Tuesday, December 10, 2013

Jerichow: A German movie review

A German soldier back from a tour in Afghanistan after a dishonourable discharge finds himself penniless in a non-descript,poor Northern German town of Jerichow. The movie begins at his newly inherited family home following the death of the main character's mother. Thomas loses the mothers' inheritance(some leafy euros in 50 notes) to a bunch of low-lifes he owes money from a gambling debt. He has to make ends meet as a cucumber harvester at a large commercial farm- a colourless,dead-end job. Then comes a chance meeting with a wealthy Turkish business man (Ali) who has his car, a Range Rover, stuck near a river after a drunken stupor. Because the cops have a trail on him and want to take Ali's driving license,the Turk asks for a favour: can he claim it was the ex-army man who was driving so he can save his driving permit? And so begins a life of temptation and a sure recipe for disaster. The rich Turk has a much younger attractive wife called Laura. It almost love at first sight between Laura and Thomas. Thomas is soon offered a job as the rich Turk's consigliere, quickly winning his trust or does he? Ali has a chain of supermarkets with a very canny business sense. But he has issues with trusting people. He believes all who work for him in his multiple retail businesses are untrustworthy and cheating him. He doesn't even trust Laura and spies on her constantly. You see, Ali and Laura are not an ordinary couple. Ali literally purchased her by buying off her hefty debt. Its a transactional relationship peppered with wife battery and emotional abuse. Ali treats Laura like one of his possessions. Laura longs for something deeper. Thomas and Laura soon fall desperately in love. They seem to fill the void in each others' lives. Laura in an unrequited marriage and Thomas in an empty life. But there is a problem. They are all broke and they are all economically dependent on Ali. Ali soon announces that he has to go away to Turkey to check on his relations and asks Thomas to take charge of his multiple business concerns. Is this an incredible opportunity for Thomas and Laura to sink into their wildest lustful desires or is this a test for both? Rottentomatoes.com usually awards a percentage mark for movies it reviews and I would give this movie a 68% rating. It is certainly worthy of your 90 minutes. The plot and concept of the movie is a brilliant one although it is not as brilliantly executed and more could have been demanded of the leads. There is alot more dramatic potential and opportunity that the director squanders. This is a good movie but it could have been a great movie. It is a little understated for those used to Hollywood-fare. Overall, one of the best German movies I have seen in a long-while.

Wednesday, December 4, 2013

Tobacco control in Africa and the challenge of a colonial political economy

Public health advocates scarcely appreciate how entrenched the tobacco industry is in Africa given its colonial political economy. An analysis of the leading tobacco companies in Africa will reveal a colonial hang over. The leading tobacco company in most of Anglophone Africa is actually British American Tobacco (BAT) and the leading Tobacco companies in Franco phone Africa are actually French. In Kenya,Uganda, South Africa,Zambia and Zimbabwe, for instance, BAT has dominant market leadership. In Burkina Faso, Mali and Senegal, the leading tobacco companies have French-ties. Using economic history lenses we would need to appreciate that the tobacco crop is actually not native to Africa. In Uganda, for instance, it was introduced in the 1920s by the British. The British were majorly interested in a colonial empire in Africa partly because they wanted a base for raw materials for their budgeoning industries and here cash crops like coffee, cotton, etc come to mind. Public health advocates need to appreciate how deeply entrenched the colonial political economy in Africa in many respects is still intact. BAT of course is no longer wholly British-owned, indigenous Ugandans for example can freely buy shares on the stock exchange in Kampala reflecting the hybridization of the colonial economy by marrying it with narrow elite African interests. The Board Chairmen of BAT Uganda have in the past ten years been very carefully selected representing the most foremost indigenous Ugandans even when all they do is really serve as fronts for complex multinational interests. By offering Ugandans shares in BAT Uganda, multinational commercial interests are diversified by co-opting a narrow African middle class thereby spreading the risk of regulatory oversight in African markets. In Uganda, UMEME, the local power company was bought by a British consortium. After getting market intelligence that the Ugandan state was growing weary of its efficiency standards and protracted grambling over a badly negotiated sale, UMEME about two years hastily sold some shares to native Ugandans. Recently, the Ugandan government threatened to reverse its power deal with UMEME which has wisely pre-empted this by hastily selling its shares to Ugandans. Today the Energy Minister announced Government will not go ahead with its threat.

