I’M PAYING PRICE FOR STICKING TO W.H.O COVID19 GUIDELINES
By Mulengera Reporters
In response to the very controversial article published by Sunday Monitor (among other things claiming her insistence on more costly options had cost the GoU $4.2m between April and June), Health Ministry PS Dr. Diana Atwine has implied she is being targeted for demonization not because she has done anything wrong but simply because she firmly insisted on procuring COVID19 response-related consumables from only manufacturers who are globally pre-qualified and validated as compliant by international standards regulators like WHO and Food and Drug Administration (FDA) agency.
In a 7 page rebuttal, Atwine says as Ministry of Health they are obliged to ensure Ugandans are only exposed to diagnostic consumables which are safe and compliant with globally acceptable standards as set, agreed upon, enforced and validated by WHO and FDA. The PS explains that currently PCR is the most recommended technology usable for purposes of diagnosing COVID19 cases. And gratefully, its what all the MoH-supervised/controlled facilities are using to diagnose COVID cases namely Roche at CPHL and aBi at Makerere and UVRI.
She asserts that the MP Mohammed Nsereko-marketed Rapid Antibody Diagnostic testing method isn’t an option available to the sector leadership because there is no proof it meets globally-enforceable safety and efficacy standards as proclaimed by WHO and FDA. Nsereko and other proponents, passing off as commission-seeking brokers have been bashing her for not prioritizing their options which are being popularized as faster and inexpensive.
But Atwine says going for such options, without relying on any validation by regulators like WHO and FDA, would be betraying the people of Uganda who are entitled to protection by their government (through MoH) against exposure to products propagated by manufacturers or dealers who are un pre-qualified.
She says this firm stand against such brokers and proxies for potential suppliers has caused many commission-seeking middle men to target her for demonization in both conventional and social media. That they hope such demonization can break her resilience not to stand up to those insisting on supplying to government COVID19-related consumables that are less than the very best on the market. Whereas for such middle men its about pocketing the commission while lining their tummies, in Atwine’s case its about the duty to ensure Ugandans aren’t exposed to products whose authenticity hasn’t been validated.
Atwine explains that Abott-affiliated testing kits, which is the other alternative to PCR which the Monitor story rightly presented as more expensive, only got the WHO and FDA approval in August 2020 and yet the Sunday Monitor condemnation relates to procurements she conducted between April and June. She says the German and US firms from which all our COVID19 testing-related consumables have been purchased are some of the few potential suppliers that had the WHO and FDA validation and pre-qualification as of March when the GoU began making COVID-related procurements.
Atwine’s information is corroborated by the latest WHO assessment (dated 11/9/2020) still rating PCR as the best technology so far for COVID19 diagnostic testing as opposed to the so-called cheaper and more affordable options as advocated for by the Sunday newspaper article. In the same media statement, the PS also reveals that there is a group of angry deal-makers who have never forgiven her for the firm stand she has taken maintaining a very big no to those wanting her to procure COVID19-related consumables from suppliers whose safety standards and manufacturing practices haven’t yet been validated or pre-qualified by WHO and FDA.
The authors of the Monitor article asserted that as a result of her imprudence, the country had lost over $4.2m so far as of June because her teams had inflated costs related to collection, packaging and transportation of the COVID testing samples. That she had gone for an option costing $33.63 per test yet there are faster options costing just $22 per test per person. In her rebuttal, Atwine responds that this misinformation could only result from deliberate malice and desire to make the entire Museveni government look extortionist and unpatriotic.
She explains the expenditure per test per person is broken down as follows; $1.80 on nasal swab, $1.80 on oral pharyngeal and $8.50 on universal transport media. The total there comes to $14.35 per person tested. The same keeps going up because of other cost drivers like freight and insurance charges or expenses. She explains that freight expenses were initially so high especially at the height of the global lock down which saw countries totally shut down their borders. That the movement of the liquid substance through which the testing swabs are transported (from one place to another) is highly regulated because the same is considered a dangerous substance only appropriately transportable by the sea.
Atwine explains that at the dawn of the Ugandan COVID response, the desire by GoU to efficiently fight back was so urgent the same had to be airlifted into the country to be able to appropriately respond to the crisis we nervously found ourselves in the moment Uganda’s first Coronavirus positive case was confirmed in March. She implies that at that point, everybody at the national taskforce meetings realized the emergency we were in and the collective desire was to have the testing kits here at earliest. That this was the way her teams operated especially between April and June 2020.
Atwine reveals that having realized scarcity and quick transportation was becoming a major constraint to Uganda’s overall COVID response, which initially delivered great results making Ugandans unanimously proud, President Museveni at some point offered to surrender his private jet to have the required consumables (especially the test kits) airlifted into the country as urgently as possible. Some task force members considered hijjacking Uganda Airlines to do the airlifting transportation into the country as some objected arguing the same wouldn’t be economically viable.
During the complex discussions it was argued as counterproductive for the country to charter a plane to carry just the test kits luggage weighing just under 500kgs at a time. Gratefully, Atwine recalls, the test kits’ supplier, leveraging on the good business relationship with the GoU, offered to transport the test kits into Uganda, a thing that relieved the taxpayer of signifcant sums of money. As Gen Museveni repeatedly communicated in his televised addresses, test kits’ scarcity globally and transport costs for months remained the biggest fear task force members kept reflecting upon.
Atwine says that for leveraging on their excellent relationship with the supplier to get the offer of transportation into the country during those very difficult months, her teams deserve commendation rather that being scorned by a newspaper of high repute like Daily Monitor. She adds the Ugandan scientists who eventually innovated and came up with cheaper locally-made liquid substance as a media to transport the testing swabs equally deserve commendation in the national newspaper because they saved the country collosal sums of money.
