation at a hospital in the western town of Kagadi sent patients fleeing and the facility scrambling to contact those who may have had the disease. In a separate incident, a convict brought to the hospital on suspicion of an infection escaped. Less than a third of the outbreak's "24 probable and confirmed cases" survived, according to the WHO. More than 350 people were isolated for testing on suspicion of having the disease. 

Ebola is caused by a highly infectious virus that spreads through direct contact with bodily fluids. Symptoms include fever, vomiting, diarrhea, abdominal pain, headache, a measles-like rash, red eyes and, at times, bleeding from body openings. Initial symptoms of Ebola can be mistaken for other illnesses such as the flu.The Ebola virus was first detected in 1976 in the central African nation of Zaire (now the Democratic Republic of the Congo), Uganda's neighbor to the west. The virus is named after a river in that country, where the first outbreak of the disease was found.

 

At least 10 people died in a separate Ebola outbreak in late August in the Democratic Republic of Congo.

 

 

 

WHO declares Uganda Ebola free

The New Vision, September 4, 2012

The World Health Organisation (WHO) has confirmed that there are no new cases of Ebola haemorrhagic fever reported in Kibaale district, Uganda, since 3 August 2012, indicating that the outbreak is coming to an end.
 A total of 24 probable and confirmed cases including 17 deaths have been reported since the beginning of the outbreak. Of these, 11 cases were laboratory confirmed by the Uganda Virus Research Institute (UVRI) in Entebbe. 
The last confirmed case was discharged on 24 August 2012 following recovery.
All contacts of probable and confirmed cases have been followed up daily and have completed the recommended 21 days of monitoring for any possible signs or symptoms of Ebola.
The partners who are involved in the response to the Ebola outbreak are transferring capacity to national and district authorities to sustain the essential functions, including enhanced surveillance and response, psychosocial support and infection prevention and control in health care facilities.

The Ebola isolation facilities in Kibaale District Hospital and at Mulago National Referral Hospital in Kampala remain on stand-by for receiving any suspected cases.
The ecological studies team in Kibaale district has collected samples from bats, primates and livestock to study the possible natural history of Ebola virus and putative initial human infection from wildlife.
Neighbouring countries
At the time of this update, an Ebola outbreak is on-going in the Province Orientale of the Democratic Republic of Congo. These two Ebola outbreaks are not epidemiologically linked and have been caused by two different Ebola subtypes; (Uganda: Ebola subtype Sudan, Democratic Republic of Congo Ebola subtype Bundibugyo).
With respect to this event, WHO does not recommend that any travel or trade restrictions are applied to Uganda.

General information on Ebola subtypes:

There are five identified subtypes of Ebola virus. The subtypes have been named after the location they have been first detected in Ebola outbreaks. Three subtypes of the five have been associated with large Ebola haemorrhagic fever (EHF) outbreaks in Africa: Ebola-Zaire, Ebola-Sudan and Ebola-Bundibugyo. 

EHF is a febrile haemorrhagic illness which causes death in 25-90% of all cases. The Ebola Reston species, found in the Philippines, can infect humans, but no illness or death in humans has been reported to.

  

Suspected Ebola patients discharged
 The New Vision, August 7, 2012
By Ismael Kasooha

 

Experts test for the Ebola virus in the newly-upgraded state of the art laboratory at the Uganda Virus Research Institute (UVRI) in Entebbe. 

A total of nine suspected Ebola patients have been discharged from the Ebola isolation centre in Kagadi hospital, Kibaale district. Those discharged include five-year-old Businge Mugabi, Geofrey Kaija, 7, Costa Mugabi, 9 and their father John Mugabi, 35. The children were admitted following the death of their mother identified as Aida Tuhaise who died with signs and symptoms of Ebola in Butumba village, Muhorro town, Kibaale district. The others discharged were prisoners from Kibaale prison who were sent back to the cells. Dr. Joseph Amonye the national coordinator of the Ebola task force said blood samples taken from these people were negative and there was no reason of confining them at the isolation centre. "We have tested their samples and found that although these children were contacts, they are not having the Ebola virus," said Amonye. The patients were given a package that includes household items such as mattresses, utensils and food for the start of their new life.

 

EA in panic as Ebola strikes again in Uganda
 The East African, August 4, 2012 

 JOINT REPORT Special Correspondents

Uganda is studying the puzzling behaviour of the Ebola Sudan virus in the latest outbreak that had killed 16 people mid last week. 

“So far what we see is that it is atypical. Its behaviour is very suspicious,” Dr Anthony Mbonye the Commissioner for Health Services at the Ministry of Health told The East African, explaining that unlike the typical Sudan strain, victims in the latest suffer fevers without the bleeding normally associated with the virus. “Thank God we took a sample early because we would be thinking they are suffering from fever yet it is Ebola,” said Mbonye.

The Uganda Ministry of Health declared an outbreak of Ebola in Kibaale district, about 160km west of Kampala. Confirmatory test results were done at the Centres for Disease Control, Uganda Virus Research Institute (UVRI) laboratory in Entebbe. Authorities were following 176 people that came into contact with the deceased while another 38 suspected cases were under observation.

 

Although it is confirmed as the Sudan Ebola strain, a viral haemorrhagic fever, it is presenting with less bleeding or haemorrhage, as should be the case with Ebola. Ebola has no cure and vaccine while this particular strain, Ebola Sudan, kills at least 50 per cent of the people who get infected so more deaths are expected. “We are not seeing much of the bleeding this time,” said Dr Jackson Amone, the Assistant Commissioner Integrated Services at the Ministry of Health who was travelling to Kagadi Hospital in Kibaale, western Uganda, where the first cases were reported. Ebola typically presents with fever, fatigue, vomiting, diarrhoea, joint pains and bleeding. “Most of the patients bleed when they are about to die with the cases we are handling. Sometimes you can confuse it for malaria because there is a high fever, vomiting, diarrhoea,” said Dr Amone. 

According to health workers, in the absence of body fluids the latest strain is easier to manage because Ebola virus is transmissible through contact with body fluids-saliva, vomit, sweat, blood or other fluids in the body of an infected person. Like in all Ebola outbreaks in Uganda, patients may have transmitted it to medical personnel. All medical personnel who were initially in contact with the people who died have been asked to stay at home until after 21 days. As more investigations are ongoing, samples have been sent to the Centres for Disease Control and Prevention (CDC), Viral Haemorrhagic Fevers (VHF) laboratory in USA. Results are expected after one week. 

“CDC is sending samples to Atlanta to do additional sequencing. But the indication now is that it is not a new strain. It is the Sudan strain based on PCR testing, which is specific,” said Erik Friedly, the associate head of communication at CDC-Uganda. 

Top of Form 

 

 

Renovated lab to ease diagnoses

The Observer, June 26, 2012

By Racheal Ninsiima

Of recent, Uganda has been a focal point for emerging and re-emerging infectious diseases, especially vector borne diseases (zoonoses).

Since 2000, we have witnessed diseases like Ebola, typhoid, anthrax, Hepatitis E and yellow fever, among others. An Ebola outbreak in Gulu in October 2000 claimed more than 170 lives including that of Dr Matthew Lukwiyaa 

The disease broke out again in Bundibugyo in November 2007, claiming 37 lives and leaving 148 people infected. According to Dr Gladys Kalema Zikusoka, a practicing veterinary doctor, zoonoses are associated with people living in close proximity with their animals.

“The burden of zoonoses is usually greatly underestimated and this has had serious consequences in terms of funding for both research and control initiatives,” Dr Kalema says.

 

Once infected, people, especially the rural poor, are less likely to have access to proper treatment. As with other neglected diseases, it is hard to calculate the national burden for zoonoses. 

Dr Issa Makumbi, head of Epidemiology and Surveillance at the ministry of Health, says sustainable control of zoonoses is reliant on surveillance but this is rarely implemented in the developing world because of lack of sufficiently cheap diagnostics. “Many zoonotic diseases are notoriously difficult to diagnose as they are often confused with other diseases; for example, where malaria is present, fevers owing to brucellosis may be misdiagnosed,” he explains. It response, the US Centres for Disease Control and Prevention (CDC) and the Uganda Virus Research Institute (UVRI) renovated the viral haemorrhagic fever lab (VHF) in Entebbe.

The lab provides for rapid detection, surveillance and diagnosis of viral diseases associated with haemorrhagic fevers like Ebola and Marburg. The lab includes specialized diagnostic equipment for virus detection, rapid tests for characterization of viruses, a high containment area with secure and limited access and improved ventilation and air access systems. 

“This state of the art containment lab will enable us to make appropriate recommendations to the Health ministry in order to effectively implement public health programmes to reduce spread of zoonotic diseases,” Dr Edward Mbidde, the UVRI director, said. 

There will be a 24-hour diagnosis of samples which hitherto had been sent to Geneva, China and South Africa

 

Virus research institute gets Shs240m lab

Saturday Monitor, June 23, 2012  

By Martin Ssebuyira


In Summary
The laboratory is expected to enable scientists to quickly identify outbreaks of diseases and limit their rapid spread because it can detect viral diseases within 24 hours. The Uganda Virus Research Institute (UVRI) has opened a Shs240 million laboratory. The laboratory was funded by the US based Centers for Disease Control (CDC). The laboratory includes state-of-the-art equipment for rapid diagnosis of viral diseases associated with hemorrhagic fevers. 

“Testing for hemorrhagic fever viruses like ebola and marburg are just several of the diseases that the laboratory is capable of diagnosing. All testing and research are conducted in a secure and isolated environment where staff are properly trained in safety and protective measures,” Mr Tadesse Wuhib, CDC Uganda country director, said last week during the opening of the laboratory in Entebbe.

He said the laboratory will enable scientists to quickly identify outbreaks and limit their rapid spread because it can detect viral diseases within 24 hours.

 Mr Trevor Shoemaker, an epidemiologist at CDC, said the organisation has a long history of working with the Ministry of Health to address public health emergencies and routinely provides surveillance, investigation, laboratory diagnostics, and response support for contingencies involving dangerous pathogens and diseases of pandemic potential.  “CDC has supported numerous outbreak investigations in Uganda, including ebola, marburg, botulism, anthrax, and typhoid. They have of late joined the ongoing investigation into nodding syndrome,” Mr Shoemaker said.  He said the laboratory would enable them come out with general statements on specific viruses and send the samples to Atlanta, US, where the CDC headquarters is based, to further specific viral diagnoses when need arises. Dr Edward Katangole Mbidde, the UVRI director, said additional virus detection capabilities will be added in the next several months to make Uganda a centre for virus diagnosis in East and Central Africa. 

Virus Research in Uganda
CDC has supported various outbreak investigations in Uganda like ebola that struck in Gulu in 2000, marburg in Kamwenge in 2007, ebola in Bundibugyo in 2007, Schistosomiasis in Jinja in 2007 and Hepatitis E in Kitgum in 2008. Others were botulism in Kasese in 2008, typhoid in Kasese in 2008, anthrax in Bushenyi in 2008, yellow fever in northern Uganda in 2010, Ebola in Luweeo in 2011, anthrax in 2010 and nodding disease syndrome in northern Uganda. 

UVRI was established in 1936 by the International division of the Rockefeller Foundation as a yellow fever research institute. In 1950 the Institute became the East African Virus Research Institute under the East African High Commission. In 1977 the East African Community collapsed and the Institute was subsequently named the Uganda Virus Research Institute.

 

Uganda: How Close Are We to Finding an HIV Vaccine?

The New Vision, May 21, 2012 

The hunt for an HIV vaccine in Uganda is younger than the hunt for rebel commander Joseph Kony of the disparaging LRA. Both have cost a lot of lives and money. 

The hunts involve the international community, hope to put an end to the scourge soon, and are so far failing to hit the ultimate target, but insist, very hopefully, that the end is drawing nearer with each passing day. 

But while Kony has killed thousands, HIV has claimed over 25 million people since 1981, according to the World Health Organisation. And efforts to eradicate it have included a lot more of research and trials consuming millions of dollars. And, according to Dr. Hannah Kibuuka, the director at Makerere University Walter Reed Project (MUWRP) in Nakasero, big diseases are usually eradicated by vaccines. "Look at smallpox!" she says, "HIV prevention and treatment strategies are very important, but a successful vaccine would give us a magic bullet."

 

World awareness day 

Yesterday was the World HIV Vaccine Awareness Day. This annual observance is meant to recognise and thank the thousands of volunteers, community members, health professionals, and scientists, who are working together to find a safe and effective HIV vaccine. It is also a day to educate our communities about the importance of preventive HIV vaccine research. In Uganda vaccine research efforts started as early as 1992, and according to Dr Juliet Mpendo, the medical director of the Uganda Virus Research Institute (UVRI), the very first HIV vaccine trial was conducted at the Joint Clinical Research Centre (JCRC).  "Since then, a number of trials have been conducted at various sites in collaboration with international organisations. We have conducted four HIV Vaccine trials so far," she says.

 Kibuuka adds that at MUWRP, two trials were conducted in 2004 and 2006.

 

The HIV vaccine

A vaccine is a biological preparation that contains an agent that resembles a disease-causing micro-organism. This agent stimulates the body's immune system to recognise it as foreign and attack it not only to destroy it, but also to keep remembering it in case it returns later.

 

Dr. Mukwaya, Uganda’s most renowned malaria researcher 

The New Vision, April 26, 2012

To mark 50 years of Uganda’s independence, New Vision will until October 9, 2012 be publishing highlights of events and profiling personalities that have shaped the history of this country. Today, Gladys Kalibbala brings you the story of Dr. Louis Mukwaya, the Ugandan face spearheading the anti-mosquito war

Dr. Louis Mukwaya, 73, the assistant director at Uganda Virus Research Institute, Entebbe, and head of the entomology department devotedly goes about his work. The researcher, who prefers to keep a low profile, is checking on the eggs of mosquitoes. He later tells me he has been doing this for a decade and that he was the first black Ugandan researcher at this center.