Tuesday, November 26, 2013

Why Uganda is in the throes of an NCDs epidemic: A bullet-point analysis

Uganda already has AIDS, malaria and Tuberculosis to worry about-infectious diseases Another tier of diseases (non communicable diseases) has been added on to the disease. EVOLUTIONARY PHYSIOLOGY AND NUTRITION REGIME CHANGES • Physiological inability of body to adapt from physically-active rural backgrounds to sedentary middle class lifestyles. • Recreational diets typically comprising roast pork and beef • Westernization and change in nutritional regimes (from low to high- cholesterol diets) INCOME AND LIFESTYLES • Urbanization (excessive sedentary use of motorized transport) • Occupation-associated inactivity; hours spent in meetings and air travel. • Epidemiological transition from infectious (e.g. AIDS) to non- communicable diseases( e.g. CVDs) DIAGNOSTIC FACTORS • Late detection, low diagnostic capacity and ignorance of family history risk factor GENDER, SOCIO-CULTURAL AND POLITICAL ECONOMY FACTORS • Males more affected by heart disease due to biology (& African race)and socio-cultural male privileges (disproportionate resource access). • African culture associates being overweight with affluence. (148 words)

Friday, September 13, 2013

Are poor African countries net creditors to rich western countries?

As Africans, we have been made to believe that African states are propped up by loans and foreign money from the west. That right from free HIV treatment to World Bank loans,to government budget support, western credit and philanthropy sustains Africa's 'failed' states. A bold recent book however challenges this widely-held perception by providing stunning economic evidence that African countries are actually net creditors to the rich industrialized world. Put in lay man terms, the book's central argument is that more money leaves Africa to the west than comes into Africa from the west. The book (recommended to me by Pelegrine Sebulime) is entitled 'Africa's odious debts: How foreign loans and capital flight bled a continent'' was authored by Ndikumana and Boyce, Economics professors at the University of Massachusetts at Amherst, the former is actually Burundian. The book is no idle polemic but provides hard economic data most of which has already been published in academic journals since 2001. One of the articles written on this precise argument won an Economics award. Leonce Ndikumana should know. He holds a doctorate in Economics from University of Washington at St Louis and was head of research at African Development Bank from 2008 to 2011.He was also Chief of Macroeconomic analysis at the United Nations Economic Commission for Africa from 2006 to 2008. In an article the authors published in the Journal of Development studies in 2001 titled’ Is Africa a net creditor?', the authors write ''We found that capital flight from 25 low-income African countries over the 1970-96 period amounted to $ 193 billion(and to $ 285 million including imputed interest earnings) comparing to this to the $178 billion in external debt to the same set of countries, we concluded that Africa is a net creditor to the rest of the world: the external assets of these countries exceeded their external debts'. Here is how Ngozi Okonjo-Iweala Nigeria's Finance Minister put it 2005 ''We make annual debt repayments of more than$1.7 billion,three times our education budget and nine times our health budget'' Compounding the outrage is the empirical fact that most of loans borrowed by African countries end up in private pockets while the loans of course, remain publically-held by African states-for generations. The book discusses compelling case studies of Mobutu Sseseko's Zaire and Fernando Marcos' Phillipines. In a memorable story from the Philippines, 2 billion US dollars was borrowed from US Export-Import Bank and a Citibank and American Express consortium to build a nuclear energy plant that never produced even an ounce of electricity yet Philippines went on to pay billions of dollars in loan repayments. The trouble, partly, was that the nuclear plant was built on a site prone to earth quakes! The book highlights the complex behind-the-scene dealings at multilateral lenders such as the IMF which was arm-twisted by the US government to lend to Mobutu's Zaire contrary to its' own assessment. Not altogether strange if you have read similar tales in the frame of'Confessions of an economic hit man'. The notion that the west has taken more out of Africa than the other way round is hardly original. It has been previously harped by economic historians and anti-colonialism African intellectuals. This book, however, is hard empirical proof of this contemporary African reality of a hemorrhaging continent. One mortgaged by its elites in lots of needless borrowing with many in the west on the take as well. ''Aid in reverse: how poor countries develop rich countries''is how one observer sums it up.

Tuesday, September 3, 2013

The reluctant president: Obama and the missed Syrian moment

I have been a loyal Obama supporter from the moment he delivered his ground-breaking speech at John Kerry's nomination at the Democrat's convention in 2004. I predicted on these very pages that Obama would win a second term before he was even sworn in for his first term. But over the years I have been underwhelmed. It's not that he has done nothing striking for Africa. I knew that first and foremost he was a President of USA. I hate to think that even George W Bush's PEPFAR program trumps anything Obama has done thus far for Africa. It is clear as well that Syria's conflict is complex drawing in many regional powers with Russia added in for good measure but surely Obama flanked the Syria chemical-use incident. Any mediocre President would still have ordered surgical strikes in retaliation against the Assad regime for gassing its own people. Not every decision has to have approval of congress surely. The element of suprise is lost and Assad has been given all the time in the world to prepare for a potential strike. Even the Bush-era 'Shock and awe' seems preferable in comparison. Clearly, Obama's reluctance is partly because of the Iraq-Afghanistan hangover and an American public wary of another endless and costly foray of foreign interventions and an economy that is slowly recovering from (partly) its effects but still.. As US president, Obama has the privilege of presidential discretion. He could have easily ordered a surgical strike against Assad without requiring approval of the legislature. Obama gets a daily intelligence briefing that requires his swift action at certain times that requires a decisive President. Now he set an unwelcome precedent for the next US presidents. This was, without doubt, one of Obama's lowest moments as US president-for me at least. May be I am not as unqualified for US president as I thought.