She recalls one bad day when the test kits totally ran out yet Uganda had many COVID tests to be carried out and a neighboring country had to lend us some testing kits which were delivered into the country at 2am when the rest of the citizens were deep asleep. Atwine says as they waited for theirs to arrive, Ugandan teams had to borrow from the friendly neighbor because the resultant gap in the overall COVID response was going to be too costly.
Atwine also says the newspaper got it entirely wrong when they referenced on Genexpert consumables as opposed to the PCR diagnostic technique which Uganda has continued to rely on for its testing because its of conventionally acceptable and comparable stabdards and reliability as certified by both WHO and the US’ FDA as leading regulators on these matters. That the $0.3-3 per test kit that the Monitor story referred to is inapplicable because it doesn’t apply to the PCR technology Uganda has chosen for its COVID testing purposes to ensure authenticity. That the fatal mistake Monitor writers made comparing the incomparables could only lead to the mismatch they ended up with.
She advises that the newspaper next time eats a humble pie and cross checks with scientists for expert opinion for their reporting to be more informative as opposed to being alarmist.
The newspaper had also accused the MoH of not being transparent regarding the generous contributions donors have been making towards the COVID response with specific emphasis to growing our testing capabilities so that more citizens are tested to have their COVID status established.
Stressing the determination by the current leadership at the Wandegeya-based Ministry to ensure maximum transparency, responsiveness and accountability, Atwine reminds detractors that on Sunday 21st June 2020, the Ministry leadership (without being prompted by anybody) addressed a grand news conference in Kampala during which all the donors were disclosed and how much each had pledged or delivered. She wonders why the same Nation Media Group, that had reporters there and carried stories about the event, could accuse them of not being transparent barely three months later. The newspaper article claimed, ofcourse infactually, that the MoH was yet to satisfactorily account for the money advanced by the GoU as all the COVID consumables used so far was contributed by donors!
Yet during the 21 June news conference the following was publicly disclosed regarding who had contributed what: UN Consortium, acting through WHO, had delivered 40,000 test kits to UVRI. Others were UNITAD 5,000 to UVRI; UNICEF 8,000 to UVRI; GAVI pledged 80,000 but so far delivered 32,000 to UVRI; IDB pledged/not yet delivered 50,000 test kits and Richard Byarugaba’s NSSF which delivered 10,000 test kits to UVRI. There is also the Chinese government which delivered 10,000 test kits to UVRI and Jack Ma/Ali Baba who supported UVRI with 38,000 test kits which came in two batches.
Yet that isn’t all that was publicly disclosed about donors at that June press conference. Others are the EAC supporting our national response to conduct 900 tests and the Global Fund’s 185,141 test kits. On its part, the GoU has so far funded 400,000 tests through MTEF and another 100,000. Atwine reflects on all these in her rebuttal disclosing that in total; 469,041 test kits have been availed to the sector out of the 911,185 committed so far once the mere pledges (that are yet to be delivered) are included. Of the resources committed so far to build the testing capacity covering 469,041 test cases; 432,243 has been carried out and it remains work in progress.
Atwine also discloses that some of the tests donated by external donors were incomplete meaning the GoU has had to procure additional consumables to make them complete so as to facilitate the actual Coronavirus testing procedures. She asserts that as opposed to the Sunday demonization by the newspaper, the GoU deserves kudos for meeting more than 50% of the overall testing expense.
Atwine also scorns the newspaper for largely relying on information provided by Beijing Genomics Institute (BGI) which is one of the many potential suppliers from which her Ministry has been reluctant to buy for lack of validation and pre-qualification status as bestowed by reputable international standards regulators like WHO and FDA.
That the gentleman (Ahmed Sayed) the newspaper quoted as an authority represents the BGI which is different from the one of Europe which only acquired WHO/FDA pre-qualification status this very month implying there is no way the MoH can appropriately be blamed for not transacting with them in March/April when most of the COVID-related consumables’ procurement decisions were being made.
Atwine, who vows never to bow to any blackmail by disappointed commission earners wanting her to go for suppliers who aren’t WHO/FDA pre-qualified, says as she procures she has an obligation to ensure Ugandans are only exposed to the best quality products because the ordinary people’s safety is of paramount importance to them as a Ministry. She also asserts that its not enough for a supplier to become WHO/FDA-certified because even their technology has to be compatible with the GoU testing equipment available at UVRI, CPHL etc.
She says inspite of all the challenges and imperfections encountered in our country’s COVID response, Uganda’s testing expenses or costs per person per test remains the lowest in the region, something for which the sector leadership merits commendation as opposed to being scorned in a national newspaper of Sunday Monitor’s repute. She is optimistic the cost will diminish even further once some of the cost drivers are effectively circumvented and overcome.
She also stresses that the testing procedure remains free in Uganda except that those wishing to volunteer to do frequent voluntary testing have been provided with a window to pay for themselves on the GoU bank account transparently operated in Stanbic Bank. The cost is Shs240,500 or $65 per test per person.
She also reflects on the private testing labs her Ministry has acredited to do the tests including MBN Lab, Lancet, Medical International Hospital and Makerere University Hospital. That these ones determine their own charges per test because they operate privately as the MoH concentrates on its own testing centers. Atwine also refers to a gentleman going by the names of Jimmy Jim (on 0785142165) who she says has been extorting money from people while holding himself out as an employee of the MoH. She urges the public to report all the extortion-related information through the MoH PRO Emmanuel Ainebyona via 0779220588.
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