C-19 Global South Observatory

UGANDA

Information last updated: August 23, 2020

  • Total population: 42.7 M
  • Population +65 yo: 2%
  • GDP Per Capita: 1,837 USD
  • Informal employment: 83% (2012)
  • First registered case: 22 March
  • Hospital beds: .70 (per 1,000 people)

Sources: TheWorld Bank and WHO  (Population over 65 years old, Informal employment, GDP-PPP, Hospital beds).

Status

Level of confinement and until when: Lockdown measures ended on May 5th, 2020. Before:

    • Nationwide curfew between 7pm and 6:30 am  (announced on March 18).
    • Public transport, use of private vehicles, and gathering above 5 people were suspended on March 30 (and expected to last 14 days, private transport allowed on May 26).
    • All educational  institutions and places of worship were suspended for one month. The country will begin to reopen on May 26.

Response set up and capacity

Uganda’s COVID-19 response is spearheaded by the central government’s multi-sectoral committee on Combating CoronaVirus Disease – COVID-19 National Taskforce It was set up by the President of Uganda under the office of the Prime Minister of Uganda. The committee reports directly to the president of Uganda. It is mainly composed of government ministries, departments, and agencies, including Health, Tourism, Security, Works and Transport, Information and National Guidance, Kampala Capital City Authority, Foreign Affairs, Internal Affairs and private sector. 

At local government level, the district’s response is fully led by the resident district commissioner (a president’s district representative), working with all district authorities. At the lowest administrative unit (community), response is led by local council 1 chairperson. 

The private sector health and emergency relief is channeled through the multi-sectoral committee. Private sector support has been mainly providing food relief for those affected by the curfew, health commodities like gloves and masks, and equipment like cars. 

The Ministry of health sent out official public health guidelines for prevention and management of COVID-19 Guidelines for Uganda and the general anecdotal public response suggests they are managing COVID-19 well. Moreover they created a Preparedness and Response Plan for March 2020 until June 2021. This plan contains 8 main pillars of work that are broken down further to specific objectives that are expected to be monitored starting in March.

Stakeholder Mapping

Entities / Organizations

• President of Uganda and office of the Prime Minister COVID 19 National Task force
• Government ministries (Health, Tourism, Security, Works and Transport, Information and National Guidance, Kampala Capital City Authority, Foreign Affairs, Internal Affairs)
• Private sector
• Districts and local councils
• Uganda Virus Research Institute (UVRI)

Additional actors

International actors:
• USAID
• The US President’s Emergency Plan for AIDS Relief (PEPFAR)
• The US Centers for Diseases Control (CDC)
• World Bank
• International Monetary Fund
• World Health Organization
• Unicef
• World Food Program

Mitigating factors - What is being done?