Sunday, August 18, 2013

Why continued access to affordable HIV drugs hangs on a bill in the Ugandan parliament

Today Wednesday 21st August 2013, a bill critical to the lives of half a million Ugandans enrolled on HIV treatment comes up for debate in the plenary of the Ugandan parliament. Not many Ugandans have heard about the Industrial properties bill (2009) but here is why we should pay attention. Uganda’s national HIV prevalence rates have shot up from 6.4% in 2005 to 7.3% in 2012 with a clearly worrying upward trajectory. Uganda continues to register steady increases in annual HIV infection rates since 2010. Annual infection rates have risen from 100,000 in 2010 to 150,000 in 2011 according to statistics from the AIDS Information centre (AIC). Now, here is why the industrial properties bill (2009) can make or break not just the lives of Ugandans currently enrolled on HIV treatment but the Ugandan economy as a whole given that a 2008 UNDP study showed that continued access to HIV treatment offsets the negative economic growth rate of HIV by 5.3%. According to the 2013 Ministerial policy statement signed by Dr Ruhakana Rugunda, the Health Minister, there are 520,000 Ugandans currently enrolled on HIV treatment- and counting. Over 90% of these half a million Ugandans depend on Indian generic antiretroviral drugs (ARVs) for treatment- according to Denis Kibira, a Pharmacist and Medicines Advisor at HEPS-Uganda. The trouble is that the Indian generic ARVs, and yes, even those manufactured by Quality Chemicals at Luzira, are not brand drugs. Put another way, the generics consumed by Ugandan ARV users were not developed by Indian pharmaceutical companies. Indian companies copied the formulas for manufacturing these drugs by companies mostly from Western Europe and North America (without their authority). Almost all these Indian ARVs were originally developed after painstaking research and development by a pharmaceutical giant after investing literally millions of dollars of their own R&D funds to develop these drugs and have taken though rigorous animal and human trials and getting them approved from agencies such as the Food and Drug Administration (FDA) in the US. These pharmaceutical giants are then granted patents or exclusive right of use and distribution of say 30 years under international trade law relating to intellectual property rights. These patents imply that the ARVs are NOT to be copied by another manufacturer, in Uganda’s case, an Indian one. Of course this would not be a problem if Ugandans could afford to buy these drugs from Pfizer or Norvatis. The trouble is that these drugs are often priced at prices tailored to western markets yet a quarter of Ugandans live below the poverty line and Indian generics, which go about a tenth of the price of brand drugs is all they can afford. Even the US’s PEPFAR program in Uganda depends on generic ARVs for 96% of those treated under its numerous implementing partners-according to PEPFAR’s 2012 country operational plan. Because of these patent and international trade law barriers to access to essential medicines, poor countries met in Doha, Qatar in 2001 and made the Doha declaration which provided for poor countries to overcome these patent barriers by domesticating its provisions in their laws allowing poor countries to disregard these pharmaceutical patents on account of public health emergencies such as HIV/AIDS. The grace period for manufacturing generic pharmaceuticals expires on 1st January 2016 unless the Ugandan parliament sits today and calls for amendments to the Industrial properties bill (2009) to include ‘flexibilities’ that allow Uganda to lawfully extend this deadline or suspend international pharmaceutical patents with regard to some specific public health emergencies or import these drugs from India. These ‘flexibilities’ were agreed upon by the World Trade Organization (WTO) in 2005 and all the Ugandan parliament needs to do is include them in the industrial properties bill (2009). Short of this, come 2016, generic HIV drugs will become illegal under Uganda law and western pharmaceutical giants would successfully enforce patents for HIV drugs in Ugandan courts. According to CSOs involved in access to medicines issues in a joint statement issued on Monday 19th August 2013, the current bill does not include these ‘flexibilities’. ’’ Every Ugandan who has ever taken a tablet or a syrup to treat an ailment should pay attention to the Industrial properties bill’’says Primah Kwagala of Center for Health, Human Rights and Development’’