Mukwaya is happy his hard work has finally been recognized with international researchers naming a new subgenus stegomyia (mosquito) after him. “It’s difficult to explain my excitement when I received the e-mail from a friend!” he exclaimed.

The report released on November 30, 2009, by international researchers; John F. Reinert, Ralph E. Harbach and Ian J Kitching from Centre for Medical, Agricultural and Veterinary Entomology, United States Department of Agriculture, Agricultural Research Science, indicated that a new subgenus stegomyia, Mukwaya, includes different species of mosquitoes found all over Africa south of the Sahara. 

It further stated that Mukwaya (the mosquitoes) is named in honour of Dr. Louis Mukwaya, in recognition of his many contributions to medical entomology. Subgenus Mukwaya was noted to transmit yellow fever, but it does not bite human beings. A month before on October 30, 2009, Mukwaya had been elected as a fellow of the Uganda Academy of Sciences.

 

Venturing into entomology 
Mukwaya traces his research instinct from his early days, when, at his parent’s home in Kangave-Kirema village, Makulubita, Luweero district, he suffered from a strange eye disease. He says the eye infection could not heal with ‘the tube’(ointment) his parents got from the hospital. “For two weeks the eyes remained swollen and very painful until an aunt picked some herbs from the bush and rubbed them on,” he recalls. 

Mukwaya adds that in two days the eyes were better and he was able to continue with school. This experience, he believes, ignited in him the passion to discover what it was in plants that made people’s lives better. He decided to study pharmacy. “Although I was in P.5, I resolved not to remain behind the counters and dispense medicine, but go deep into research,” he recalls.

In 1965, while still at Makerere University, he succeeded in the multiplication of over 100 grasshoppers at his laboratory. His lecturer, Prof. Rowell Hugh, who he calls his mentor, had given him this project.

“Like all other people I did not know how grasshoppers produced because we only saw them come around in May and in November,” Mukwaya says. He picked a few from the lights outside and put them into cages in the laboratory at the Zoology Department. He fed them and monitored them, and kept changing types of grass since he did not know what type they exactly needed.

The doctor later celebrated his success when he got over 100 of them without waiting for the month of May or November to come. After his PhD in 1972, Mukwaya who had joined Uganda Virus Research Institute as a trainee, where he met and interacted with only two other black men from Zambia and Kenya, was given a hard task. 

Dr. Williams Miles, the then director of the institute, wanted Mukwaya to find out why the mosquitoes transmitting yellow fever, which seemed to be all over the country, were only infecting people in the western region (Bundibugyo). 

According to Mukwaya, this heavy task could also have been a turning point for him as it took him deeper into his research. Since he required a good laboratory where he could work from, he started sending applications abroad to for a place to work on his research. 

His luck came when the director, Vincent G. Dethier, gave him a vacancy at Princeton University in the US in 1973. WHO in Geneva funded his stay there for one year.  He was the first black man to do research at this laboratory. 

Mukwaya says he walked a distance of 3km to this laboratory every day for a year since he could not afford transport. “Even during winter I walked and would be in the laboratory by 9:30am, leaving at 1:00am, ” he recalls. Mukwaya says he benefited a lot as he worked alongside Dethier, who also researched on the feeding of insects. Although on completion of his research the director wanted him to stay in the US, he had plans to come back and accomplish his dreams. 

“When I came back in 1974, there was a lot of insecurity in the country during Idi Amin’s regime, which did not allow me to start my work immediately,” Mukwaya says. In 1975, he was elected a fellow of the Royal Entomological Society of London and in 1976; he was elected a member of an Expert Advisory Body for Vector Biology and Control, working with the World Health Organisation (WHO) in Geneva.

In 1979, WHO invited him to Florida for a three-year study about the diseases of insects with a view of starting a programme in Uganda. “The study was about controlling insects without using chemicals. Due to financial constraints the programme has never taken off,” he says.

 

Educational background
Mukwaya was born on August 2, 1939 to late Yowana David Basajjassubi Makumbi and Marian Nansubuga. His mother died in labour in 1941 when he was about two years old. 

He says after their mother’s death, their father worked hard to raise him and two of his siblings. He died in 1967, when Mukwaya had just completed his course at Makerere University. He studied at Kangavve Preparatory School, then Kijjaguzo Primary School in Luweero, where he completed P.6 in 1952 and was ranked the second-best pupil in Buganda.

Mukwaya went to Rubaga Junior School in 1953, while living with relatives at Lungujja. Due to his being naughty all the time, students at Rubaga connived and elected him head prefect, which annoyed him. At the end of their P.3 he was among the three boys that performed well and were offered places at St Mary’s College, Kisubi. He was good in physics, chemistry and biology, which later enabled him to join Makerere University in 1960 and completed in 1965. He hails the late Senkubuge whom he met at UVRI when he had just joined, but later worked with him even after the hard times of the breakup of the East African Community.

“He was a P.4 drop-out but taught me a lot about mosquitoes,” he says. Mukwaya explains that with time, with the use of grants, he has been able to train students in his field where four of them have attained PhDs and there are over 10 technicians.

He is married to Annet Mukwaya, a housewife and together they had eight children (two have since passed on). The other six are Dr. Josephine Birungi who works with UVRI; Anthony Makumbi of Plan International; Christine Mukwaya, a senior water officer at the water ministry; Annet Namukwaya who works with the Malaria Project and Solomy Mukwaya of the Walter Reed Project, Kayunga.

 

  

HIV drug resistance worries Uganda medics
The Observer, April 24, 2012
 
By Racheal Ninsiima

As the Ugandan Anti-retroviral Therapy (ART) programme matures, new challenges have begun to emerge. Available research indicates that the longer one stays on ART, the more likely for them to develop HIV drug resistance (HIVDR). The emergence of resistance in persons on antiretroviral therapy and transmission of drug-resistant HIV strains to newly infected persons are now major public health concerns.

According to Dr Cissy Kityo, the Deputy Executive Director Joint Clinical Research Centre (JCRC), HIVDR is a situation whereby a client on ART does not respond to the prescribed drugs and therefore, experiences health deterioration despite the fact that he/she takes the drugs efficiently and effectively. 

“This means the clients have to be moved from first-line therapy to second line ART, the latter being a more expensive course of treatment,” Kityo explains.

 

A recent survey by the Health ministry of infected young people in Kampala showed that 8.6% had evidence of the drug-resistant virus, with resistance to all three classes of ARVs currently available in the country. 

How drug resistance occurs 
According to Prof Tobias Rinke de Wit, the Research and Development Director of PharmAccess – a Dutch foundation that provides HIV treatment services for the private sector in Sub-Saharan Africa – drug resistance is caused by changes (mutations) in the virus’s genetic structure. 

“These mutations can lead to changes in certain proteins, most commonly enzymes, that help HIV reproduce (replicate),” he explains. 

Prof Rinke adds that mutations are very common in HIV because HIV replicates at an extremely rapid rate and does not contain the proteins needed to ‘correct the mistakes’ it makes during copying. Mutations occur randomly on a daily basis, but many are harmless. In a research conducted by AIDSMEDS, most mutations actually put HIV at a disadvantage because they reduce the virus’s “fitness” and slow its ability to infect CD4 cells in the body.

“However, a number of mutations can actually give HIV a survival advantage when HIV medications are used, because these mutations can block drugs from working against the HIV enzymes they are designed to target,” reports the research. 

Accordingly, continued viral replication in the presence of drug pressure allows for the progressive accumulation of mutations that can lead to increased resistance. Some ARVs require only a single-point mutation to have high-level drug resistance, whereas others require multiple-point mutations. The number of mutations required to confer resistance contributes to the genetic barrier to resistance.

 

Causes of resistance 
Prof Rinke says poor treatment adherence to ARVs is the leading cause of drug resistance. 

“In order for HIV drugs to work correctly, they must be taken exactly as prescribed. Skipping doses or not taking your medication correctly can cause the amount of an HIV drug to decrease in the bloodstream. If the drug level becomes too low, HIV can reproduce more freely and accumulate additional mutations,” he explains. 

Poor absorption 
Dr Kityo says not only must HIV drugs be taken on schedule; they need to be absorbed effectively into the bloodstream. A drug or combination of drugs that is not absorbed properly can result in levels in the bloodstream that are too low and, ultimately, allow HIV reproduction and the accumulation of drug-resistance mutations. 

Effects of drug resistance
According to Prof Pontiano Kaleebu, the Director, Uganda Virus Research Institute (UVRI), drug resistance means that clients on ART that have developed resistance can transmit an HIVDR virus.

 

“Mothers may pass on this virus to their unborn babies, meaning that by the time a child is born, they resist drugs, which exposes them to high infant mortality,” Kaleebu says.

 

What has been done?
A number of initiatives have been taken to address challenges presented by HIVDR in ART programmes. One of the critical activities is to monitor emergence of HIVDR among patients that have started ART.  Prof Kaleebu says the Uganda Virus Research Institute has established a national HIV drug resistance surveillance programme charged with the duty of monitoring the spread of HIV.

“We have established an HIV technical working group under this programme and its main duty is to monitor and report early warning indicators like drug stock outs, patients’ adherence to the drug and drug resistance in individuals among other roles,” Prof Kaleebu says.

More, the JCRC with other partners have for the last four years carried out research on the emergence of HIVDR in clients on ART over time. Prof Peter Mugyenyi, the Executive Director JCRC, says the research was done in both adults (18 years and above) and children below 12 years with the aim of minimizing HIVDR prevalence in selected geographical settings (Kampala, Fort Portal and Mbale) and other African countries such as Kenya, Nigeria, Zimbabwe, and variations within individuals.

 

Challenges 
According to Dr Alex Ario, the national coordinator of the ART programme in the ministry of Health, of the 1.2 million people positively living with HIV, 577,000 need ARVs and only 331,000 are on treatment.  This is because drug resistant tests are expensive (about Shs 1.3 million). 

“While determining the viral load can help you determine if your drugs are not working effectively, it cannot explain why this is happening and hence the need for drug resistance testing,” Dr Ario says. 

With budgets for HIV/AIDS treatment already shrinking as a result of the global economic crisis, and second-line ARVs costing at least five times more than first-line drugs, this could stall efforts to expand treatment access.

 


 

2011
 

Virus Institute warns of yellow fever outbreak

The New Vision: July 19, 2011

By Gladys Kalibbala 

RESEARCHERS at Uganda Virus Research Institute (UVRI), Entebbe have warned of a possible outbreak of yellow fever due to the encroachment on Ziika forest located around Kisubi on the shores of Lake Victoria in Wakiso district. 
Researchers are concerned that people have encroached on the buffer zone which is supposed to be 300meters from the boundaries of the forest. 
“They have instead put residential structures at the edge of the forest which is dangerous not only for their lives but the whole nation,” observed Dr. Josephine Birungi. 
UVRI deputy director, Dr. Louis Mukwaya explains that the deadly mosquito “Aedes africanus” known to transmit yellow fever from monkeys to human was first traced in Ziika forest in 1971. 
Dr. Mukwaya however, accuses Wakiso district land Board for issuing land titles to the occupants. 
He said UVRI will with immediate effect clear its boundaries and later advise the concerned authorities to evict those found in the buffer zone of 300metres. 
“We immediately vaccinated the people around Kisubi that time and isolated the mosquito by keeping the public off the forest, “he said. 
Mukwaya explained that the known “Aedes africanus” behavior is to stay inside the forest but adds that once it bites someone there, the person may infect a large population. 
“This may occur when the same person is again bitten by another type of mosquito known as “Aedes simpsoni” (this one stays in the community),” he explained. Since “Aedes simpsoni” stays in the community it can easily transmit the fever to a number of people getting it from the first victim. 
Mukwaya expressed worry that the encroachment may force the deadly mosquito to change its behavior and start feeding on human blood. 
“Unfortunately between 10 to 20% of the people who get the disease will die so it’s important to avoid it,” Dr. Birungi advised.

 

  

East Africa: Health Experts Fight Deadly Fevers

East African Business Week, July 17, 2011

Arusha — A meeting of EAC experts on Viral Hemorrhagic Fevers (VHFs) took place in Entebbe, Uganda to devise strategies to counter the various VHFs the region is susceptible to.

These fevers, most of which are fatal, include Ebola, rift valley fever, yellow fever and Marburg fever. The 12-14 July experts' meeting hosted at the Uganda Virus Research Institute (UVRI) was part of a process to formulate a regional policy to address the frequent outbreaks of various VHFs in the EAC Partner States and neighboring countries. It will also discuss integrated disease surveillance and response. 

Over the last three decades, EAC Partner States have experienced recurrent outbreaks of Viral Hemorrhagic Fevers including yellow fever (most recently in Uganda), Marburg fever, Ebola, and rift valley fever (Kenya in 2006/2007 and Tanzania in 2007).

 

Opening the meeting, EAC Secretary General Amb. Dr. Richard Sezibera noted that although the incidence of Viral Hemorrhagic Fevers was not regular compared to infectious or vector borne diseases like tuberculosis or malaria, their impact was enormous, especially due to their high case fatality rates. 

In a speech read on his behalf by the EAC Principal Health Officer, Dr. Stanley Sonoiya, the Secretary General observed that outbreaks of VHFs often take long to detect and confirm due to limited financial, technical, infrastructural and human resources as well as organizational and institutional capacity to mount effective and sustained emergency preparedness and response at national and regional levels. 

