All Ugandans irrespective of age or employment status will have to fork out Shs 15,000 per year should the cabinet approve the proposed National Health Insurance Scheme bill, Health minister, Dr Ruth Aceng has revealed.

There have been various failed attempts by the Health ministry to establish the National Health Insurance Scheme since 2004. The latest attempt was last year when parliament passed the bill only to be withdrawn shortly after. Now, Aceng says in the new proposals, they are making it mandatory for everyone to join the scheme after establishing that Ugandans don’t appreciate what they don’t pay for.

"We have done a good job consulting many people and drafting this bill. In this bill, the National Health Insurance Scheme it is mandatory for all of us to join. Mandatory! When I say it is mandatory it means you don't have a choice whether you're working or not working. Whether you're in the village or whether you're a boda boda [rider], it is mandatory! Because people don't appreciate services that they don't pay for and I can give you very good examples. When you go and find patients in Nakasero hospital, they behave, they don't break the toilet door or pull off the doors. They use the toilets very well and they pay for their services. But go to Mulago, they want to pull off the door, they want to break the windows, the beds are mishandled. People don't appreciate what they don't pay for," said Aceng.

She adds that the more dependants one has, the more money they will be required to contribute to the pool.

"I'm going now to tell you the sad news. The sad news is that the more the dependants and the more the children, the more you pay because you have to pay for your dependants, nobody is going to pay for your dependants. So if you're a hajji here and you have 3 wives with 25 children you pay your Sis 15,000 per child - all of them. And me who has 4 children, I will pay for the four. But if your child is 18 and above let them pay. Those are adults, we must instill in our children a spirit of hard work. You can give them some work to do and they pay for themselves and that way we shall be able to mobilise resources. We need money and when you have money you can get better services," added Aceng. 

However, experts differ on the idea of having everyone contribute to the scheme. In an earlier interview, for instance, Dr Githinji Gitahi, the AMREF Health Africa chief executive officer suggested that the government does mapping to determine, which people can afford to contribute irrespective of whether they work in the informal or formal sector.  

He suggests the use of village health teams (VHTs) to determine those who can afford the annual contribution and this he says has to be a continuous process because poverty levels keep changing. On her part, Grace Kiwanuka the executive director of the Uganda Healthcare Federation (UHF), says that the government’s proposal to have everyone pay irrespective of their financial capacity is a welcome move as it will protect the integrity of the fund.

“Where people don’t contribute experience globally is all beneficiaries need to contribute to appreciate the scheme and not to abuse it. To ensure the risk pool is managed, they consume responsibly because their money is in there as well," she said.

According to her, people are already paying for their healthcare anyway, and that health cannot be free or funded fully by the government as there is no big enough tax base. However, in the new proposals, the formally employed who are already covered by private health insurance will continue with their insurance plans already subscribed to, though they will still be mandatorily required to contribute to the NHIS. - URN/The Observer

Burundi’s Health Ministry declared an outbreak of cholera on Wednesday with 15 cases reported in the western part of the country, which is prone to water shortages.

“The cholera patients were admitted at a hospital in the municipality of Bujumbura and other treatment centers,” Polycarpe Ndayizeye, spokesperson for the Ministry of Public Health and AIDS Control, told reporters in the capital Gitega.

Ndayizeye urged health authorities and residents in affected areas of Bujumbura, Gatumba and Rugombo as well as all other stakeholders to join efforts against cholera.

He also urged residents, especially those living in affected districts, to abide by hygiene rules.

Earlier this year, cholera killed two people in the health district of Bujumbura, particularly at the Kajaga beach on Lake Tanganyika.

Water shortages are regularly reported in the western part of Burundi, especially during drought periods from May to September, causing cholera outbreaks.

A recent cholera outbreak in the World Health Organization (WHO) African Region has affected 15 countries, according to an August update report. The latest outbreak affected six countries, including Burundi, Cameroon, Kenya, Mozambique, Uganda and Zimbabwe, accounting for more than 200 new cases.

The WHO said the trend across the region is on the decline and is being closely monitored.

However, it called on countries to enhance readiness, heighten surveillance and institute preventive and control measures in communities and around border crossings to prevent and mitigate cross-border infection. - James Tasamba, Anadolu Agency

A recent report released by UNAIDS has recognized Rwanda as one of the top four countries that have effectively managed the HIV/AIDS epidemic. The country has achieved significant milestones in terms of treatment, testing, and raising awareness about HIV status among its population.

Titled "Are efforts for HIV prevention waning?" the report, unveiled on Thursday, July 13, revealed that Rwanda, along with Botswana, Eswatini, and Tanzania, has successfully met the "95-95-95" targets set by UNAIDS.

The "95-95-95" target entails ensuring that 95 percent of individuals living with HIV in a country are aware of their status, 95 percent of those aware of their HIV-positive status are receiving antiretroviral treatment, and 95 percent of people on treatment have achieved viral suppression.

The report further highlights that 16 other countries, including eight in sub-Saharan Africa, a region accounting for 65 percent of all HIV-positive individuals, are also close to achieving these targets.

"The end of AIDS is an opportunity for a uniquely powerful legacy for today's leaders," Winnie Byanyima, Executive Director of UNAIDS said. "They could be remembered by future generations as those who put a stop to the world's deadliest pandemic. They could save millions of lives and protect the health of everyone. They could show what leadership can do," she added.

The report emphasizes that successful HIV responses rely on strong political leadership, data-driven decision-making, addressing inequalities, empowering communities and civil society organizations, and ensuring sufficient and sustainable funding.

"Notably, the most significant progress has been observed in countries and regions that have made substantial financial investments, such as eastern and southern Africa, where new HIV infections have decreased by 57 percent since 2010," the report noted.

Globally, the number of people receiving antiretroviral treatment has nearly quadrupled, rising from 7.7 million in 2010 to 29.8 million in 2022.

However, the report also emphasizes that ending AIDS requires intentional efforts and cannot be achieved automatically.

"In 2022, AIDS claimed a life every minute. Approximately 9.2 million people still lack access to treatment, including 660,000 children living with HIV," the report stated.

The report highlights the disproportionate impact of HIV on women and girls, particularly in sub-Saharan Africa.

"Global statistics reveal that in 2022, 4,000 young women and girls were newly infected with HIV each week. Currently, only 42 percent of districts with HIV incidence over 0.3 percent in sub-Saharan Africa have dedicated HIV prevention programs for adolescent girls and young women," the report emphasized.

To put an end to AIDS, the report recommends increasing political will and investing in sustainable HIV response, including evidence-based prevention and treatment programs and health system integration.

According to the report, an estimated 39 million people worldwide were living with HIV in 2022, with 29.8 million accessing antiretroviral therapy. During the same year, 1.3 million individuals acquired HIV, while 630,000 people died from AIDS-related illnesses.

The Rwanda Population-based HIV Impact Assessment (RPHIA), a comprehensive country-wide survey conducted in 2019, revealed that the prevalence of HIV among Rwandans aged 15-64 is 3 percent. - Hudson Kuteesa, The New Times