Sunday, August 4, 2013

Ugandan housemaids a most at risk population for HIV infection-Daily Monitor

Ugandan housemaids are said to be an at most risk population for HIV infection according to the Daily Monitor newspaper of 5th August 2013.House maid are typically teenage girls who are ferried from a life of poverty and destitution in rural Uganda to urban middle class homes in Kampala to work as domestic servants engaged to do domestic chores like cooking, cleaning, looking after babies etc. Here is the article in its entirety: ''...The Ministry of Health has included house maids on the list of most at risk population in the spread of HIV/Aids. With a seven per cent prevalence rate, housemaids are feared to get infected and spread the virus at almost the same rate with prostitutes and fish mongers. According to junior Health minister (General Duties) Elioda Tumwesigye, the sexual network arising from housemaids is among the largest while their vulnerability puts the whole network at risk. “A housemaid may have sexual intercourse with the owner of the house, the male child, the home guard, the Shamba boy, the delivery boy and even neighbouring men, sometimes they have no power to dictate the use of condoms especially with their bosses,” Dr Tumwesigye told journalists at the Uganda Media Centre. Due to the nature of their jobs and lack of sensitisation, housemaids are also believed to be reluctant in seeking for medical help as well as finding out their status. The most recent UN Aids report indicates that Uganda is losing the fight against Aids given the increased prevalence rate, a fact the government blames on the reluctance of the population due to the presence of ARVs and low sensitisation on behavioural change as a tool against the virus. “The population has changed its mentality against the fight since they now know they can live with HIV/Aids,” said Dr Jane Aceng, the Director General Health Services.''

Saturday, July 27, 2013

Ugandan activists decry patent barriers to accessing affordable generic HIV drugs

The World Trade Organization (WTO) last month extended the deadline for enforcement of patents and copyrights, mainly held by multinational companies, in the world’s least developed countries (LDCs) by a further eight years which elapse in 2021. The extension did not however include cheaper generic HIV drugs or pharmaceutical products in general whose deadline expires in 2016. Human rights organizations warn that the lives of half a million Ugandans enrolled on HIV treatment will hang in the balance if generic drugs are outlawed based on international trade law or the Trade Related Aspects of Intellectual Property Rights (TRIPS). According to Denis Kibira, medicines advisor for the non-governmental organisation HEPS-Uganda, over 90% of all HIV drugs in Uganda are generics manufactured in India. Generic drugs are identical copies of brand drugs manufactured by originator pharmaceutical companies, most of which are based in Western Europe and the US. HIV treatment was previously a preserve for patients in the west on account of the high prices of antiretroviral drugs (ARVs) and international patents which did not permit manufacture of ARVs at cheaper prices. HIV treatment became a possibility for millions in Sub Saharan Africa principally because of the introduction of generic ARVs in 2001. HIV drugs must be affordable Joshua Wamboga from The AIDS Support Organization, where over 100,000 people are enrolled on HIV treatment, said: "The ability to access cheap medicines on the market will be curtailed and the fight against HIV in Uganda may be lost if expansive trade laws are adopted without improving the incomes of Ugandans." According to the Ugandan Ministry of Health, there are over 500,000 antiretroviral users in the country. PEPFAR, the leading funder of HIV treatment in Uganda, indicated in its 2012 country operational plan that it depends on Indian generic drugs for 96% of those treated under its implementing partners. Generics drugs were a major factor in scaling up access to the over seven million who are currently on treatment in Africa according to a UNAIDS report of May 2013. Medicins San Frontiers reported this month the price of first line and second line antiretrovirals has fallen due to competition among generic drug manufacturers, further making antiretrovirals affordable by poor countries. The much more expensive second-line and third-line drugs, which are prescribed when a patient develops drug resistance to the first-line drugs are however, still patent protected. Putting lives at risk Outlawing generic antiretrovirals would jeopardize the lives of those already on treatment and be a crippling impediment to further scaling up access for those who become eligible for treatment. The demand for antiretrovirals in Uganda is set to increase given the increase in national prevalence of HIV from 6.4% in 2005 to 7.3% in 2012, according the Ugandan health ministry. The new World Health Organization HIV treatment guidelines issued on 30 June, recommend antiretroviral therapy now be initiated earlier before people’s CD4 counts get too low. So the demand for generic HIV pharmaceuticals is set to increase even further based on these recommendations. Professor Brook Baker of the US-based organisation Health GAP, in a joint statement with Uganda’s Centre for Health, Human Rights and Development (CEHURD), calls for least developed countries to start early in their quest for an unconditional extension to the grace period given by the World Trade Organization for manufacture and sale of generic antiretrovirals, which elapses in 2016. Uganda’s pharmaceutical industry Moses Mulumba, director at CEHURD, said: “Uganda has major technological and infrastructural deficiencies for its indigenous pharmaceutical industry to be able to develop its own original antiretrovirals. This would require millions of dollars in investment and highly qualified researchers.” He advised that Uganda could overcome these challenges through technology transfer arrangements with countries such as Brazil, China and India. Quality Chemicals is currently the only Ugandan pharmaceutical company manufacturing generic HIV drugs in a joint venture with Cipla of India.