He thus urged Partner States to utilize funding secured from the World Bank to initiate sustainable long-term measures to address the frequent outbreaks of these deadly fevers and rallied EAC to join hands with specialized technical agencies to develop and implement a "robust" EAC Regional Viral Hemorrhagic Fevers Strategic Emergency Preparedness and Contingency Plan: 2012-2016. 

The proposed Contingency Plan seeks to, among others, raise the regional capacity to respond to the VHFs and other emerging and re-emerging diseases of epidemic and pandemic potential in East Africa. Over the last five decades, Africa has suffered frequent outbreaks of Ebola, rift valley fever, yellow fever Marburg hemorrhagic fever, among other special pathogens while EAC States have suffered VHFs over the last three decades.

 

 

 

 

Rwanda: Regional Health Experts Meet Over Deadly Fevers 

The New Times, July 15, 2011 

By Eric Kabeera

 

East African experts on Viral Hemorrhagic Fevers (VHFs) are meeting in Uganda to devise strategies to counter the various VHFs affecting the region. 

The fevers, most of which are fatal, include Ebola, Rift Valley Fever, Yellow Fever and Marburg fever. 

The two-day meeting hosted by the Uganda Virus Research Institute (UVRI) is part of a process to formulate a regional policy to address the frequent outbreaks of various VHFs among EAC member states and neighbouring countries. 

Opening the meeting, the EAC Secretary General, Dr. Richard Sezibera noted that although the incidence of VHFs was not regular compared to infectious or vector borne diseases like tuberculosis or malaria, their impact was enormous, especially due to their high fatality rates.

 

He observed that outbreaks of VHFs often take long to detect and confirm, due to limited financial, technical, infrastructural and human resources as well as organisational and institutional capacity to mount effective emergency preparedness and response at national and regional levels. 

He urged EAC member states to join hands with specialised technical agencies to develop and implement a "robust" EAC Regional Viral Hemorrhagic Fevers Strategic Emergency Preparedness and Contingency Plan between 2012 and 2016. 

The proposed Contingency Plan seeks to, among others; raise the regional capacity to respond to the VHFs and other emerging and re-emerging diseases of epidemic and pandemic potential in East Africa.

The head of other Epidemic Infectious Diseases unit at Rwanda Biomedical Centre, Dr Thierry Nyatanyi, noted that Rwanda has a surveillance system was put in place to detect such fevers. 

"So far, we (Rwanda) have never recorded any case of these fevers," he said.

 Dr Nyatanyi further acknowledged that harmonisation of policies on regional level was necessary to continue fighting VHFs that have become prevalent in some regional countries. 

"If we have a strong collaboration in all EAC member countries, we shall be able to share knowledge and fight this problem," he said.

 

East Africa: Experts Declare War On Viral Fevers 

The Citizen, July 13, 2011

Arusha — Health experts from the East African Community (EAC) partner states are meeting in Entebbe, Uganda, to devise strategies to counter Viral Haemorrhagic Fevers (VHFs) in the region. 

The fatal diseases under the category include ebola, rift valley, yellow and marburg fevers. The three day meeting which is hosted at the Uganda Virus Research Institute (UVRI) ends today and is part of a process to formulate a regional policy to address the frequent outbreaks of various VHFs in the region as well as the neighbouring countries. It has also discussed integrated disease surveillance and response. 

Over the last three decades, the EAC member countries have experienced recurrent outbreaks of Viral Haemorrhagic Fevers, including yellow fever (most recently in Uganda), Marburg fever, Ebola, and rift valley fever in Kenya in 2006 and 2007 as well as in Tanzania in 2007. 

Opening the meeting, the EAC secretary general, Dr Richard Sezibera, noted that although the incidence of Viral Hemorrhagic Fevers was not regular, when compared to infectious or other diseases like tuberculosis or malaria, their impact was enormous, especially due to their high fatality rates. 

The EAC principal health officer, Dr Stanley Sonoiya, observed that outbreaks of VHFs often take long to detect and confirm because of limited financial, technical, infrastructural and human resources, as well as organisational and institutional capacity to mount effective and sustained emergency preparedness and response at national and regional levels.

 He urged partner states to utilise funding secured from the World Bank to initiate sustainable long-term measures to address the frequent outbreaks of these deadly fevers. He also rallied EAC to join hands with specialised technical agencies to develop and implement a robust EAC Regional Viral Hemorrhagic Fevers Strategic Emergency Preparedness and Contingency Plan 2012-2016. 

The proposed contingency plan seeks to, among others, raise the regional capacity to respond to the VHFs and other emerging and re-emerging diseases of epidemic and pandemic potential in East Africa, according to a press release issued by the EAC secretariat in Arusha yesterday.

Over the last five decades, Africa has suffered frequent outbreaks of Ebola, rift valley fever, yellow fever and Marburg hemorrhagic fever, among other special pathogens, while EAC Partner States have also experienced recurrent outbreaks of these VHFs over the last three decades.

 

Scientists see promising Aids vaccine future 

The Sunday Monitor, May 22, 2011  

By Evelyn Lirri 


Scientists speak out on Aids vaccine

Prof. Pontiano Kaleebu is one of Africa’s foremost Aids vaccine researchers having been part of the team that conducted the first Aids vaccine trial on the continent in Uganda in 1999. He is now the director of the Medical Research Council at the Uganda Virus Research Institute. He tells Sunday Monitor’s Evelyn Lirri the challenges of trying to find a vaccine 30 years into the epidemic and why there is now light at the end of the tunnel. 

We have had successes in managing HIV/Aids but not in a vaccine. Why? 
We at the Uganda Virus Research Institute are doing a lot of research that will help us find a vaccine. We do research in humans to try and find out what should a vaccine do. 

For instance, we still do studies to look at people who get infected and they progress very quickly to Aids and those who take a long time to get Aids and we compare to see why some people take long. We also look at those who get exposed to the virus and don’t get infected.

If we find out why some people don’t get infected, that can contribute to finding a vaccine. These are the laboratory studies we are doing now.
But we continue to do vaccine trials and two weeks ago we started on two new trials--one in Entebbe and the other in Masaka. These trials are funded by the International Aids Vaccine Initiative. Although they are being conducted by two groups, we are testing the same vaccine. 

Which kind of people are taking part in these trials? 
We are testing these vaccines in low-risk individuals who are HIV negative because we are still trying to find out whether these vaccines can lead to people to produce the right immune responses—antibodies or T-cells.
It’s going to run for about two years.

 

In recent years, there have been some promising clinical trials although most of them are out of Uganda. What do they mean for your local efforts here?
Recently we have had a few breakthroughs in HIV prevention. First, it was the Thailand trials with a vaccine that protected a few individuals and scientists are using that information to find out how did these vaccines protect individuals and they are using that information to produce better vaccines. 

Currently, we have better vaccines that have been tested in humans using the same method and concept as that vaccine used in the Thailand trial.
Outside HIV vaccines, there have also been some breakthroughs in using antiretroviral based prevention approaches—microbicides having gels that have anti-retroviral like the trial that was conducted in South Africa and also doing what we call PREP—individuals taking medicine if they are exposed and these medicines preventing them from getting infected. There were results in Thailand again that showed that this approach can prevent infection in gay men.

Then the other trial that came out recently that has made scientists very excited is the trial that was conducted in discordant couples where treatment was given very early in HIV positive individuals. 
It showed that if we give antiretroviral to these people then they are not able to infect their partners who are HIV negative by up to 96 per cent. 

Are these trials going to be replicated here?
For this trial of treating HIV positive people to prevent transmission, we now know that it works. 
But the challenge is how to implement it. These other trials of PREP and microbicides, yes they are going to be repeated and in fact in Uganda within MRC we are working with the International Partnership on Microbicides to start a trial in a few months time that contains one of these drugs to be used as a microbicide ring. We are at preparatory stages.

 

Does this mean we have to put more people on ARVs when their CD4 count is very high and what would be the cost implications of doing this?
If we have people who are in a discordant relationship—the earlier you start the one who is positive on treatment early the better. 
If you can counsel them, do Voluntary Counseling and Testing (VCT) and start them on treatment, the better in preventing them from infecting their partners.

The challenge will be the cost implication and getting people to go for VCT because many people are in these discordant relationships when they don’t know that one is infected. You will need more drugs and this gets even more expensive. 

What are the challenges for a scientist working on a complex subject like HIV/Aids research in a developing country like Uganda?
One of the biggest challenges we face is lack of funding. A lot of the funding we get is from donors and you need to write competitive proposals to get this funding and yet you are also competing with other very good scientists globally so getting money is a challenge.

 

But also when we get scientists and train them, retaining them is a challenge because the pay is low. So we try and get external funding to supplement on their salaries in order to retain them. Unfortunately, our governments do not have enough money to fund research.

 

How long do we have to wait for a vaccine? 
I don’t want to put timelines anymore because that is the question everyone is asking me—when shall we have a vaccine. Once we said in the next 10 years we shall have a vaccine, that time passed and we still don’t have one. But recent breakthroughs have already provided us with important clues which should eventually lead to better and effective vaccines.

 

So what’s the way forward?
Generally, we are saying we should come up with as many new HIV prevention approaches as possible. Before we have a vaccine, we need a combination of prevention methods but there must be a lot of efforts to find a vaccine because in the long term the best way to prevent new infections will be having a good vaccine. 
If you have a good vaccine, it gets cheaper and it’s easier than using drugs. Drugs have their complications like side effects and also changing human behavior is still a challenge but a vaccine is the best hope. 
We still Who is Dr Kaleebu?

 

Prof. Pontiano Kaleebu is the Director at the Medical Research Council/Uganda Virus Research Institute (Research unit on Aids). He is a board member of the newly formed Africa Aids Vaccine Programme which Uganda is hosting. 

Besides this, he is the head of the MRC-UVRI basic sciences programme. According to the MRC website, Prof. Kaleebu is also the deputy director for research at the UVRI and head of Immunology department at the same institute.
Previously, he worked as the executive director of the UVRI-IAVI vaccine programme until December 2010. 

As a leading Aids vaccine researcher, Prof. Kaleebu holds the title of honorary professor at the London School of Hygiene and Tropical Medicine, Faculty of Infectious and Tropical Diseases and a visiting Reader at the Imperial College London Chelsea and Westminster’s department of Investigative Sciences. 

He was also awarded the 2010 fellowship by the Imperial College of London Faculty of medicine for his outstanding contribution to HIV research and particularly vaccine development 

“Fellowships of the Imperial College Faculty of Medicine are awarded to persons who are not members of the faculty but who are of outstanding distinction in fields related to medical science or particularly supportive of the aims and vision of the faculty, “said Prof. Stephen Smith, the principal of the College while announcing Prof. Kaleebu’s nomination for the award.

 

With his vast experience in the world of HIV/Aids and vaccine development in particular, Prof. Kaleebu has served on several national and international committees including the World Health Organization HIV vaccine advisory committee and the Global HIV Vaccine Enterprise Scientific committee. 
The highly acclaimed professor started his medical career in Uganda after graduating in 1986 with a degree of medicine from Makerere University and later studied for a diploma in Immunology and a doctorate degree at the Royal Postgraduate Medical School, Hammersmith Hospital and St Mary’s Hospital part of University of London. 

He joined UVRI in 1988 and MRC-UVRI in 1995. His major areas of interest include the protective immune responses against HIV to contribute to the design of an HIV vaccine, HIV vaccine trials, HIV molecular epidemiology and resistance to anti-retroviral drugs.

 

 

2010

 

Aids fight: What we have got from 20 years of research

Sunday Monitor, November 21, 2010 

The first HIV/Aids case was identified in the country along the shores of Lake Victoria in 1982 when Uganda was experiencing political unrest. For the next five years no research about the virus was done because leaders were submerged in power struggle. But as Benon H. Olukawrites, the Uganda Virus Research Institute got down to serious business in 1987 and has never looked back:-

As he reflects on the more than two-decade journey of the Entebbe-based Uganda Virus Research Institute in HIV/Aids research, Executive Director Edward Katongole-Mbidde beams with restrained satisfaction.

In that time, UVRI, which began HIV/Aids research around 1987, has registered a number of significant milestones. In a series of collaborative research initiatives with partners from different countries in Europe and the Americas, UVRI has tracked the spread of HIV/Aids for more than 20 years, carried out the first HIV vaccine trial in Africa, and undertook a trial which showed that the most common disease of the central nervous system in HIV-infected people in Africa could be prevented with a pill.
Propped up by support from the Medical Research Council (MRC) of Britain, UVRI also undertook a trial to develop specialised anti-retroviral therapy for Africa, which helped save money.

In addition, UVRI was the first to isolate more than 20 new arboviruses, including West Nile Virus, Bwamba Fever, Semliki Forest Virus, Orungo, Kadam, and O’nyong’nyong. While UVRI has grown to become the centre for virus research in the country and one of the most renowned on the continent, Dr Katongole-Mbidde says its beginnings were quite modest.

 

Research neglected
The senior researcher explains that in a country that was still embroiled in seemingly endless political turmoil and civil wars up to the 1980s, research and academic pursuits were the last things on the minds of leaders whose tenures were far from guaranteed. Until, that is, the HIV/Aids virus opened a new war front against the people of Uganda. 

“At that time the infrastructure in the country was probably at its worst, but luckily enough we had new leadership which had come into the country under President Museveni and because of the openness of the President and his government regarding the HIV/Aids epidemic, a lot of help started flowing into the country,” he said.

 Initial support for HIV/Aids research at UVRI came from the World Health Organisation’s Aids Control Programme, which later became the Joint United Nations Programme on HIV/Aids (UNAIDS), and the UK Overseas Development Agency (ODA), now the Department for International Development (DFID). 
The two provided the support that enabled UVRI to become a national reference laboratory for HIV testing; to isolate and characterise the HIV/Aids virus, as well as train its staff. 

