Baylor College of Medicine
Children’s Foundation - Uganda
Children’s Foundation - Uganda
Urgent action needed to prevent a public health catastrophe: addressing antimicrobial resistance (AMR)
Dr. Jane Ruth Aceng signs the symbolic 2nd National Action Plan on AMR (NAP-AMR II, 2024–2029) as Musa Sekamatte, the National One Health Platform Coordinator looks on.
The 9th National Antimicrobial Resistance (AMR) Conference was held from 20th – 22nd November 2024 at Hotel Africana in Kampala, Uganda. This three-day event, running under the theme “Educate, Advocate, Act Now,” brought together stakeholders from the human, animal, and environmental health sectors, alongside policymakers, partners, and political leaders. The event was officiated by the Hon. Dr. Jane Ruth Aceng, Uganda’s Minister of Health.
The conference aimed to raise awareness of the escalating threat of antimicrobial resistance, a critical global health crisis. The event also demonstrated Uganda’s commitment to a multi-sectoral approach in combating AMR through the achievement of notable milestones, including:
A Looming Global Health Epidemic
AMR arises when bacteria, viruses, parasites, and fungi develop ability to resist the medications intended for their treatment. This happens through mutation and selection where these microorganisms or germs develop defence mechanisms against antibiotics.
According to the Global Burden of Bacterial Antimicrobial Resistance (GRAM) report, AMR caused approximately 1.27 million deaths worldwide in 2019. If left unchecked, this figure could rise to 10 million deaths annually by 2050. In Uganda, the crisis is particularly alarming. In 2019, AMR directly caused 7,100 deaths and contributed to over 30,700 fatalities.
This places Uganda among the countries with the highest AMR-related mortality per capita globally. AMR is now a leading global cause of death, rivalling HIV/AIDS and malaria. Without urgent action, common infections could become untreatable, posing catastrophic risks to public health.
Despite the implementation of Uganda’s One Health approach was formally implemented in Uganda in 2013, challenges in the following areas remain in tackling AMR:
Strategic Plans for AMR Mitigation
Uganda reaffirms its commitment to combating AMR with the launch of the One Health Strategic Plan (2024–2029) and NAP-AMR II. These initiatives emphasize the interconnectedness of human, animal, and environmental health.
Dr. Jane Ruth Aceng highlighted the importance of coordination among all the relevant stakeholders: “We must strengthen the governance framework for AMR surveillance. This calls for better collaboration among public health officials, veterinary services, environmental experts, and other stakeholders. A clear, well-resourced, and accountable governance structure is essential for tracking AMR trends, guiding policy decisions, and ensuring evidence-based action.”
Advocacy Action against AMR
The Inaugural chairperson for the AMR parliamentary forum, Dr. Charles Ayume underscored the pivotal role of parliament in combatting antimicrobial resistance. He highlighted the need to widen the conversation beyond the community, advocating for the involvement of the media, religious leaders, political leaders, and the community members. In a speech delivered on behalf of Rt. Hon. Annet Anita Among, the Speaker of Parliament, Dr. Joseph Ruyonga, conveyed her commitment to rallying national and community action against AMR.
“Parliament will also support the newly established Forum on AMR to effectively undertake its mandate. Additionally, parliament will continue to support the line ministries in executing their mandates as outlined in the newly launched National Action Plan on AMR (2024 – 2029) through legislative action, resource appropriation and diligent oversight,” she added.
Dr. Ruyonga then led the parliamentarians in officially launching the Parliamentary Forum on Antimicrobial Resistance, marking a significant step in the collective effort to address this critical public health challenge.
Institutions, including Baylor Foundation Uganda (Dr. Dithan Kiragga, Executive Director on the left side of signature boar (in a khaki sleeveless jacket), Dr. Peter Elyanu, Director of Global Health Security (second on right in blue suit) and Rogers Kisame (sitting next to him) joined the members of parliament to demostrate their commitment to combatting AMR.
In addition to the UN quadripartite (WHO (World Health Organization), United Nations Environment Programme (UNEP), FAO (Food and Agriculture Organization), and WOAH (World Organisation for Animal Health), and most recently Uganda received support from the new Fleming Fund country grant II, a UK aid program managed by Mott MacDonald through Baylor College of Medicine Children’s Foundation-Uganda. This new partnership is focusing on capacity-building, stakeholder awareness, promoting responsible antibiotic use, generating quality-assured data to guide evidence-based policies and interventions.