Friday, June 28, 2013

Beware Ugandan cultural expressions are being ‘stolen’, repackaged and sold to you

It was October 2010. President Yoweri Museveni was locked in a bitter presidential election contest with Dr Kizza Besigye. A decisive blow, an event, an endorsement was needed by either camps to turn the tide. Then came the idea of turning a ,then recent, video skit in which President Museveni ‘rapping’ a traditional Ankole song ‘mpa enkoni’ into a modern hip hop rap track complete with electronic beats and baptized ‘another rap’. It was an instant success. ‘ Do you want another rap’ became viral on you tube. Hundreds wanted to watch a head of state who could rap like Eminem. More importantly for the producers of ‘another rap’, who included respected Producer Richard Kaweesa, ‘You want another rap?’ got traction among the critical Ugandan youth voters who formed the demographic bulk of registered voters. Beyond the electoral contest, ‘another rap’ became a pop culture hit in Uganda, and beyond.The President was advised to copy right the song. Not so fast, said Mwambustya Ndebesa and Dr Deo Katono. The historians maintained that ‘another rap’ could not be copy righted arguing that it was a traditional cultural expression of the banyankole people and could not therefore be claimed as private property by an individual. ‘’ I sang Mpa enkoni before I went to school. It was sang by my father, and grand father before him. It has been here for many generations. President Museveni must have first sang this song before he was probably four. He did not make any intellectual in put into it’ Mwambustya Ndebesa, a political historian at Makerere University, told a meeting of intellectual property rights experts at Africana Hotel on 28th June 2013. The dispute regarding whether ‘Another rap’’ merited copy right protection went as far as the Ugandan courts which held that ‘Another rap’ was a ‘derivative’ work’ –an adaptation taken from existing work. And that is the crux of the debate. What constitutes Ugandan folklore and who owns it? And when does an adaptation from it qualify as copy right?. The Africana hotel workshop which attracted Ugandan intellectual property rights legal experts and performing artists interest groups was organized by Anthony Matovu, a PhD student, with funding from the University of Illinois in the US. Mwambutsya blamed the current debate on turning collectively-held cultural rights into privately-held commodities on ‘marketization’ where ‘’ the rich appropriate the cultural resource of the poor’’. He argued that privatization and individual economic rights are western concepts which is why in Africa, cultural expressions were communally held but the advent of western neo-liberal ideology is endangering African cultural expressions. One of the participants observed that African people are an oral people and as such did not document their cultural expressions as well as western societies, which is why they remained largely in orature form. From 1980’s with Philly Lutaaya’s ‘Tulo tulo kwata omwana’ to the contemporary Nawulira by Navio, Ugandan artists have taken Ugandan cultural expressions and converted them into popular culture saleable commodities. But just how much is their individual in-put and what remains cultural property? According to Jeroline Akubu, Principal Legal Officer at Uganda Law reform Commission, Ugandan folkore or ‘cultural expressions’ are not currently protected by existing intellectual property laws which opens them up to several private copy right claims by individuals claiming that they have added value to the folklore existent in Uganda’s over 60 ethnic groups. Ghana has done better than Uganda on cultural assets by imposing a domestic tax on folklore by visiting foreigners. ‘’ We can make our cultural expressions a brand because we live in a world of markets and brands. There has been a favourable shift in attitude by Ugandans towards folklore which, in the past was seen as inferior’’ said Roger Mugisha, the renown radio personality, who attended the workshop. He reported that some enterprising Chinese are studying the traditional ‘endingidi’ with a view of teasing out a commercial prototype that they can re-package and sell- no doubt to a super market near you. Ndere Troupe’s Steven Rwangyezi said he was uneasy about reported efforts to seek a private patent for Ugandan bark cloth. A representative of the Ministry of Trade, at the workshop, reported that studies are yet to be done to quantify the contribution of Uganda’s cultural assets and industry to GDP. ‘’ We often complain that we have high youth unemployment rates but converting our cultural assets and industry into the market economy can help reduce unemployment. One Ugawood film script can create 100 jobs through actors, script writers, directors etc and a Ugandan CD can create 50 jobs through studio staff, graphic designers and vendors’ said Dick Matovu, General Secretary of Uganda Musician Union. ‘’ Nigeria is the second highest oil producer in Africa but nollywood is the second national revenue source. Cultural industries are overtaking traditional industries in some countries’’ he added. Charles Batambuze, an intellectual property rights expert, reported that government has set up a national creative economy committee under the Office of the Prime Minister and efforts are being made to document and quantify the importance of this industry to Uganda. Expressions of folklore are collective cultural assets and ordinary Ugandans should not be deprived of them. Globalization poses a clear and present danger of commoditization of African cultural expressions in a manner of exclusion. Ugandans as a people should document all the cultural expressions in their diversity and recognize them and protect them by law as Ghana has done. From that baseline, determining works that merit copy right protection, and those that Uganda can package and sell to the world, will be made a lot easier.