With that support, UVRI started its ground-breaking work on the HIV/Aids virus in Rakai District in 1987; the research that opened the window of opportunity in the fight against HIV/Aids, which eventually saw Uganda receive world-wide recognition as a model in Africa for fighting the disease after halving its prevalence in the 1990s. 

However, according to Dr Katongole-Mbidde, the funding at the time was not sufficient given the magnitude of the problem. When the situation became increasingly desperate as the effects of the HIV/Aids virus escalated, the government sought more help from research-savvy countries and organisations.

Foreign assistance
Consequently, in 1989, after the government invited their British counterparts to offer assistance, the Medical Research Council (MRC) of the UK set up an HIV/Aids unit at UVRI premises. Then, in the mid-1990s, the United States Centre for Disease Control also set up its own centre at UVRI.
Such support helped build research capacity at UVRI and, in 1999, Uganda became the first African country to get involved in HIV vaccines trials – with the institute playing an integral role in that effort.
In early 2000, according to Dr Katongole-Mbidde, the International Aids Vaccine Initiative (IAVI) started collaborating with UVRI on HIV/Aids vaccine research, with their special interest being the potential contribution of Ugandan researchers and the country in general to the initiative.

“Earlier on we really advocated for Africa not to be left behind in this endeavour so each time we went to meetings, we reiterated to the international community and to our own governments to make sure we participated in HIV/Aids vaccine trials,” said Dr Katongole-Mbidde.
However, while there was evident commitment by the Ugandan researchers to lead the HIV/Aids vaccine trials, it was not matched by equipment and human resource capacity needed to be involved at different stages of a vaccine trial. 

Whenever the UVRI needed to carry out more comprehensive tests, according to UVRI officials, samples had to be shipped to laboratories in the United Kingdom or the United States, wasting valuable time and money.

In a bid to reduce such inefficiency, the Uganda government and other partners of UVRI set out to provide the Institute with better equipment and to develop the capacity of its employees. 

The Acting Permanent Secretary in the Ministry of Health, Dr Kenya Mugisha, says the political instability in the 1970s and 1980s had denied Uganda opportunities to train scientists. He explains that while UVRI is semi-autonomous, the health ministry is mandated to provide guidance and oversee its activities. 

However, according to Dr Mugisha, the government lacked the institutional structures to equip UVRI. “Virus research is a very expensive area,” said Dr Mugisha. “That is a highly specialised area. There is no way we can fund all their activities. What we do is work with partners [and then] oversee what they do.”

One of those transformations is personified in the case of Betty Oliver Auma, a laboratory technician who joined UVRI in 1998. Ms Auma, who has since that time been employed in the Institute’s Immunology Section, where she largely works with a flowcytometer; a machine used to measure the physical and chemical characteristics of cells or other biological particles. 

Initially, Ms Auma carried out her research on the responses of white blood cells to HIV infection using a Facscan flowcytometer machine that enabled cells to be viewed using only three colours. 

But when UVRI acquired an LSRII 18-colour flowcytometer, Ms Auma was not yet trained to operate the new machine efficiently enough for the researchers in the Immunology Department where she is employed to exploit its full potential. 

“I was not trained on how to use the new machine,” she said. “When the institute bought the new machine, the LSR II, I was sent to the National Institute for Communicable Diseases in Johannesburg [South Africa] to train on how to use it.” 

After attending her first training in September 2007, Ms Auma had another training programme in Johannesburg in December 2008. Other UVRI employees are currently having similar specialised training. For instance, Mr Enoch Muyanja is training in the use of a DNA microarray at Florida (USA) and University of Montreal (Canada). A microarray is a powerful tool used to study genes that are switched on during disease processes and vaccinations. Dr Fiona Kalinda is also training in South Africa.

 

Dr Katongole-Mbidde says the three were trained as part of collaborative effort called the Canada-Africa Prevention Trials Network (CAPTN) which brings together researchers from Canada and those from Uganda, Kenya and South Africa. The two-year training programme that UVRI benefitted from, which comprises the first phase of the CAPTN initiative, was developed in 2006 to enable HIV researchers in Africa to acquire knowledge, skills and experience in areas that are critical to effective prevention trial research, including research ethics, epidemiology, community and stakeholder engagement, grant writing and project management.  Dr Katongole-Mbidde believes UVRI is gaining from such programmes. He said: “Ugandan researchers are being trained in high level science and they are coming back to the Institute to work here within our programmes so that the chances of retaining them are very high. So, in a sense, we are preventing brain drain.”

 

The training conducted as part of the first phase of CAPTN has already had some immediate benefits according to Ms Auma. As she conducted a brief tour of the laboratory where she does most of her work, Ms Auma said that her training has been very beneficial. 

“Now we are not incurring expenses to ship samples abroad. We used to send samples to be analysed in the UK and the USA and, you know, the costs we would incur were high but now the technology is here. We can do the work here. Those days we used to preserve samples and ship them but here we get fresh samples and work on them right away. So it has made work easy and we get results in the shortest time possible,” she explained. “We were limited by the three colour machine.” Ms Auma said, “With the new machine I can look at eight so the time taken to perform a study has been shortened so we get quicker answers than before. UVRI has made efforts to multiply the benefits from training undertaken by Ms Auma and others trained by the CAPTN. 

According to Dr Katongole-Mbidde, the plan is to ensure that whoever undergoes any training at UVRI is expected to train colleagues in order to multiply its benefits. Ms Auma has so far trained five of her colleagues at the Institute. 

“When you train a trainer, then you have got a multiplier effect and all these people are involved in training. We are a research institution but part of our mission is to increase knowledge and build capacity,” he explains. 

Dr Katongole-Mbidde believes that the capacity building initiatives provided through training programmes of the kind provided through the CAPTN will ultimately improve their vaccine trials efforts. He said UVRI has over the years built a network that includes researchers from the Infectious Diseases Institute at the Makerere University Medical School, Mbarara University of Science and Technology, and The Aids Support Organisation (Taso), an indigenous HIV/Aids service organisation in Uganda that was founded in 1987. 

“The whole focus is on prevention. We all know in this country that the people who are getting on ARVs every year is outstripped by the number of new infections, which is about 130,000 ever year, so that if we don’t do a lot of work in prevention, the epidemic is not going to be stopped. So there is need to treat those who are HIV/Aids infected but there is also need to put emphasis on preventing those who are not HIV positive from getting infected,” explains Dr Katongole-Mbidde.

 

More programmes
However, there are a series of other programmes through which UVRI has benefitted. The MRC of the UK, among other things, provides training to medical students and young researchers and through support to its partner inst itutions. IAVI on the other hand is involved in training scientists to carry out vaccine trials. 

Having started humbly and eventually developed world renowned scientists, Dr Katongole-Mbidde believes the sky is the limit for UVRI in its HIV/Aids research efforts.

 

“We are among only a few centres on the African continent which are really developing this capacity,” he said. “We think we are ready to be able to apply the knowledge that we have gained because of all the expertise we have brought on board.”

 

Landmark giant steps taken by Uganda Virus Research Institute 

  • Tracking the spread of HIV 
    In a surveillance area in South West Uganda, UVRI and its partners have been documenting the course of the HIV epidemic and its drivers for 20 years. 
    During the 1990s, this project demonstrated for the first time that at the population level the number of new infections per year was declining in Uganda.
  • This observation helped to provide the evidence based on which Uganda has been hailed for turning the course of the epidemic. 
    Data from the same project showed recently that the epidemic may be on the rise again; leading to renewed strong efforts by the National Aids Control Programme to accelerate HIV prevention.
  • Vaccine trials
    In 1999, the unit collaborated on the first ever HIV vaccine trial in Africa - the first of many trials to come. 
    While a highly effective Aids vaccine has still not been identified, UVRI and its partners have made giant strides in understanding how such a vaccine might be designed.
  • Cryptococcal disease prophylaxis trial
    A trial in Uganda showed the most common disease of the central nervous system in HIV infected African people could be prevented with a pill. 
    Around 10 per cent of HIVpositive people in Africa are affected by cryptococcal disease and about half of those people die from it. 
    The trial helped to show that HIV-positive people are far less likely to get the deadly disease if they take a regular dose of the medicine Fluconazole, an inexpensive drug which is safe to take.
  • Developing Antiretroviral Therapy for Africa (DART) trial
    Researchers from Uganda contributed to a major advance in understanding HIV treatment which could see life-saving drugs extended to more than one million extra people at no additional cost. 
    They found that routine laboratory testing of blood for signs of drug side-effects - long regarded as essential for HIV treatment - is unnecessary. 
    By abandoning routine laboratory testing, which is costly and requires sophisticated equipment only available in hospitals, the money saved could be used to buy and distribute extra anti-retroviral drugs.
  • Jinja Art Roll Out trial
    Local scientists helped to show that vital HIV anti-retroviral (ARV) drugs can be given by trained and supervised lay health workers to patients in their homes, just as effectively as ARV treatment through health centres but significantly cheaper. 
    This could dramatically increase access to these drugs, particularly in areas with limited health clinics and a shortage of doctors and nursing staff. 

Other Milestones
The institute was the first to isolate more than 20 new arboviruses, including West Nile Virus, Bwamba Fever, Semliki Forest Virus, Orungo, Kadam, and O’nyong’nyong.

 

Scientists seek solutions to Uganda’s plague problem

The Monitor, October 7, 2010    

By Evelyn Lirri 

Scientists in Uganda are intensifying research aimed at ending the spread of plague and other Zoonotic diseases in the country. The scientists will specifically focus on the West Nile region which has experienced endemic plague over the years.

Mr Nackson Babi, a programme manager for plague research at the Uganda Virus Research Institute (UVRI) said that although several research interventions have been carried out in the past to address the problem, more work will be needed to eventually end the problem of plague. “Studies have been going on to find out why plagues have remained in Uganda especially in the West Nile region. Part of the problem is that the Democratic Republic of Congo which is also plague endemic has not put in place control interventions,”said Mr Babi. 

Current research according to scientists at the UVRI is also looking at the various rodent species to find out which of these species is a common reservoir for plague, and also which specific flea species is transmitting the plague. 

Plague is a disease associated with rodents which carry fleas that can be spread to humans from the bites of the infected fleas. In people, plague infects the lymph glands. If diagnosed in time, plague can be treated using antibiotics 
Common symptoms of plague are fever, headache, cold and fatigue. Health experts say plagues are common in the rainy season when the rodents come out of the fields and bushy areas to seek shelter in houses. Most of them come carrying the fleas which end up biting and infecting humans.

State Minister for Health, Dr Richard Nduhuura said women and children in West Nile are most affected by the plague because they sleep on the floor while the beds are a reserve for men. “The beds are such that the fleas can’t attack the men while the women and children are left to be bitten by these fleas. We should ensure that women also sleep on beds,”he said. 

Dr Nduhuura also reiterated the need to carry out cross-border control interventions if the plague situation is to be addressed. “If we continue to prevent and control here and our neighbours don’t do anything, we shall continue to have these outbreaks,”he added.

 

Mr Yovani Adriko, the LCIII chairperson of Logiri Sub County, one of the most affected areas in Arua district said public health education campaigns are being carried out to encourage hygiene in homes and surrounding environments like bushes which are fertile breeding ground for the rodents.

 

New HIV virus type hits Uganda

By Raymond Baguma  and Agencies

                                                                                    The New Vision: September 05, 2010

A new type of HIV has hit Ugandan fishing communities in Wakiso and Masaka districts on the shores of Lake Victoria, according to an ongoing research by the Uganda Virus Research Institute (UVRI). 

The new virus strain has been defined as "recombinant" because it combines existing strains, the UN News agency IRIN News reported. 
The most common HIV types in Uganda are A and D, which were found in most of the 117 people from the five fishing communities. 
However, the researchers also found that 29% of the infected people have virus forms of A/D and D/A. This is evidence that HIV re-infection has occurred. 
The final data on the prevalence of the drug-resistant HIV will be available in 2012. 
Dr. Pontiano Kaleebu, the director of UVRI, said: “We are starting to see transmission of viruses that are resistant to some drugs and need to inform even those already infected not to engage in risky behaviour to avoid super-infection." 
He said people could be re-infected with a strain that is resistant to certain ARVs. IRIN News recently reported that researchers want to develop interventions targeting the fishing communities, such as education on how to reduce HIV risk through abstinence, faithfulness, condom use and male medical circumcision. 
"We want to work with these communities and learn more in order to see how we can intervene, but also prepare for future research in vaccines and microbicides [female-controlled HIV prevention products]," said Kaleebu. 
Uganda has achieved success in reducing the HIV prevalence from 30% in the 1980s, to the national average of 6.4% by using the ABC strategy which emphasises abstinence, faithfulness and condom use. However, the HIV prevalence in the fishing communities is at 28%, which is higher than the national average. 
Uganda is implementing other programmes such as Voluntary Counselling and Testing, ARV treatment as well as Prevention of Mother To Child Transmission. 
However, there are concerns the country is losing the HIV fight with evidence of stagnation in prevalence and rising new infections especially in married couples.

 

 

 

--

 

Scientists seek solutions to Uganda’s plague problem

The Monitor, October 7, 2010 

By Evelyn Lirri

Scientists in Uganda are intensifying research aimed at ending the spread of plague and other Zoonotic diseases in the country. The scientists will specifically focus on the West Nile region which has experienced endemic plague over the years.