AMR is an all-society One Health Problem requiring all our involvement of ministries, parliament, health workers, animal health professionals, agriculturalists and environmentalists, academicians, media and the civil society organizations. The conference requested urgent action from all the stakeholders to support 10% reduction in mortality in AMR, 20% reduction of inappropriate use of antibiotics in humans and 30% reduction of inappropriate use of antibiotics in animals by 2050.
Additionally, the conference underscores the urgent need for a unified, cross-sectoral approach to combat AMR effectively. Failure to act decisively could easily escalate this silent epidemic into a full-blown global catastrophe.
KAYUNGA, Uganda: On Monday, 28th October 2024, the Ministry of Health through its Non-Communicable Disease (NCD) Unit rolled out the “Integrating and Scaling up Sickle Cell Disease Care in Primary Health Services” program in Kayunga district. This is in conjunction with Texas Children’s Global HOPE program and Baylor College of Medicine Children’s Foundation-Uganda, Uganda National Health Laboratory and Diagnostic Services (UNHLDS), Makerere University, Uganda Pediatric Association, and Mulago National Referral Hospital. The Bristol Myers Squibb Foundation (BMS Foundation), an independent charitable organization, is providing funding to kickstart this program that will build on the extensive existing primary health systems in Uganda to integrate and scale up access to essential sickle cell disease care in Uganda. This initiative aims at ensuring every infant in Uganda is screened for sickle cell disease, and those that have the disease, receive essential lifesaving care, namely: timely childhood vaccinations, penicillin to prevent fatal infections, and hydroxyurea – a drug that reduces sickling of blood cells to prevent complications of the disease.
Sickle cell disease (SCD) is a lifelong, inherited disorder affecting red blood cells and is a leading cause of childhood illness and death in Uganda. Characterized by lifelong anemia, bone crushing pain episodes that last for days or weeks, disability from brain strokes in childhood, and early childhood death from infections, SCD brings severe health challenges in Uganda and many African countries. In 2023, an estimated 7.7 million people were living with SCD, with over 80% residing in sub-Saharan Africa.
In Uganda, approximately 20,000 children are born with SCD each year, according to a 2016 study published in The Lancet Global Health. While survival rates in high-income countries allow 90% of children with SCD to reach late adulthood with optimal quality of life, nearly half of children born with SCD in Africa die before their fifth birthday. In Uganda, SCD complications are now among the leading reasons for hospital admissions for children.
“The enormity of the scourge of sickle cell disease in Uganda, and across Africa, requires public health approaches grounded in primary health systems. We don’t have to build those systems from the ground up. Instead, this program is integrating SCD care in existing child healthcare systems to be cost effective, sustainable, and reach affected children in their communities,” said Dr. Henry Mwebesa, the Director of Health Services at the Ministry of Health.
Many pilot programs have been conducted in Uganda by a variety of stakeholders; they have demonstrated that basic interventions used to control SCD in Western countries are equally effective in African settings. However, like Uganda, many African countries have spotty services that are based at referral hospitals and only reach a small minority of children with SCD. This new program leverages the experience and systems of successful HIV care delivery in primary health settings across Africa to deliver a package of high impact, evidence-based SCD care and reach the bulk of affected children.
“Our shared vision is to end the unconscionable suffering and childhood deaths for children with sickle cell disease. We, as Uganda, are proud to be ground zero for rolling out a new day for these children, for the future of Africa,” said Dr. Diana Atwine, the Permanent Secretary of the Uganda Ministry of Health.
This effort aligns with the Ministry of Health’s 2020/21 – 2024/25 Strategic Plan to reduce the burden of SCD in Uganda and reflects the commitment of partners to support Uganda in achieving this vital goal. Dr. Joseph Lubega, the Director of Texas Children’s Global HOPE program, which has trained many of the first African pediatric SCD specialists and are spearheading this public health scale up across the region, reaffirmed the commitment of Texas Children’s Hospital and Baylor College of Medicine to support the initiative. “This is the beginning of bringing an end to over 8,000 years of intolerable pain, disability, and tragic deaths because of SCD across Africa. These children and families cannot wait any longer.” He emphasized that the program’s success will rely on partnerships with communities, advocacy organizations, health workers at healthcare facilities, non-government implementation partners, and leadership at the national level. Dr. Lubega, an associate professor of pediatrics at Baylor College of Medicine, also thanked the Bristol Myers Squibb Foundation (BMS Foundation) for continuing to provide essential support to address the major health challenges affecting children in Africa and other underserved communities across the world.