Monday, June 17, 2013

Relief in Uganda as LDCs granted TRIPS deadline extension

After intensely heated and acrimonious negotiations, The World Trade Organization (WTO) on 11th June 2013, agreed an eight-year deadline extension on enforcement of trade marks, patents and copy rights which are largely held by western companies and individuals, collectively known as intellectual property rights (IPRs) in the world’s poorest countries. Under a 1995 WTO treaty known as the Trade Related aspects of Intellectual Property Rights (TRIPS), a 2013 ‘transition’ deadline was set for enforcement of intellectual property rights ranging from educational books, pharmaceutical products to high-yield agricultural seeds. Intellectual property law protects the rights of innovators and inventors from copyright infringement. Most patents and copyrights are held by western companies and individuals, including in poor countries where the overwhelming majority of patents and applications are held and filed by foreign entities. The 2013 deadline meant that trademarks, patents and copy rights were to be enforced in poor countries and any breach would be punishable by law especially in countries like Uganda which have recently reformed their laws to recognize intellectual property rights. The latest WTO deadline extension goes as far as July 2021 and provides for a further deadline extension application. In November 2012, Haiti, on behalf of poor countries designated as ‘Least Developed Countries’ (LDCs), formally sought an unlimited extension whereby intellectual property rights enforcement would be suspended for as long as a country was designated as an LDC. The negotiations were long drawn-out and took several months. The Ugandan NGO, Centre for Health, Human Rights and Development (CEHURD), in a joint-statement with Health GAP , applauded the extension as ‘a partial victory’. They argued that the WTO decision will enable ‘’access to more affordable medicines and medical technologies, educational resources, agricultural inputs, and green and climate control technologies.’’ adding that ‘’ The US and Europe had pushed these countries to implement the standards of patent protection, copyrights, trademarks, and other forms of intellectual property in the next few years that today’s rich countries refused to implement while they were focused on development’’. The WTO in informal negotiations was willing to grant a TRIPS deadline extension of 5-7.5 years which LDCs opposed as too short a period with in which to build a viable technological base. "This is unacceptable as the TRIPS Agreement states that upon a duly motivated request, the TRIPS council shall grant an extension. LDCs, to which Uganda is categorized, are justified in seeking an unlimited extension for so long as they are so classified because the suggested 5-7years will not give us adequate time to overcome capacity constraints to develop a viable and competitive technological base," says Moses Mulumba, a director at the Center for Health, Human Rights and Development (CEHURD). The deadline for enforcement of the even more critical pharmaceutical patents is not until 2016 . It is understood that LDCs are planning a similar negotiations, in this regard, starting next year. ‘’In addition, LDCs and their allies will have to begin early to win an even better extension of the pharmaceutical product transition period which will expire in 2016. Here, too, the LDCs should insist on an unconditional extension (like the one they won in 2002) and it should last as long as a WTO member is an LDC. The fight against HIV, tuberculosis and malaria, and the simultaneous fights against neglected tropical diseases and non-communicable diseases, depend on affordable access to generic medicines of assured quality’’ said Prof Brook Baker of Health GAP. “As a region with overwhelming capacity constraints in local pharmaceutical production and 80% of the population depending on generic drugs, this offer to extend the transition time illuminates how much more effort civil society needs to put in asking for an indefinite extension of pharmaceutical product patents come 2016. It is very evident that civil society in the third world has a voice in the global agenda on trade in intellectual property rights,” said Moses Mulumba, Executive Director of CEHURD. “We are glad to see that our governments stood up to pressure, and fought for the right to pro-development policies,” added Kwagala, Policy Advocacy manager for CEHURD. “An extension of 8 years with a possibility of a further extension come 2021 is important. This will position our region to benefit from flexible intellectual property policies to be able to build a viable technology base. It is also opportune timing to focus on building the capacity of our local industries.” She said.