Mr Nackson Babi, a programme manager for plague research at the Uganda Virus Research Institute (UVRI) said that although several research interventions have been carried out in the past to address the problem, more work will be needed to eventually end the problem of plague. “Studies have been going on to find out why plagues have remained in Uganda especially in the West Nile region. Part of the problem is that the Democratic Republic of Congo which is also plague endemic has not put in place control interventions” said Mr Babi. Current research according to scientists at the UVRI is also looking at the various rodent species to find out which of these species is a common reservoir for plague, and also which specific flea species is transmitting the plague.

Plague is a disease associated with rodents which carry fleas that can be spread to humans from the bites of the infected fleas. In people, plague infects the lymph glands. If diagnosed in time, plague can be treated using antibiotics 
Common symptoms of plague are fever, headache, cold and fatigue. Health experts say plagues are common in the rainy season when the rodents come out of the fields and bushy areas to seek shelter in houses. Most of them come carrying the fleas which end up biting and infecting humans. 

State Minister for Health, Dr Richard Nduhuura said women and children in West Nile are most affected by the plague because they sleep on the floor while the beds are a reserve for men. “The beds are such that the fleas can’t attack the men while the women and children are left to be bitten by these fleas. We should ensure that women also sleep on beds,”he said.

Dr Nduhuura also reiterated the need to carry out cross-border control interventions if the plague situation is to be addressed. “If we continue to prevent and control here and our neighbours don’t do anything, we shall continue to have these outbreaks,”he added.

Mr Yovani Adriko, the LCIII chairperson of Logiri Sub County, one of the most affected areas in Arua district said public health education campaigns are being carried out to encourage hygiene in homes and surrounding environments like bushes which are fertile breeding ground for the rodents.

 

Studies on the HIV vaccine

 By Dr. Annet Nanvubya

The New Vision, May 14, 2010

 

 

 

May 18, is World Vaccine Awareness Day. Uganda was home to the first-ever HIV vaccine trial in Africa in 1995, which was conducted at the Joint Clinical Research Centre. Since that time, Uganda has remained an important contributor to HIV vaccine research and development. 
HIV Vaccine Awareness Day provides a great opportunity to thank people who are helping find an effective vaccine. These include the clinical trial volunteers, health professionals, community members and the researchers. It is also an opportunity to learn more about vaccine research. An AIDS vaccine is described as the best hope for ending the spread of HIV. 
Dr Annet Nanvubya of Uganda Virus Research Institute (UVRI), Entebbe, says an effective AIDS vaccine will protect people from acquiring HIV and prevent or slow down the rate at which those who are already infected can progress to AIDS. 

Although many trials have been done worldwide and produced no vaccine approved for use to date, great strides have been made. Every time a trial has stopped, there are discoveries, new information and developments that take researchers closer to discovering the vaccine. 

Vaccine trials in Uganda 
Two bodies are involved in the research. 

One is the Medical Research Council (MRC), which co-operates with the International AIDS Vaccine Initiative (IAVI) and UVRI at Entebbe. 
The other is Makerere University Johns Hopkins University project (MUJHU) and Makerere University Walter Reed Project (MUWRP), which are also conducting trials in Masaka.

 

 

How the vaccine to fight HIV/AIDS is developed

The New Vision, May 14, 2010

A vaccine is a substance that is introduced into the body to prevent infection caused by any disease-causing organism, such as a virus, bacteria or parasite. 
It teaches the body how to defend itself against an invader by creating an immune response,” Dr Annet Nanvubya of UVRI, says. 

Types of vaccines
There are different types of vaccines; preventive and therapeutic vaccines. 
A preventive vaccine is designed for individuals who are not infected with the targeted disease.
Weakened bacteria or viruses are injected into a person to provoke the body to produce antibodies to fight the invaders. 
These antibodies expel the bacteria and remain in the body looking out for a similar invader, thus preventing the individual from becoming infected for a long time. 
A therapeutic vaccine is given to infected individuals to form immune responses that would allow better control of the infection or disease. In case of HIV, it slows the disease from progressing to AIDS.

HIV vaccine
Unlike other vaccines where weakened germs are used, no HIV is used in AIDS vaccines. 
They use a synthetic virus, made in the laboratory, which cannot cause HIV infection. The vaccine does not contain any material from HIV infected individuals. 
But the replica of the virus made is still able to convince our soldiers that there is an invasion of an enemy looking like the virus and this triggers off a variety of defence mechanisms that help the body fight against HIV.
According to IAVI documents, it starts with a biological concept. Experts in how our immune system works suggest ways in which an HIV virus can be stopped.
These are discussed by many experts and polished. The convincing idea is then tested in a laboratory. 
Even when it fails at this stage, new information is learnt about the behaviour of HIV and our immune system. 
When it succeeds, it goes to another level of testing it in animals. Normally, scientists use rats, rabbits and monkeys. 
This gives the researchers an idea of the effects the candidate is likely to have in humans. Success at this stage is seen in terms of safety and effectiveness in stopping the disease,
When a vaccine candidate succeeds in animals, it is then approved for use among humans. 
These clinical trials go through three phases. The first phase is conducted in a small number of low risk and healthy individuals to evaluate the vaccine’s safety and, to a small extent, effectiveness. This may last between 12-18 months.
When it succeeds, it is then taken to the second phase. Here, it tested on many people, up to several hundred participants. 
Researchers want to identify common short-term side effects and information on its effect on the immune system. The trials may last between 12-18 months.
Success at this level is not all. The vaccine candidate has then to be tried on a third phase.
These are large clinical trials conducted on several hundreds to several thousands of high risk individuals and may last between 3-5 years. For the vaccine to succeed, it must produce a desired clinical effect against the disease or invader and must also be safe to human beings. 
Many vaccines we use today, like the TB, Polio, measles or small pox vaccine went through the same process. The difference is that they used a weakened or disabled germ to trigger off an immune response. 
A weak TB germ for example, is introduced in the body. Our defences identify it and kill it easily. But in the process, they reproduce lots of soldiers to remain on alert to fight the same germ in case it returns into the body.

 

 

I took part in the HIV vaccine trial 

The New Vision, May 14, 2010

Paul Wetaka volunteered in Uganda’s first HIV vaccine trials by Joint Clinical Research Centre between 1995 and 2000. 
The robust man talked to Ben Okiror about his experience. 

Have you felt any discomfort as a result? 
Not at all: I have not felt any changes in my body. On the contrary, I feel proud of participating in the trial. I have been part of attempts to find a vaccine that would save the next generation. This particular vaccine is in its third phase trial in Thailand. 

Ours was the first phase. I have since been supporting many other initiatives. 
When you look at the vaccine against small pox and measles, some people had to make the sacrifice. It was an honour to be part of the first African vaccine trials rather than wait for one from the developed world.

How much were you paid? 
It is voluntary work. We are only facilitated when there are meetings and seminars with transport re-imbursement. So there is no material benefit for me as an individual. 

How many were you? 
We were 40, most of them from the military. 

Was it an order? 
No. I was inspired by Maj. Rubaramira Ruranga. He asked us to test and some of us who were negative volunteered for the trials. 
At that time, HIV prevalence was very high. Many people were dying. We lost many colleagues in the army and other places. So, I wanted to be part of the process to stop the scourge. 
What exactly did you go through during the trials? 
Apart from the initial classes before the trials, went through several tests to weed out those with allergies and other diseases and only the healthy ones were selected.
I was then given four injections in intervals of one month, two months and 26 months before a follow up after one year. During that period, I would go for periodical testing, where my blood would be drawn and reactions and side effects were registered. But they provided medical care whenever I fell sick. 

What happened later? 
After two years, in a process called “unblinding”, it was revealed to us the type of vaccine we had been injected with, its effects on our bodies and the next steps. 
My immune response was just 5% and yet they were looking for 70-80%. So we were told the trials would move to the second phase, which was meant for European countries. Thailand was chosen and they are now in the third phase of the trials. 
After that, what did you do to fight against HIV? 
I became a member of the community advisory board, representing vaccine volunteers. 
Later, I was invited to the Walter Reed project as a co-opted Community Advisory Board member since I was experienced. They were starting new research and I shared my experience with them. 
After sometime, I went to Entebbe to the Uganda Virus Research Institute (UVRI) to do mobilisation and sensitisation of the community, especially when the International AIDS Vaccine Initiative (IAVI) in collaboration with UVRI conducted three vaccine trials. I have been also attending conferences within and outside the country, sharing my experience. 

How did your family and relatives react to your participation?
 
They expressed mixed feelings. Some of them thought I was HIV positive and that was why I was part of the process. 
They were also worried that I could contract the virus during the trials. Fortunately, after I explained the whole process, they became supportive. 
My wife was by my side because we were advised to go with our wives for the meetings and seminars and so she knew the whole process. There was also the assurance that should anything go wrong, they would compensate us. 

Have you heard of anybody who was compensated because things went wrong? 
Luckily no one has experienced adverse effects as far as I know. In the last 15 years that vaccine trials have been conducted all over the world, nothing of that nature has been reported. 

Would you take part in another vaccine trial if asked? 
Scientists advise us not to take part in more than one vaccine trial unless otherwise because it takes a long time to follow up on the effects of the vaccine. 
You cannot tell what reaction would take place if these vaccines interacted in a person’s body. 
Any word of advice? 
I call upon people to volunteer for the trials because you never know. Your efforts may lead to the discovery of a vaccine.

 

 

Mosquito named after Ugandan scientist 

The New Vision, February 28, 2010
By Arthur Baguma

GREAT inventions of the world have been inspired by great thinkers. Famous people in history have made scientific discoveries and these discoveries have been named after them. And on this long list, a Ugandan scientist has been added. 
A team of renowned international mosquito taxonomists has named a new subgenus of the genus stegomyia (aedes) mosquitoes after Dr. Louis Godfrey Mukwaya, the assistant director, and head of the department of entomology, at the Uganda Virus Research Institute, Entebbe (UVRI).
The mosquito is named after him in recognition of his contribution to medical entomology and knowledge towards St. simpsoni, now known as St. (Mukwaya) simpsoni.
A detailed description of Mukwaya’s discovery was recently published in the Zoological Journal of the Linnean Society of London by three renowned mosquito taxonomists — John F. 
Reinert, Ralph E. Harbach, and Ian J. Kitching of the Center for Medical, Agricultural and Veterinary Entomology, Gainesville, Florida and the department of Entomology, the Natural History Museum, London, U.K are the authors of the article. 

Who is Mukwaya?
Mukwaya joined the East African Virus Research Institute (now UVRI) in 1965 as a trainee entomologist and the first Ugandan scientist to work at this institute. 
He had previously, worked at Makerere University College as a graduate research assistant in the department of Zoology where he bred and colonised a grasshopper called Ruspolia deferens (nsenene) in the laboratory. 
At the institute, he has risen through a number of ranks to the present substantive post of assistant director (Research). 
He went to Kangavve Preparatory Primary School, Kijaguzo Full Primary (in Luwero District), Lubaga Junior Secondary School, St. Mary’s College Kisubi and later Makerere University College. 
He holds a B.Sc. degree of the University of London obtained at Makerere University College in Zoology, Botany and Chemistry. He has a PhD. in medical entomology specialising in feeding behaviour and behavioural genetics of mosquitoes. 
He was a post-doctoral fellow (1973-74) in Prof. Vincent G. Dethier’s laboratory, a renowned scholar of sensory physiology and insect behaviour, in the department of biology, University of Princeton US.
In 1975, he was elected fellow of the Royal Entomological Society of London and a year later appointed to the World Health Organisation (WHO) Expert Panel of Vector Biology and Control in Geneva. 
At the end of 1979, WHO awarded Mukwaya a fellowship to study insect pathology at the laboratory of insects affecting man and animals at Gainesville, Florida, US, with a view of starting a laboratory for biological control of mosquitoes in Uganda. 
In 1981, the US Academy of Sciences National Research Council, invited Mukwaya to participate in drawing up guidelines for mosquito field research in developing countries. 
He was among the scientists who met at Imperial College, London in 2001 to discuss risks and benefits with a view of developing a field trial with genetically modified mosquitoes for the control of malaria. 
A genetically modified mosquito is immune to any particular malaria parasite and loses the ability to transmit the disease. 
Mukwaya has won several competitive research grants and served as a Consultant on various projects including WHO Consultant for the yellow fever outbreak in Nigeria which claimed about 10,000 lives in two years.

