That Uganda has established a reputation for managing deadly epidemics is no longer a surprise. Starting in the 1980s with the HIV-AIDS epidemic to the more recent COVID-19 and Ebola outbreaks – the country has emerged victorious in the manner it has dealt with them.
There are several lessons Uganda can draw from her handling of the Covid-19 pandemic and the Ebola epidemic to better prepare for future emergencies.
First, the national preparedness plan needs to be rethought to respond to future pandemics. For example, as the COVID-19 pandemic hit, a new structure of a national preparedness plan to respond to the pandemic was developed. The structure included multi-dimensional governance and coordination mechanisms. Specifically, between 2020 and 2022, the government response to COVID-19 led to the establishment of a National Taskforce for COVID-19, chaired by the Prime Minister, supported by sub-task forces at national and local levels.
However, community structures proved to be more helpful in uniting people toward a common objective of battling the epidemic by responding to health emergencies, identifying the vulnerable, and forming self-organizing collectives. Future emergencies will require the development of strong community networks for successful responses.
While the task force initiative faced significant pressure on restructuring and planning for public health infrastructure, the implementers of COVID-19 guidelines faced plan implementation gaps. The task force ended up under-resourced, overworked, and overburdened, limiting the extent of service delivery to most of the population.
Measures such as lockdown severely hit the economy coupled with the worldwide recession’s gross effects. Business actors need to innovate business processes that embrace digital technologies that can support operational continuity in the face of pandemics based on the experience of COVID-19. This is especially true in the informal sector, which employs over 85 percent of Uganda’s workforce. The most vulnerable population was in the informal sector, and the emergency response plan, which included social protection and stimulus packages, did not reach everyone vulnerable.
For the emergency relief interventions, at the onset of the first lockdown in March 2020, it was projected that over 1.5 million urban poor in Kampala and neighbouring central districts of Wakiso and Mukono would benefit from the COVID-19 food relief. However, emergency relief in Kampala was frequently insufficient, had quality gaps, and complicated by a lack of openness and poor targeting. There was no single social registry from which information could be derived to target the appropriate vulnerable group, including refugees. In future, to better tackle the food relief response, officials could leverage the already established decentralised system from the district level to the village level, under the parish development model—to undertake future nationwide food distribution campaigns.
During the second lockdown in June 2021, there were shifts from food relief to cash transfers to provide a more flexible mechanism for disadvantaged people to benefit and decide about their families’ most immediate needs, but this was not effectively done. Most of the targeted vulnerable households did not benefit because of a lack of disaggregated data to determine equitable transfers.
For future responses, there is a need to improve the registration and verification process of beneficiaries and identify the most vulnerable population to create a database for transparency. This will require an update of the national social registry with suitable information to build a database for vulnerable people for such a package.
Similarly, temporary relief measures such as the ban on disconnecting utility services for vulnerable consumers, landlord eviction, and debt repayment, among others, need to be structured in 2023 as a relief package for future interventions among business actors in case of new pandemics.
Besides developing national preparations and assistance packages, the Ugandan government must implement steps to combat pandemic misinformation in 2023. In the years leading up to 2022, there were many misconceptions about the COVID-19 virus and vaccines, necessitating adequate communications and outreach initiatives to address such local concerns.
In the same light, more information regarding Ugandans who were vaccinated and demystifying concerns about the vaccines’ adverse effects and safety should be promoted.
This year, more vaccination of Ugandans needs to be rolled out to help more equitably and effectively deliver COVID-19 vaccines. We expect the ongoing vaccination campaign will span for years. By investing in these solutions today, we believe we can lay the groundwork for routine immunization solutions that can be quickly deployed whenever a new vaccine (or booster) is introduced.
COVID-19 and Ebola will not be the last emergencies we or future generations will face. We can arm ourselves now to face future emergencies well prepared.
Featured photo credit: UNICEF