Wednesday, June 12, 2013

The economic cost of HIV/AIDS in Uganda

There is hardly a Ugandan who has not been touched by AIDS. It may have been a parent, a brother, a cousin, a friend, an old boy, a neighbour or the main bread winner in a family. We have all had our share of the grief and pain that AIDS visits upon us. The emotional strain and social face of HIV and AIDS is visible and tangible. Seeing your loved one painfully and helplessly waste away before your very eyes, feeling the pain and anguish of looking after the ill and subsequently attending that funeral with the mixed emotions of loss and a guilty relief-it is all over. For the patient and for you; the long suffering caregiver. AIDS is no longer only a human loss but a substantially economic one, which poses a serious threat to economic growth, development prospects and poverty alleviation in Uganda. In Uganda,the HIV prevalence rate has risen from 6.4% in 2005 to 7.3% in 2012, with even higher rates shown in some longitudinal studies in Masaka and Rakai, the direct and indirect economic costs of the epidemic are set to become greatly compounded. According to UNDP, Uganda has 130,000 new HIV infections every year. This equates to around 10,000 people being newly infected with HIV every month, which is a worrying trend. Surprisingly, there have not been many recent empirical studies on the economic impact of the epidemic in Uganda as compared to say, South Africa, where several studies and models have been developed. The reasons for this differ not least of which is that macro-economic models for estimating the economic toll of the epidemic vary, and there has been debate on their accuracy of findings (how do you isolate HIV from other factors?) but the economic impact of HIV is undeniable. A Ministry of Finance and Uganda AIDS Commission study (Assessing the Macro Economic impact of HIV/AIDS in Uganda) funded by UNDP shows that Uganda’s economic growth rate will slow by 1.2% due to the impact of HIV on Uganda’s labour force and the costs households incur in treating their infected members. The report, released in November 2008, estimates that by 2025 Uganda’s economy will be reduced by up to 39% on account of the epidemic. The same study shows that HIV and AIDS raise the overall poverty rate in Uganda by 1.4% every year. Times this by ten years and the cumulative effect becomes mind boggling. ‘’When a poor family is affected by HIV/AIDS, it increases poverty by 2% on individual homes across the country,” says Dr Keith Jeffries who led the study. Other studies now show that the HIV pandemic has resulted in socio economic reversals that cut off 4% on national economic growth rates in Sub Saharan African countries. The World Bank shows that in Uganda the economic impact of HIV-related deaths is stronger than other types of deaths such as malaria since households spend their savings on prolonged treatment and funerals. From an individual perspective, the economic toll is evident. The costs of prolonged hospitalizations, buying drugs, depleting personal savings for treatment costs, loss of productive hours while caring for the sick and those notoriously expensive Ugandan funerals push individuals and households down the poverty ladder. In Botswana, according to a 2006 UNAIDS study it was estimated that, on average, every income earner was likely to acquire one additional dependent over the next five years due to the AIDS epidemic. “We will see a ripple effect from the individual to firstly, households; secondly, businesses and communities, and lastly the welfare system,” said George Gavin, research fellow at the Health Economics and AIDS Research Division of the University of KwaZulu-Natal in South Africa. A 2002 study estimates that households suffer a decline in income of between 48 percent and 78 percent when a member of their household is lost to HIV, excluding the costs of funerals. Household expenditure on funerals can be as much as seven times their total monthly household incomes as reported by some families in some studies in South Africa. The loss of young adults due to prolonged illness and of course death in the most productive age group of 25-54 reduces the country’s labour supply and productivity. In the Uganda Railways Corporation, the loss in productivity per employee on account of AIDS is $300 according to a recent study. Ugandan businesses’ competitiveness and profitability has been impacted by HIV due to employee absenteeism on account of illness, expenditures on employee medical care, staff funeral expenses and attendance and training costs to replace departed workers. In Ethiopia, a World Bank Study on 25 rural households found the average cost of treatment, funeral and mourning expenses totaled several times the average household incomes. In a Henry Kaiser Foundation study conducted in South Africa in 2002, poor households with members living with HIV and AIDS were reducing spending on necessities. Households were likely to cut spending on clothing by 21% and on electricity by 16%. Even expenditure on food was reduced among 6% of the households affected by HIV with nearly a half of all households reporting not having enough to eat at some point. Neither is agriculture spared by HIV. A study by the Zimbabwe Farmers’ Union revealed that the AIDS-related death of a breadwinner led to a reduction in Maize production in the small holder farming sector by as much as 61%. HIV and AIDS has diminished the available agricultural production workforce in Southern African by between 14-20%, compromising food security at household and national levels. Ironically, those on antiretroviral therapy need lots of food due to the toxic nature of antiretroviral drugs. The education sector does not remain unscathed. A reduction in enrolment is one of the effects of the epidemic as pupils stay at home to look after sick parents and pupils drop out due to sick parents’ inability to raise fees. There has also been a reported direct loss of teachers to the epidemic. In Swaziland, a 2002 UNAIDS report shows that school enrolment dropped by 25-30% on account of AIDS 2000. Although antiretroviral therapy (ART) has been shown to reduce the economic impact of HIV, prevention remains the greatest hope of responding to the pandemic as treatment efforts are hopelessly outpaced by the increasing prevalence rates. A 2011 UNAIDS report estimates that for every patient put on antiretroviral therapy, two are newly infected in their place. Source: Key Correspondents » Login to post comments Pri