 

HIV researchers target an African-focused agenda

The New Vision, January 24, 2010 

By Gladys Kalibbala

THE World Health Organisation (WHO) has proposed to change the time when people living with HIV start on ARVs. Dr. Kihumuro Apuuli, the director of Uganda Aids Commission, says WHO recommends that people living with HIV start on ARVs when their CD4 count is below 350 and not 250 as has been the case. 
This means about 700,000 people will be eligible for the drugs which we cannot afford, he explained. 
Kihumuro was speaking at the recently concluded 5th African Aids Vaccine Programme (AAVP) conference at Serena Hotel in Kampala.
He said, currently, of the 400,000 people in Uganda who require ARVs, only 191,500 access them.
Kihumuro said: “This is a big challenge on the African continent and we need a vaccine to be found urgently.
Participants at the conference noted that Africans needed to take advantage of the AAVP Secretariat’s shift to Uganda to concentrate on finding an AIDS vaccine and reduce the spread of the disease on the continent. 
The headquarters of AAVP which have been based in Geneva since 2000 will soon be transferred to Uganda Virus Research Institute (UVRI), Entebbe. Uganda beat Botswana and South Africa to host the organisation. 
Uganda was selected because of the Government’s commitment and the good research environment. 
AAVP is a network of African HIV vaccine stakeholders led by Africans across the continent, with a vision for an AIDS-free Africa. It was created with the specific intention of mobilising support and advocating a more African-focused vaccine agenda. 
The programme intends to involve Africans in the development of the vaccine supported by WHO and United Nations Programme on HIV/AIDS (UNAIDS). 
During the conference, it was noted that the AIDS pandemic continues to be the most serious public health challenge facing the world today, with Africa having the highest infections with unprecedented medical and socio-economic consequences. 
The best hope to end the AIDS pandemic remains in the development of an effective HIV vaccine and its distribution to all communities,” said Dr. Ponsiano Kaleebu, the acting director of UVRI. 
He says 30 years after the first cases of AIDS were reported and HIV identified as a the cause, Africa, with only 10% of the world’s population, is home to more than 65% of the 33 million people living with AIDS worldwide.
Researchers say the annual rate of new infections continues to rise. For instance, in 2007, about 2.5 million people were infected. According to the 2006 UNAIDS report, about 40 million people worldwide are infected with HIV, 62% of them in Sub-Saharan Africa. 
The report adds that about 25 million people have so far died worldwide as the infection rate increases to an estimated 4.3 million people annually. However, only about one million HIV-infected people currently receive antiretroviral therapy in sub-Saharan Africa. 
This shows that treatment alone cannot help, we need a vaccine to halt the spread,” Dr Sam Okware, the commissioner for health services at the health ministry observes. 
He adds that developing an effective HIV vaccine is the greatest challenge in biomedical research. 
Prof. Fred Wabwire of Makerere University Walter Reed Project noted that many women drop out of the vaccine trials and called for their participation. 
It will be unfortunate if we come up with a vaccine which works for men without knowledge of how it works for women,” he said. 
The researchers urged African leaders to embrace the programme by showing their support through funding. Jeannette Kagame, the First Lady of Rwanda, was appointed AAVP’s ambassador and will represent the association at various meetings and policy forums. 
Kagame urged leaders to raise an awareness of Africa’s concerns at the international level and stop downplaying the gravity of the pandemic since this may hinder the vaccine’s development process. 
Likewise, Janet Museveni, the First Lady of Uganda, called for other preventive measures alongside the ABC (abstinence, be faithful and condom use) strategy if the pandemic is to be curbed.
There was also a call to control TB which has become more challenging. It was noted that the existing BCG vaccine is ineffective against the disease and poses risks in HIV-infected children. 
There was also a call to control TB which has become a challenge with the emergency of multi-drug resistant strains, especially in people living with HIV. 
Researchers highlighted the need for boosting BCG vaccine to meet this challenge.

 

 

Scientists end year in style

By Gladys Kalibbala 

The New Vision, January 18, 2010

RESEARCHERS on Friday got a break from their laboratories at Uganda Virus Research Institute (UVRI), Entebbe to party with friends. 
This end of year party for employees was also meant to celebrate Uganda's successful bid to host the African Aids Vaccine Programme (AAVP) Secretariat which has been shifted from Geneva. 
The acting director of UVRI, Dr. Pontiano Kaleebu said: "Let us dance and eat because we have earned it through the success registered last year." 
A jovial Dr. Sam Okware, the director of Uganda National Research Organization, urged researchers to form quality groups in order to improve on the quality of their research in the new year. 
Francis Runumi, the deputy director of general services at the Ministry of Health was the guest of honour. Runumi, who displayed exciting dancing strokes, said there was hope for many good things to come. 
Mohammed Kawuma, the Entebbe Municipality Member of Parliament, also attended the function. Guests were entertained by Ndere Troupe. 


 

2009

 

Uganda is new host of Africa HIV programme

December 17, 2009 

By Vernon Tugumizemu

The Entebbe-based Uganda Virus Research Institute (UVRI) has been selected to host the Africa AIDS Vaccine Programme (AAVP) Secretariat. UVRI defeated eight competitors in seven countries, including research institutions from South Africa, Burundi, Senegal, Botswana, Mozambique and Tanzania, said Dr. Alash’le Abimiku, global co-chair of the AAVP.

 

Abimiku announced UVRI’s successful bid at a press conference held at Kampala Serena Hotel on December 14. The Minister of Health, Dr. Stephen Malinga, said Uganda felt honoured to host the programme.
“As two thirds of the global AIDS epidemic is situated on our continent, we welcome the transfer of African AIDS Vaccine Programme to Africa; Uganda is honoured to have been chosen to host this programme,” Malinga said.
The minister added that because many lives were at risk due to the AIDS pandemic, Uganda will take this responsibility seriously “and pledge to work tirelessly towards the day when a safe, effective HIV vaccine will be available to protect Africans from the pandemic.”
AAVP has since its formation in 2000 been based at WHO headquarters in Geneva. The AAVP secretariat will operate alongside other trial centres in South Africa, Kenya and Nigeria, in an effort to develop an effective vaccine for HIV. 

“The new AAVP secretariat and four AAVP centres of excellence will provide enhanced support to research and capacity building and networking activities,” said, Dr. Catherine Hankins, chief scientific advisor to UNAIDS

 

 

Kaleebu came home to find cure for AIDS

The New Vision, November 29, 2009

By Gladys Kalibbala 


FACT FILE
 
Name: Pontiano Kaleebu 
Age: 49 
Schools attended: Jinja Kaloli Primary School, St Mary's College Kisubi, Kampala High and Makerere University 

DR. Fred Lyagoba, a senior scientific officer at the Uganda Virus Research Institute (UVRI) in Entebbe recalls how his group struggled to make their places clean after using monkeys and other animals in their research work. The monkeys could attack the men who fed and kept them. 
Lyagoba says in the 1980s they were dealing with attempted virus isolations using one-day-old suckling mice. Dr Pontiano Kaleebu then trained him the group in the techniques of isolating viruses using modern technology like tissue culture and DNA/RNA isolation. 
The group’s work was made easier by Kaleebu’s training and advice. 
“Science has advanced. Instead of getting 20ml of blood samples for a tissue culturing to see a virus in between 14-28 days, I will only need 2ml with results in just a week. We need to have more Kaleebus in this country,” Lyagoba explains. 

Dr. Kaleebu, who has trained many other researchers, says it was towards the end of his training as a medical doctor at Makerere Medical School in 1986 when he first experienced the torture of HIV/AIDS among the patients at the wards. 
During his internship at Nsambya Hospital in 1987, the wards were always full of HIV/AIDS patients. Dr. Merriam Duggan, the medical superintendent at that time, started a special clinic for these patients. 
Whenever he was at the Ward, he always got closer to the patients as he prescribed medicine while asking many questions about how they felt. He confesses that he realised AIDS was not far from him since he saw people he knew of his age coming to the wards coughing terribly and having many disorders.  Kaleebu then made his decision to go in for a full time research career in order to get to the root of this disease, which was getting more complicated every day. 
That is when he saw an opportunity to do a lot of research at UVRI to contribute in getting a cure or a vaccine. 
When he discussed the idea with his mother, she was not happy with him leaving hospital for a research institution, where he would not see patients more often and nobody would ever recognise his work. 

Indeed many doctors were opting to remain in the wards and the idea of a career in research was not popular among the young doctors. 
Luckily, Kaleebu had already made up his mind as he was not satisfied with the methods of only caring for the sick when the epidemic was increasing. 
In late 1987, Kaleebu was asked by then director of UVRI, the late Dr. Sylvester Sempala, to be recruited into UVRI. 

One year after joining UVRI, he was given a scholarship to study immunology at the Royal Postgraduate Medical School, Hammersmith Hospital in London. 

The study exposed him to the basic concepts of immunology and vaccinology and also initiated his contact with experts in HIV research. 

After completing his masters, the university offered him a scholarship for a PhD. He says his stay at the University of London for the PhD benefited him when he worked under a good researcher in HIV/AIDS, Prof. Jonathan Weber, at St Mary's Hospital, London. 

Kaleebu was able to characterise viruses and immune responses from Ugandan patients living in London and those in Uganda. 

He was also exposed to many other international experts participating in the WHO/HIV virus Isolation and characterisation Network. Unlike other colleagues, who opted to remain in Europe and USA, he saw more opportunities in Uganda. 

In 1995, Kaleebu was appointed head of the immunology department and he joined MRC/UVRI research programme in 1996. He says the funding from the UK to UVRI gave them a lot of opportunities. 

"With other colleagues, I concentrated on the work of developing basic research in immunology and virology," he explains. 
Kaleebu says their collaboration with the International AIDS Vaccine Initiative has also been important in their efforts to find a vaccine. 
Five years ago, he was chosen to chair the steering committee of this programme with its headquarters in Geneva. 
The programme has contributed to capacity building, advocacy and has been able to address issues around ethics and research regulation in Africa. 
Kaleebu says the programme is soon moving from WHO to become an autonomous organisation based in one of the African countries, where Uganda, Botswana and South Africa have been short listed among the many that bidded. 
“Am hopeful that Uganda will be selected to host this programme because of the work we have done and the commitment shown by the Government.” 

He says if Uganda is chosen, there will be opportunities for more networking in Africa and chances of more funding which will enable more research and train more scientists for the future. 
Kaleebu reveals that they met a lot of opposition as they prepared to start the first HIV/AIDS vaccine trial in 1999. 

"Many people claimed we wanted to use Ugandans like Guinea pigs! We sensitised the masses through the media and after numerous workshops, we ended up with the Cabinet and Parliament for approval. 
UVRI has played a big role in building the local capacity to conduct HIV vaccine research, development and other HIV prevention research and care. All the research is done locally in the laboratories. 
In December, Uganda will host the 5th AAVP Forum, where the first ladies of Uganda and Rwanda among other dignitaries and stakeholders will attend. 

ACHIEVEMENTS 
Dr. Kaleebu heads the MRC Basic Science Programme at UVRI and is the acting director of UVRI. 
Contributed to HIV-vaccine research and the training of young scientists in the country. 
Kaleebu leads a Network of Excellence funded by European Developing Countries Clinical Trials Partnership (EDCTP) involving 27 institutions in East Africa. 
He is part of the group that started a Programme called African Aids Vaccine Programme (AAVP) in 2001. 
Initiated the HIV-drug resistance prevention, surveillance and monitoring programme. 
Chairs the National HIV-drug resistance working group within the Ministry of Health.

 

 

Government should invest in HIV vaccine research

 BY HALIMA SHABAN 

The New Vision: November 27, 2009

UGANDA was the first country in the world to bring down the HIV incidence from 18% to 6.4%. 

The country was also the first in Africa to carry out an HIV vaccine trial in 1999. Dr Pontiano Kaleebu, the acting director of the Uganda Virus Research Institute, says since then, five more vaccine trials have been carried out. 

However, today, experts are worried that with the stagnation of HIV rates and the lack of funds for HIV vaccine research, Uganda could lose its place as the champion in the fight against HIV. 

A vaccine is a product designed to prevent individuals from getting a disease. Vaccines do not cure but help the body develop means of expelling or containing the virus. An ideal HIV vaccine would block HIV from entering the body or slow down the progress of AIDS. 

However, all the vaccine studies done here are originated and funded by donors. 

According to Parliamentary sources, 80% of the country's HIV/AIDS budget is funded by donors and none of the remaining 20% goes into vaccine research. 

Dr Zainab Akol, the HIV/AIDS programme manger at the health ministry, says much as Government does not put money directly into HIV vaccine research, it gives its contribution by harnessing resources to develop infrastructure for vaccine research like laboratory equipment. 

"The Government also spends money on preventative approaches and treatment like anti-retroviral drugs," she says. 

Between December 13 and 15, Uganda will host the fifth International Conference on The African AIDS Vaccine Programme (AAVP) to drum up support for the scientists who are working on the HIV vaccine. According to the AAVP secretariat, 67% of the global HIV incidence is in Sub-Saharan Africa yet funds for preventive strategies are expected from outside Africa. 

One of the objectives of the conference is to urge Africa's policy makers to give research greater financial support. According to Julius Ecuru, at the National Council of Science and Technology (UNCST), spending on research has almost tripled from sh31b in 2003/04 to about sh82b in 2007/08. 

However, this money does not go to HIV vaccine research because those studies are funded by development partners. The Government funds other research in agriculture, disease, construction and manufacturing, waste management and pollution control studies, he says. 

Ecuru however agrees that the money allotted to research (0.4% of GDP) is low. "The Government is supposed to spend at least 1% of its GDP on research." 

According to Kaleebu, while the Government provides institutions where they operate from, Africa must consider investing directly in research to ward off the HIV scourge. 

Addressing a forum of HIV researchers in Yaounde, Cameroom in 2005, Kaleebu called on African countries to invest in HIV vaccine research. "Capacity building and technology transfer are key issues for HIV vaccine research in Africa. Through research, Africa could become part of the solution to the AIDS crisis. But we need to start funding and owning it." 

AAVP should champion the mobilisation of the Government to start contributing to vaccine research. Advocacy groups need to mobilise policy makers to make it a priority. Ecuru says there is no clear national policy on research financing in Uganda. "Under Section 20(3) of the UNCST Act 1990, the Government established a National Science and Technology Fund to promote research, but the fund has never been operationalised." 

Where is the HIV vaccine? 
HOW TO BE A VOLUNTEER 
Dr Hannah Kibuuka at MUWRP, says one must be:

  • Aged 18 ¡V 50, of sound mind and able to make independent decisions.
  • Not be pregnant or breastfeeding.
  • Volunteering for the first time.
  • A Ugandan willing to give consent.
  •  Willing to test for HIV repeatedly and get results.
  •  Willing to use effective family planning methods, if sexually active.
  • Available during study period and willing to comply with protocol.
  • All body organs functioning well. 
    Those meeting the conditions can register either at IAVI, MUWRP, or MUJHU or at any sensitisation seminars about the volunteering. 