According to Dr. Dithan Kiragga, the Executive Director of Baylor College of Medicine Children’s Foundation-Uganda, “this partnership brings together key players who contribute extensive technical expertise to ensure the project’s success by improving service delivery for sickle cell disease across all levels of the healthcare system—from the community level to health facilities and up to the national level.”
“Families in Uganda know the devastating impact of sickle cell disease all too well,” shared Catharine Grimes, President of the BMS Foundation. “For Ugandans living outside of major urban centers, finding care is a significant challenge and sometimes not even possible. Our new initiative, in partnership with the Ugandan Ministry of Health, will integrate lifesaving early-stage interventions into primary care facilities in non-urban areas by leveraging the infrastructure and local health care capacity we have already built to address previous urgent crises like HIV/AIDS. We are focused on empowering Ugandan health workers to provide sustainable, long-term care. The Bristol Myers Squibb Foundation is proud to be working in partnership with these local health care professionals to turn the tide against this dire public health threat and deliver a brighter, healthier future for families across the country.”
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In the early months of 2024, Evaristo Ayebazibwe, a monitoring and evaluation officer at Baylor Foundation Uganda, introduced the 7-1-7 target to district leaders, health teams, and cultural leaders in the Kasese District. They were experiencing an outbreak of measles, and Ayebazibwe thought it could help the response.
The British High Commission in Kampala has announced that the UK will provide £1 million to Baylor College of Medicine and the Infectious Disease Institute to support Uganda’s response to the current Mpox outbreak.
On October 10, 2024, the Ministry of Health handed over equipment valued at $125,965 to implementing partners at Baylor College of Medicine Children’s Foundation-Uganda (Baylor Foundation Uganda) in Mulago. The equipment that included blood pressure machines, stethoscopes, thermometers, hospital beds, weighing machines, and their accessories was procured by Baylor Foundation Uganda with support from PEPFAR through the U.S. Centers for Disease Control and Prevention (U.S. CDC). The handover ceremony was attended by dignitaries from the Ministry of Health, the U.S. CDC, Baylor Foundation Uganda, district health officials, and implementing partners.
This donation aims to improve services for the prevention of mother-to-child transmission of HIV at lower-level healthcare facilities, which are mostly accessed by pregnant women in rural communities.
In his remarks, Mr. Albert Maganda, the Director of Strategic Development, Monitoring & Evaluation at Baylor Foundation Uganda, expressed delight to be a part of the handover ceremony. “Children are our soft spot as Baylor Foundation Uganda, so we are excited to support the Ministry of Health in its effort to improve PMTCT services at the HCIIs,” he remarked. “These medical supplies will help mothers and babies access quality health care in over 378 health facilities in the country, and we really appreciate the US government and the American people for this great donation,” Mr. Maganda added.
Dr. Linda Nabitaka, the HIV focal person at the Ministry of Health, thanked the AIDS development partners for responding to the needs of the Ministry. She stated that although early infant diagnosis services are provided at HC IIIs, over 46% of the mother-infant care is carried out at HCIIs. “We have therefore endeavored to extend these services to HC IIs to improve healthcare services to HIV-exposed infants and their mothers in rural communities,” she said. She further requested for health worker training on how to use the equipment so that they can do their jobs better.
Ms. Juliet Busingye, the PMTCT specialist at the U.S. Centers for Disease Control and Prevention (CDC), thanked the Ministry of Health for improving health service delivery at HCIIs, where most mothers in rural communities access antenatal services. Ms. Busingye further appreciated the Baylor Foundation Uganda for taking the lead in the procurement of the equipment. She also thanked the US government for the funding and all the other implementing partners present for contributing to the overall goal of eliminating mother-to-child transmission of HIV in Uganda.
To provide Artisan skills training to Adolescent Girls Young Women(AGYW)
Disposal by the sale to the Public of used motor vehicle tyres&Rims.
Baylor Foundation Uganda is seeking for passionate and skilled Artisan Trainer(s) with strong background in hands-on skills and entrepreneurial skills, who is enthusiastic about mentoring and empowering others. As an Artisan Trainer (s), you will be responsible for delivering practical skills training, fostering entrepreneurial mindsets, and supporting the personal development of our trainees.