  • 18 March: The first Lock-Down Guidelines for Uganda are announced. They include the closure of all educational institutions, places of worship, rallies, weddings of more than 10 people, cultural gatherings, conferences, discos/bars, sports, music shows, cinemas/concerts; bans on all movement of Ugandans to or through category one COVID-19 countries (return of Ugandas is allowed provided they undergo mandatory quarantine at their own expense). In addition, all public transport and cattle/food markets are allowed. Burials are also allowed but must be attended by a few people only. Government also issues guidelines on prevention and suppression of transmission- mainly hygiene SOPs.
  • 25 March: The second Lock-down guidelines for Uganda are announced. These include stopping all public passenger transport, and suspension of all  non-food sellers at markets. 
  • March 30: The third Lock down guidelines for Uganda are published. These include the prohibition of all movement (curfew put in place between 7pm and 6:30 am), including private vehicles and gathering beyond 5 people. All non-food stores, malls/arcades, saloons, lodges, garages, are closed, except those selling agricultural/veterinary products, detergents, pharmaceuticals, supermarkets, factories, and construction sites. These are allowed to remain open but with standard operating procedures (SOPs) and observing a social distance of four meters. Government vehicles that do not belong to the army, police, prisons, or wildlife are pooled and deployed at District Health Offices, with their drivers, to help in health emergencies.All government work is suspended except for the army, police, health workers, power, and telecom workers. Distribution of food to vulnerable populations affected by the shut-down begins, though the police arrest politicians distributing food – advised to contribute it to the COVID-19 National Task Force. The lockdown was extended until May 5, 2020.
  • April 10: Mandatory testing for truck drivers
  • April 12: Lockdown and curfew extended for 21 days
  • May 4: lockdown and curfew extended for another 14 days and masks are mandatory in public
  • May 18: Uganda reaches 200 confirmed cases of Covid-19 and lockdown is extended 14 days 
  • May 26: Private cars with only 3 people and general merchandise shops allowed with strict social distancing
  • June 4: Public transport in non-border districts resumes by carrying half of the capacity
  • June 22: It is announced through a presidential directive that schools will remain close and a long-distance education program  through radio will be implemented.
  • July 16:  World Bank approved $15.2 million to support Uganda’s efforts to prevent, detect and respond to COVID-19
  • July 21: Shopping in arcades is allowed and beauty salons were reopened
  • July 24: First reported death
  • July 27: Boda-Boda drivers began carrying passengers again and the curfew was shortened to be from 9 pm to 5:30 am
  • August 17: highest record of cases in a day with 66 new infected people. 

COVID-19 Mitigation measures by Uganda’s Ministry of Healt. In terms of public health, the Ministry of Health set up six (6) strategies to curb COVID-19 including:

  1. contact tracing and follow up of COVID-19 alerts, 
  2. following up on 18,860 returnees from abroad – some quarantined and others tested, districts following up and taking samples, 
  3. decentralized COVID-19 activities to districts, 
  4. enhanced COVID-19 risk communications to regional levels, districts, and communities, and issued toll free lines for public for information, 
  5. screening and testing of all incoming cargo drivers from the East African Community Area,
  6. follow-up of people in quarantined centers and tracking new people. Both local & international civil society organizations and other actors have been fully in support of the government’s efforts. 

COVID-19 Response from International Actors in Uganda:

  • The United States Agency for International Development (USAID) is supporting the Health ministry to develop and scale-up risk management communications for Covid-19 and is working to expand virtual learning and telemedicine platforms to regional hospitals. USAID is also participating in the Covid-19 response National Task Force strategy sessions.
  • The US President’s Emergency Plan for AIDS Relief (PEPFAR), procured urgently needed Information Technology hardware to improve communication among hospitals and district officials, facilitated dissemination and implementation of Covid-19 guidance, and established virtual platforms for the Health ministry meetings and communications.
  • The US Centers for Diseases Control (CDC) is supporting Covid-19 surveillance, building capacity of Ugandan health workers and laboratory staff, and strengthening incident management and emergency operations. CDC personnel are supporting local laboratories in building their sample transport network and training lab staff to collect specimens, test, and report results.
  • The World bank approved $15.2 million in support to Uganda’s public health system and to help in the prevention, detection and response for the pandemic. This money will be given as a $12.5 million IDA credit and a $2.7 million grant.