Dr Kaleebu says scientists are putting a lot of effort in two new vaccine candidates, which have been identified as the most viable against HIV after two decades of research. These are Adeno5, manufactured by a company called Merck and DNA plus Adeno5 by the Vaccine Research Centre, in the US. 
Both vaccines are currently undergoing the phase two trials worldwide. 
Kaleebu, said the two vaccine candidates successfully stimulate the body to produce the substances that may be able to protect the body from infection (antibodies and T-cells). 
IAVI is dealing with Adeno5 and is undergoing the second phase involving 27 Ugandans, 10 of whom are female. 
Makerere University John Hopkins University Project and Makerere University Walter Reed Project (MUWRP) are also conducting a phase2 trial for both vaccine candidates. 
IAVI, together with the Medical Research Council, are funding a study for the DNA plus Adeno5 vaccine. The trial, set to start at UVRI in Entebbe next month requires 300 volunteers. Of these, Uganda will provide 35 high risk individuals, who have been identified. 
There is a third vaccine candidate called Alvac, which has reached phase three trials. It is being tested in Thailand on 15,000 volunteers. 
Kaleebu says there is a long way to go for the final vaccine, but there is hope that in the next five to seven years, we could at least have a vaccine that controls the virus, where if one got infected with it, they would not get AIDS and the viral load wouldn't shoot up to affect the functioning of the body. 
2006-2007: A002 (tgAAC09) AAV vectored Vaccine at Uganda Virus Research Institute 

2006-2007: Adenovirus vectored HIV vaccine at MUWRP 

2005: Trial vaccine for children born to HIV-positive mothers at Makerere University John Hopkins University Project

 

Epidemics-Virus research institute could close over incapacity

The New Vision, October 18, 2009  

By Gladys Kalibbala

WITH the increasing number of pandemic outbreaks in the country, Uganda Virus Research Institute (UVRI), Entebbe lacks modern laboratories to arrest the situation. The acting director of UVRI, Dr. Pontiano Kaleebu, says the poor state of affairs may force the World Health Organisation (WHO) to close the centre unless it meets international standards. 
The in-charge of influenza surveillance project at UVRI, Julius Lutwama, says the National Influenza Centre which was renovated recently at a cost of $700,000 (about sh1.4b) still requires the same amount of money to reach the required standards. 
Surveillance for influenza viruses was started at UVRI in the 1960’s by WHO. By then, there was little information about the disease in East Africa. After research by WHO, it was established that influenza A and B viruses were present in East Africa and UVRI was designated as the National Influenza Centre in the early 1980s. 
The activities of the centre reduced to nil until the highly pathogenic avian influenza surfaced recently. 
The bio-safety laboratory-2 which is a joint venture of Makerere University Walter Reed Project (MUWRP) and UVRI cannot handle all cases especially when there is more than one epidemic at ago. 
Kaleebu says once an outbreak occurs, the centre needs three to four days to disinfect the place, clean it and prepare chemicals for the new venture. 
“We cannot work on two different deadly viruses in the same laboratory for fear of creating a more deadly virus just in case the two viruses are mixed up by mistake," he says. 

Officials at UVRI add that although the institute tests and confirms all diseases in the country, it is not given attention by the health ministry.
"Even the sh1b promised by President Museveni on his visit to UVRI has not been seen,” says one of the officials. 
Kaleebu further explains that once the necessary laboratories are put in place, they will benefit all aspects of research in diagnosis of new emerging diseases like swine influenza, Ebola, Marburg and rift valley fever, among others, and not be limited to avian influenza. 
Prof. Fred Wabwire, the principal investigator at MUWRP, says epidemics have been taking the country by surprise because of the weak diagnostics, surveillance and monitoring systems. 
“The laboratory was renovated to maintain an effective programme of diagnostics and surveillance of vector borne viral infections, to collect data and information on arboviral diseases, ensures prompt recognition and confirmation of disease outbreaks which would enable action to be taken before the disease has affected many people," Wabwire said. 
Reports indicate that due to insufficient security, many health workers have in the past been exposed to infectious diseases, with some resulting into death. 
Training of staff and lack of vehicles were noted as issues which should be fixed urgently. 
"Imagine someone carrying an Ebola sample in a kaveera and using a taxi. What if they get an accident and the virus is let free or someone steals the kaveera?"asks Lutwama. 
Because the centre cannot handle samples in a safe manner, it suggests samples of various epidemics be handled at the UVRI gate instead of carrying them to the offices where many people's life is exposed to danger. 
Recently, a team of 15 MPs from the Social Services Committee visited UVRI to understand why the place required funding, but they discovered it was below international standards and required money urgently. 
The MPs visit was prompted by a communication from the Ministry of Health that a loan approved by WHO in 2008 to modernise the laboratories at the institute was about to be cancelled because Parliament had failed to approve it. 
UVRI officials say documents for the approval of the loan were submitted to the office of the Prime Minister in December 2008. 
Parliamentarians pointed out a ‘missing information gaps between the Prime Minister's office and Parliament which needed to be checked. 
The MP for Buliisa, Stephen Biraahwa, says: “The ministry should prioritise UVRI matters because the country is facing different epidemics. 
The legislators also learnt that the medical team which has been screening people for swine flu at Entebbe Airport and Entebbe Hospital abandoned its work over lack of pay. 
The 70-member-group stopped working a month ago. "We risked our lives during that risky period, but now that the threat of the disease has decreased, the Government seems not to care about us anymore. Now people just enter the country without any screening, “says one of them. 
Dr Jackson Amone, the assistant commissioner integrated curative at the Ministry of Health, says the team will be paid once the money is ready. 
Meanwhile the director of health services at the Ministry of Health, Dr Kenya Mugisha adds that the Ministry of Health plans to contact WHO and the National Influenza Task Force to reconsider the screening exercise. 
“We should look at a review of the best scenario of handling the screening exercise since swine flu has now spread in many countries,” he suggests . "All border entries need screening teams and it may be expensive for the Ministry. 
Some cases of swine flu were reported at Kitabi Seminary in Bushenyi and other isolated areas but they were treated. The health ministry says there is no need for pani

--

 

Uganda is now proud owner of Influenza Centre

The Observer, September 23, 2009 

By Shifa Mwesigye 

Uganda has opened up its own laboratory with the capacity and facilities to test and detect influenza viruses, instead of sending samples abroad for testing as has been the case.  The National Influenza Centre Laboratory, which was commissioned by the Minister of State for Primary Healthcare, James Kakooza, at the Uganda Virus Research Institute in Entebbe, will enhance surveillance of influenza and influenza-like viruses in humans, animals and birds in Uganda. 

The H1N1 virus, commonly known as swine flu, and H5N1 avian influenza virus, which is termed bird flu, have been a major threat to Uganda and the world, killing over 100 people. 
The laboratory will provide the equipment and training necessary to enable researchers analyse influenza samples. 
“When you look at the disease burden today, it is important to consider research on emerging disease burdens. We need mechanisms of supporting scientists to continue research because new viruses keep emerging that are a threat to the human population,” Kakooza says. 
The upgrade of the laboratory was supported by the U.S Department of Defence’s Global Emerging Infections Surveillance and Response System, Centre for Disease Control and Prevention, World Health Organisation, and the US Agency for International Development. 

Because viruses spread so fast globally, Uganda could not afford to wait for weeks or even months while samples are being verified. Swine flu, which broke out in Mexico in April 2009, made its way to Uganda within only two months. 
It was at this laboratory that nine cases in Uganda were confirmed. Other threats have been bird flu, Marburg, Ebola and Polio. 
“Now we don’t have to send samples to the US, they can be tested in Uganda as well as continuous surveillance for any new viruses around the country,” Kakooza said. 

According to Dr. Pontiano Kaleebu, acting Director of the Uganda Virus Research Institute, surveillance for influenza viruses started at UVRI in the 1960s by the World Health Organisation team, but at the time there was scratchy information about the influenza in Uganda. 
UVRI was then a designated National Influenza Centre. But in the 1980s and 90s, the activities of the National Influenza Centre were reduced almost to nil, until a decision was reached to reopen because of the re-emerging cases of influenza viruses. The NIC has so far tested 2,700 influenza samples with a positive rate of about 15% for either H1N1 virus, or the H5N1 virus. 

It has also been involved in the investigations and control of Ebola and Marburg outbreaks in the country. 
“It became necessary to have more space for all of these activities and today we witness the handing over and official opening of the renovated laboratories,” Kaleebu said

 

 

Swine flu hits four in Kampala 

The New Vision, September 19, 2009

 By Raymond Baguma 

 

FOUR members of a family in Kampala have been taken ill with swine flu. This brings the total in Uganda to 12, since the first swine flu case was reported in July. 
Dr. Sam Zaramba, the director general of health services yesterday said on phone that a man, who recently visited an Asian country, returned home last week exhibiting flu-like symptoms at Entebbe Airport. Subsequent tests at the Uganda Virus Research Institute (UVRI) in Entebbe confirmed the presence of the swine flu virus and the man was confined in his home, Dr. Zaramba explained. 
However, three other family members have since been taken ill with the virus. Zaramba added that the family members were in stable condition and recovering. "They are confined in their home and we are treating them from there," he said without revealing the location or their identities. Swine flu is air-borne and presents itself with symptoms that include sudden on-set of fever, sore throat, cough and flu, which occur within seven days after contact with an infected person. 
Meanwhile, media reports from Kenya have indicated that 20 students from a Nairobi school have been quarantined after they were taken ill with the fever. Zaramba said the disease can be prevented by washing hands regularly with soap and of plenty of water and sneezing or coughing into a handkerchief or tissue. When asked how students in Ugandan schools are safe, Zaramba said, “The disease is with us here and we have to be careful and that is the message we want to get out to the entire public." 
The disease was first reported in Mexico in April before it spread to US and other countries. WHO declared the virus an epidemic and there are fears that it could mutate to become more lethal. 
Apart from Uganda, the disease has been confirmed in Kenya, Tanzania, Zimbabwe, Morocco, 
South Africa, Tunisia, Egypt, Ethiopia, Cape Verde, Ivory Coast, Mauritius and Algeria.

 

National Influenza Centre laboratory launched in Entebbe

The New Vision: September 13, 2009 

By Gladys Kalibbala & Halima Shaban

A modern National Influenza Centre and laboratory was launched with a call on Government to provide more funds in order to make it fully equipped. 
The Bio-safety laboratory-2 (BSL-2) located at the Uganda Virus Research Institute, Entebbe (UVRI) is a joint venture of Makerere University Walter Reed Project (MUWRP) and UVRI. 
According to the acting director of UVRI, Dr. Pontiano Kaleebu, the laboratory will be a key component in the diagnostics and surveillance of vector borne viral infections. 
It will be used to collect data and information on arboviral diseases, ensuring prompt recognition and confirmation of disease outbreaks which would enable action to be taken before the disease spreads. 
Officiating at the opening ceremony, the state minister for primary health care, James Kakooza, promised the Government's commitment in promoting and supporting research. 
He said the Government would set Uganda National Health Research Organisation (UNHRO) to fully coordinate and harmonise research in the country

 

Influenza laboratory needs more funds

The New Vision, September 05, 2009 

By Gladys Kalibbala and Halima Shaban

Uganda Virus Research Institute (UVRI) Entebbe now has a modern laboratory that can screen for influenza viruses, Dr. Pontiano Kaleebu, the Acting Director has said. 
However the laboratory still requires about $700,000 to enable it reach the required standards according to the in-charge of Influenza Surveillance Project at UVRI, Dr. Julius Lutwama. 
“We can do some diagnosis but we cannot fully characterize all viruses and sub-type them as we lack all the necessary equipment," he said. 
Kaleebu said the laboratory will be a key component in the surveillance of influenza and influenza-like viruses in humans, animals and migratory birds in Uganda. 
“It has so far been able to confirm the 9 cases of Swine Flu which occurred in the country." 
The up-grading of the laboratory started in 2006 after Bird Flu hit parts of the.

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HIV-resistant Ugandans found

The New Vision: April 05, 2009  

BY Charles Wendo

 

A SMALL fraction of Ugandans have been able to naturally knock off HIV from their body, a development that could lead to an HIV vaccine, scientists have said. 
Dr. Pontiano Kaleebu, an immunologist heading the Basic Sciences Programme of the MRC/UVRI Uganda Research Unit on AIDS at the Uganda Virus Research Institute (UVRI), told Saturday Vision that an ongoing study and a previous one at the institute had unearthed signs that some Ugandans may be resistant to HIV. 
They have special white blood cells that can only be produced when the virus attacks the body. However, even with the most sophisticated tests, HIV could not be found in these individuals, implying that the virus had tried to infect them but the immune system kicked it out. 
“We are seeing some immune responses but it is still too early to see if there is a lot of meaning to these responses,” said Kaleebu. 
"Such people are of interest to many researchers worldwide." 
At the AIDS Information Centre in Kampala, the UVRI scientists are studying 70 discordant couples to see if some of them are indeed resistant to HIV. These are couples that have had unprotected sex for more than a year, one partner has had HIV for long while the other has not become infected. “We have set up a clinic in Kampala where doctors and counsellors do a lot of counselling and give them condoms to reduce risky sexual behaviour," Kaleebu said. 
Despite early signs of resistance to HIV, Kaleebu said meaningful results can only be released at the end of the study. The five-year research, expected to be completed in 2010, is sponsored by the US National Institutes of Health through the British Medical Research Council (MRC). It is part of a multi-country study coordinated by the US-based Center for HIV/AIDS Vaccine Immunology (CHAVI) and involving Oxford University of UK. 
Prof. Heiner Grosskurth, the Director of the MRC/UVRI Uganda Research Unit on AIDS, said: "lack of ability to becoming HIV infected is extremely rare, but there is evidence meanwhile that people who have this characteristic exist worldwide, although in very small numbers."
Although they are so few, he said, studying them could generate new knowledge that would enable scientists to develop a vaccine. “Such work is going on with a lot of speed and effort in many countries, but there is no breakthrough yet! I think it will still take years until we have good vaccine candidates." 
Earlier in 2002, Prof. Andrew Mc Michael of the University of Oxford and the late Dr. Anthony Kebba of UVRI announced that they had identified some eight Ugandans in Kampala and Entebbe, who were exposed to HIV but remained uninfected. One fifth of the discordant couples they studied showed some signs of resistance to HIV, but this required further confirmation. Mc Michael is involved with Kaleebu in the new study. Similar studies are going on in Kenya and the Gambia. 
Kaleebu cautioned that nearly all people are vulnerable to HIV and Ugandans should not relax simply because a few individuals seem to be resistant to the virus. “It has to be clear that this apparent resistance is not a common thing. If you are HIV negative and your partner is HIV positive we cannot say you are resistant and you cannot become infected. If you continue to have unprotected sex you might become infected in the long run," said Kaleebu. 
Indeed, in the late 1990s some people in Rakai were reported to have become infected with HIV after being discordant for many years. On discovering that they were discordant, scientists had advised them to begin using condoms. Later, some of those who declined to use condoms became infected.

 

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Virus institute to hold science fair for schools 

The New Vision, March 03, 2009 

By Hilary Bainemigisha 

Tomorrow, students will convene at the Uganda Virus Research Institute (UVRI) in Entebbe for a science fair, intended to familiarise them to science and research. 
The gala, the first of its kind, is organised by UVRI in corroboration with Makerere University to promote capacity building in scientific research in Uganda. The Open Day will run under the theme You Can Be a Scientist Too. 
Dr. Edward Mbidde, the director of UVRI, says the initiative offers secondary school students (S3 and above) and undergraduates a chance to interact with scientists as well as research and motivational speakers. 
Students will find out what scientists do, what a career in science is like and what they need to do if they wish to follow a career in science. 
A total of 43 schools have been invited mainly from Wakiso, Kampala, Mukono and Mpigi. The fair will be extended countrywide in corroboration with Makerere and UVRI's upcountry field stations. Tomorrow, scientists from both institutions will display their work in a trade fair format with booths and works from a wide variety of disciplines, including information on basic science; medicine, veterinary medicine, social science, statistics and modelling. 
The institute's training committee and the School of Graduate Studies will also provide career guidance and information through presentations. Students will access selected laboratories and departments of the institute. 
“The displays will be interactive so that students can try out things for themselves. Participants will also have the opportunity to meet practicing scientists and ask them about their careers,” says Mbidde. 
The UVRI is endowed with excellent laboratory facilities, which are not readily available in many universities. Young researchers can have a chance to use the modern research equipment at the UVRI. 
The event is sponsored by Wellcome Trust, which is providing the core funding. Other partners are Medical Research Council, International AIDS Vaccine Initiative and Centre for Disease Control. The event will be held every two years, alternating between the UVRI and Makerere campuses. 

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Virus research body to promote sciences 

The New Vision, February 28, 200 

By Elvis Basudde & Gladys Kalibbala

UGANDA Virus Research Institute (UVRI) and Makerere University are planning a fair to promote science in schools. The event, which will take place on Thursday, will run under the theme; "You can be a scientist too." 
According to Dr. Edward Katongole Mbidde, the UVRI chief, the Open Day is a new initiative to for students in S3 and above and undergraduates to learn about opportunities and careers in science and scientific research. 
Students will be able to find out what scientists do and what they need to do if they wish to follow a career in science. 
The event will include schools from Entebbe, Wakiso, Kampala, Mukono and Mpigi districts. 
At the open day, scientists from both institutions will display their work in trade fair format with booths. There will also be career guidance for students. 

 

 

2008


Uganda set for haemorrhagic fever centre 

Weekly Observer, May 22, 2008

By Moses Talemwa

The World Health Organisation has approved the establishment of a regional centre in Uganda to test and determine the presence of hemorrhagic fevers in the East and Central Africa region. This will lead to a significant upgrade of the facilities at the Uganda Virus Research Institute (UVRI).

The development will also stop epidemiologists from Uganda, Kenya, Tanzania, Rwanda, Burundi South Sudan and Democratic Republic of Congo taking samples to the US, before determining a disease outbreak. According to a senior epidemiologist at the WHO, Dr. William Mbabazi, the development follows the persistent outbreaks of severe fevers such as Ebola, Marburg and Hepatitis-E in the region.

The new centre, to be named the ‘Regional Centre for Epidemic and Ecological Surveillance’, will be established in the present premises of the UVRI, at Entebbe, over the next three years.

This follows regular disease surveillance studies which showed that five new diseases have emerged in Uganda over the last two years alone. These are; new strains of Meningitis in Yumbe and Nakapiripirit, Ebola in Bundibugyo, Hepatitis-E in Lira and Pader, as well as Marburg fever in western Uganda. 
The initial government response was to establish an epidemic surveillance department in the Ministry of Health, with senior epidemiologist Dr. Oscar Kamukama as head. He was deputised by three other epidemiologists, and a bio-statistician.

However, Dr. Kamukama died last year, and two of the three epidemiologists resigned, leaving the department originally meant to have seven specialists with just one epidemiologist and the bio-statistician.

To make matters worse, the department, which is supposed to monitor disease outbreaks across the 80 districts in the country on a daily basis, had been running on a miniscule Shs 70 million budget, so most of the work reverted to the World Health Organisation, in coordination with the US-based Centre for Diseases Control.
“You see medical work is by nature labour-intensive, so the lack of manpower was a major impediment in the implementation of the department’s efforts.” Dr. Mbabazi said.

By coincidence, the WHO surveys also showed that there were similar disease outbreaks in Kenya, Angola and the DR Congo over the same period. 
Dr. Mbabazi’s office began looking at new strategies to deal with a common problem.

“We realised that if we established a regional hub to deal with hemorrhagic fevers, it would allow us to tap into the available manpower in the region, with each country contributing,” he explains.

Dr. Mbabazi is particularly keen that more trained personnel be made available to augment the WHO efforts in disease surveillance and detection.
According to the Ministry of Health spokesman, Paul Kaggwa, Uganda had to deal with insufficient technical expertise in diagnosing Ebola last September, so it was at the forefront in lobbying to have the equipment brought into the country permanently.

“During the first Ebola outbreak, they had brought the equipment from the US, and after the epidemic was tackled that equipment went back. But this time it is here, and will be used to detect all sorts of hemorrhagic fevers, right from Bird Flu to Ebola,” Kaggwa said.

But that is only the first stage of the process. The second process involves upgrading the present laboratory at UVRI from its present state of Bio Safety Plus-Level-2 to a higher level called Bio-Safety Plus Level-3. 
Africa has only one laboratory elevated to Bio-Safety Plus Level-3, able to carry out specialised investigations, like those involved in the detection of hemorrhagic fevers in specimens, and it is in South Africa.

Maintaining such a facility requires a capital injection of $1million per annum, excluding remuneration of staff manning it. According to the WHO, the Uganda Virus Research Institute is only at Bio Safety Plus-Level-2, but also requires some refurbishment. Maintaining the refurbished facilities would require up to $150,000 per annum.

By offering the UVRI for upgrade to Bio-Safety Plus Level-3, the government is hoping that the centre will benefit from resources available in the region, including monetary contributions for the construction, as well as manpower and more resources for maintenance.

Presently the UVRI is already carrying out regional surveillance and research on Polio, HIV and Measles among other diseases in collaboration with the CDC and the Medical Research Council of UK, as well as Kenya, Tanzania, Rwanda, Congo Republic and the Democratic Republic of Congo.

The move to expand UVRI into a regional hub to look at hemorrhagic fevers will see the new centre expand its scope into looking at various human diseases, as well as other diseases that may result from human interaction with ecological agents such as birds (bird Flu) and other animals.

For now the effort to upgrade the facilities in Entebbe has already received both the Uganda Government and WHO support. The design stage is presently underway at the Regional WHO office in Brazzaville.

 

 

2007

 


2006

Uganda’s health sector scores against odds

The New Vision: Nov 01, 2006

The Health Sector has continued to register progress despite insufficient funding and shortage of qualified staff.
For 20 years the Ministry of Health has been moving towards fulfilling the mission of the health sector; the attainment of a good standard of health by all the people in Uganda, in order to promote a healthy and productive life.
Paul Kagwa, the Assistant Commissioner of Health Education and Promotion, says when the Movement government took over power 20 years ago, there was a total breakdown of health services. 
Subsequently, the government set up the Health Review Commission, headed by Prof. Raphael Owor, to give direction to the health sector. 
This resulted into the development of three-year, five-year and 10-year plans as well as the Health Sector Strategic Plan (HSSP) I and II. The first plan (HSSP I) was implemented in the 2000/01-2004/5 period. 
Upon its completion, the ministry embarked on the second plan (HSSP II), which is an improvement and a consolidation of the achievements of HSSP I. Below are the achievements of the first plan.

Health infrastructure
This includes buildings, medical and hospital equipment, communication facilities, ambulance services and other transport facilities. Kagwa says patients used to walk over 10km to access health care but the distance has been reduced to less than 5km. 
Following the transformation of Mbarara University Teaching Hospital into a national referral hospital, there are three national referral hospitals and 10 regional referral hospitals. Hospitals and health centres have been constructed in Kamuli and Kisoro districts.
For mental health, Butabika Hospital has undergone major rehabilitation. In addition six mental health units have been constructed at selected regional referral hospitals. 
Other developments include the procurement and distribution of multipurpose vehicles and the supply and installation of imaging equipment to two regional referral and general hospitals.

Drug stock
The problem of drug shortage has been minimised with the introduction of credit lines. This is a system where districts order for drugs directly from the National Medical stores (NMS).
In addition, clinical guidelines have been provided and distributed for use by health workers at all levels, and 101 Medicines and Therapeutic Committees (MTC) have been established in the country.

Manpower Development
Health Sub-districts have been set up with full-time doctors and other health workers. During HSSP I, about 2,900 health workers were recruited. 
The ministry has continued to support postgraduate training at various higher institutions of learning. However, the responsibility of pre-service training of health workers lies with the Ministry of Education and Sports. 
The Ministry of Health retains the role of defining the standards and to guide the Ministry of Education on the number of people to be trained for a particular position.
Malaria control
Since 2000, major progress has been made in implementing national malaria prevention and control programmes. 
The Home-Based Management of Fever (HBMF) strategy has been designed and implemented in 54 out of 56 districts. It involves the training of distributors and thereafter availing them with antimalarial drugs.
There has also been increased treatment of children within 24 hours, the use of bed nets in rural areas and a reduction in death of malaria patients.
Immunisation
The Uganda National Expanded Programme on Immunisation (UNEPI) is a countrywide programme whose target population comprises infants and women of childbearing age. It targets eight diseases. 
Consequently, no case of wild polio virus has been identified since 1997; reported measles cases have reduced by 85 percent and during 2004 no indigenous cases of guinea worm were reported.

HIV/AIDS
Focus in the fight against HIV/AIDS and other sexually transmitted diseases was placed on Behavioural Change Communication, Voluntary Counselling and Testing (VCT), Prevention of Mother-to-Child Transmission (PMTCT), care and support including Anti-Retroviral Therapy (ART) and a National HIV/AIDS Sero-Behavioural survey which indicated a decline in the HIV prevalence from a peak of 18 percent in 1992 to seven percent in 2005.
Health research institutions
The major health research institutions in this period include the Uganda National Health Research Organisation (UNHRO), Uganda Virus Research Institute (UVRI) and the Uganda National Chemotherapeutics Research Laboratory (UNCRL).
Significant steps have been taken in the production of health research priorities, continued research in the area of AIDS and drafting guidelines for registration of herbal medicines.
Internally displaced Persons (IDPs)
The main obstacle to the provision of healthcare and social services in Gulu, Kitgum, Pader, Lira and Apac was the insurgency.
This obstacle spread to Katakwi, Soroti and Kaberamaido in 2003. Irrespective of the odds, provision of drugs in these areas has been going on. 
Care for AIDS patients was done through education, provision of anti-retroviral drugs, condoms and voluntary Counseling and testing (VCT).

Pregnant women received clean delivery kits.
This was coupled with the provision of emergency sanitation in the camps, control of disease outbreaks, Immunisation and training of health workers and Community Own Resource Persons (CORPs) in the management of common disease conditions.
As the ministry embarks on the second Health Sector Strategic Plan (HSSP II) for the 2005/6-2009/10 period, it should be commended for the gains made so far and be assisted in achieving its goal.

 


2005

 


2004

 


2003


SARS suspect cleared 

The New  Vision, Jun 20, 2003

TESTS of the Chinese man who was quarantined after being suspected of having the Severe Acute Respiratory Syndrome (SARS) about a month ago have come out negative, reports Edris Kisambira. 
A memo from the acting director of the Uganda Virus Research Institute (UVRI), Dr. Miph Musoke, to Dr. Sam Okware, the chairman of the national task force on the pneumonia-like disease, said , “I am glad to inform you that results of diagnostic tests for SARS on samples collected by the UVRI lab team from a traveller on Air Tanzania who arrived in Uganda some weeks ago (originating from Beijing, China) and was quarantined / investigated by the national SARS task force were negative.”
The memo, dated June 12, said the UVRI team was on standby to handle any other case of the SARS nature. 
Okware on Wednesday said the results were a great relief. 
He said the quarantine facility the task force has been setting up at Entebbe is complete with 14 beds. 
He said UVRI had also strengthened surveillance. 
The health desk that was set up at the height of the epidemic in the Far East is still operational. Okware said more than 10,000 people had gone through the desk.

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