Risks, vulnerabilities, obstacles

  • There have been several threats to what seems to be Uganda’s spirited COVID-19 response. First, since the shutdown, stories abound of health facilities operating short of health workers as many cannot travel to work; some staying away out of fear of the virus, health facilities being overwhelmed, patients suffering from other ailments, expectant mothers stranded or delivering in worst circumstances, shortage of and dysfunction of the ambulance system, as well as a shortage or lack of personal protective equipment like gloves and masks. President Museveni in his several addresses to the nation has also rallied investors and well-wishers to donate vehicles to pool a fleet of ambulances that can be used across the 125 districts to transport mothers and other patients.
  • Medical doctors alike threatened to lay down tools over continued torture by security forces during the lockdown over coronavirus. The doctors say they have continued to receive the wrath of security forces. They were listed as essential workers supposed to work during lockdown, but some were struggling to get stickers. Incidents of health worker torture, arrests and battering were recorded. 
  • There have been suggestions for massive testing by sections of the public, but this has been ruled out by both government and public health experts as a very expensive venture.
  • Earlier in April the health ministry had projected that Uganda would have 18,878 positive cases and over 500 people dead by end of April, if stringent measures of lockdown and social distancing were not strictly followed. Similarly, Dr Githinji Gitahi, the CEO of AMREF Health Africa had also indicated that the disease would likely peak in May and June with thousands getting infected. However, this situation seems out of context given that Uganda seems to have gone past those fears (there are currently (May 20) 264 cases of confirmed Covid-19 patients and no deaths have occurred yet). 
  • Besides health, Uganda has suffered several shocks due to COVID-19. Among them are the unlawful beat up of community members by law enforcement agents, mothers dying in labor due to transport lock down, a stop of inflow of new refugees/asylum seekers in a country that currently hosts the largest refugee population in Africa with 1,411,098 refugees and asylum seekers, and a looming lack of food among those living hand-to-mouth that are not working due to COVID-19. Some economic sectors like tourism, hotels, sports, entertainment may be badly hit.  Earlier in April, traders had taken advantage of the situation by increasing prices of essential commodities. However, the government put in strict measures to avoid price racketeering. 
  • The government has put in place several efforts to educate citizens on the COVID-19 risks, precautions and necessary measures by publishing a set of guidelines on mask use, public gatherings and  use of transportation among others.
  • Moreover, there is a present risk regarding the refugee population in Uganda (1.4 million) due to the conditions in which they live that makes following health precautions an impossible task. These groups of refugees are considered to be among the most vulnerable population

Potential actions and demands

  • There is already an outcry that Uganda needs to avoid the danger of buildup of COVID-19 numbers rapidly that may overwhelm an already challenged healthcare system. The argument is that with already critical health care challenges like HIV, TB, Malaria, women who still need to access services to deliver, children who need to be immunized and all the other conditions, if cases of COVID-19 build-up, the healthcare system would struggle to cope. 
  • There have also been demands by opposition politicians for the allocation of funds during this time and to focus attention on critical sectors that support COVID-19 spread. For example, that the 10 billion shillings provided for the member of parliament (MPs) should be put to the support of COVID-19. 
  • Two key propositions have been suggested as priorities including:
      • Quickly supporting and preparing the healthcare system, to the extent possible, to confront the pandemic, include planning, staffing, training, revising pay packages, equipping, ensuring needed supplies, expanding facilities, COVID-19 testing and surveillance, research and development.
      • Supporting the actions to curtail the spread of virus, including programs for getting school children safely home, supporting hygiene measures by providing necessities like soap, water, disinfectants; spreading out food markets and supporting their hygiene; decongesting prisons, removing taxes on rent, communication, mobile money; food and welfare support for vulnerable communities during lockdown (welfare centres should have been established all over the country).
  • Furthermore citizens are calling to attention the abuses of power done by the security officers who have allegedly killed 12 people while enforcing measures to restrict the spread of the virus.
  • Stakeholders in the tourism sector are pressuring the government to open the Entebbe International Airport so they can plan and start working on the plan to receive tourists again
  • In an open dialogue meeting organized by the UN and the Prime Minister’s Office ,which had over 100 representatives from different sectors, a set of recommendations were made to confront the pandemic such as :
      • The reiteration of the importance of moving beyond addressing emergencies to include recovery and building resilience  
      • To leverage digital solutions
      • Improve incomes through disaster risk financing 
      • Build capacities for Disaster Risk Reduction (DRR), especially at local level. 
      • Use Covid-19 to advance disaster agenda to catalyze investments in DRR

Key resources

Contributor(s): Anne Marie van Swinderen and Andrew Magunda – from L-IFT.

The C-19 Global South Observatory is a collaboration between