Tuesday, May 28, 2013

Uganda tobacco industry shifts to indirect advertising-study

Every year on May 31st, the world stops to reflect on the millions of lives lost to tobacco use around the world and the one billion set to lose their lives to tobacco use this century unless current trends are reversed. Uganda already has AIDS and malaria to worry about and yet a perfectly preventable epidemic of tobacco-use associated diseases is brewing. Tobacco use is the most preventable cause of death globally and is currently responsible for killing one in 10 adults worldwide. Globally, tobacco use kills more people every year than AIDS, malaria and Tuberculosis combined. This year, the World Health Organization (WHO) has selected theme of the ban on tobacco advertising, promotion and sponsorship. Scientific studies unequivocally show that a comprehensive ban on tobacco advertising has been followed by a reduction in cigarette consumption and that children and young people are more vulnerable to deceptive tobacco advertising. On 24th June 2007, Uganda became a signatory to the first global public health treaty in history known as the Framework Convention on Tobacco Control (FCTC) part of which commits countries to institute a comprehensive ban on tobacco advertising, promotion and sponsorship (TAPS) under article 13. Last year between June and August, I was principal investigator in a survey to investigate Uganda’s compliance with the ban on tobacco advertising, sponsorship and promotions made possible by a grant from the Geneva-based Framework Convention Alliance (FCA). Our research team scoured four key streets in each of the survey towns of Kampala, Gulu and Mbarara ,to reflect three strategic parts of Uganda, to collect data on Uganda’s compliance on the ban on tobacco advertising, promotion and sponsorship. As we commemorate World No Tobacco Day, it is an opportune moment to disseminate the findings of this study. First the good news: Our research team did not come across any billboard advertising tobacco in the streets of Kampala, Gulu and Mbarara we visited which suggests that direct tobacco advertising has reduced considerably. And now, the not so good news: The tobacco industry in Uganda has changed strategy from direct to indirect advertising in response to advertising restrictions. It circumvents the ban on advertising through innovative indirect forms of advertising such as ‘corporate social responsibility schemes’, product launches and promotions, branding and more recently, cigarette price increases in the print media. Violations at retail outlets are widespread in Uganda and considerable pictorial evidence was compiled for this report in the three towns visited. Point of Sale violations were abundant at super markets, kiosks and stalls, bars, gas stations .The violations are in form of posters, umbrella shades, branded display cases and branded tobacco company vehicles. Ugandan youth have been especially targeted by the industry as the tobacco posters we came across were placed in places favored by youth such as night clubs. Tobacco promotional events happen in youth hang outs. A 2002 Global Youth Survey revealed that almost 60% of Ugandan youth had seen pro-cigarette ads in newspapers and magazines in the past 30 days.. The industry especially targets youth because they are impressionable and therefore more susceptible to acting on tobacco messages, an irresistible lure of recruiting life-long clients to replace half of their clientele who eventually die from tobacco use. Additionally, countries like Uganda have very young populations compared to say Europe with the majority under the age of 30 and therefore a potentially lucrative market. In low and middle income countries, a third of young people own an object with a cigarette logo-according to the International Union against Tuberculosis and Lung disease. Unsurprisingly, the Tobacco Atlas (2012) lists Uganda among countries with a ‘complete absence of the ban on tobacco advertising’. The WHO 2009 report card on Uganda indicates that is no national ban on tobacco advertising, With the tobacco control bill (2012) coming before parliament soon, Uganda needs to follow in the footsteps of Kenya which instituted a ban in 2007, South Africa in 1999 and Ghana in 2012, to legislate for a comprehensive ban on tobacco advertising, promotion and sponsorship in all its forms, both direct and indirect.

Friday, May 24, 2013

Thousands of Ugandan lives at stake after generic AIDS drugs deadline extension snub

The lives of thousands of Ugandans enrolled on HIV treatment hangs in the balance if an application by poor countries to extend the deadline for manufacture of generic AIDS drugs indefinitely, is rejected by the World Trade Organization (WTO), in on-going negotiations under a treaty known as Trade Related Aspects of Intellectual Property (TRIPS) . Over 90% of HIV drugs in Uganda are generic drugs manufactured mostly in India, according to Denis Kibira, a pharmacist and Medicines Advisor at HEPS-Uganda. Generic drugs are identical copies of drugs manufactured by brand names. Quality Chemicals, a Ugandan pharmaceutical company also manufactures generic drugs. Generic drugs which go for only about a tenth of the cost of brand drugs, were a major enabling factor for the acceleration in access to HIV treatment to the over six million currently on treatment. More than 1.6 million Ugandans live with HIV with an estimated 300,000 currently enrolled on antiretroviral treatment in Uganda. “The ability to access cheap medicines on the market will be curtailed and the fight against HIV/AIDS in Uganda may be lost if expansive trade laws are adopted without improving the incomes of Ugandans.” said Joshua Wamboga from TASO The initial deadline for the manufacture of generic HIV drugs was set to end in 2016 but an application by Haiti in November last year ,on behalf of all poor countries, to extend it indefinitely, has met with stiff opposition at the World Trade Organization which is dominated by rich industrialized countries where most patents for HIV drugs are held by large western multilateral giants such as Norvatis and Pfizer. The US,Europe and other developed country groups are reportedly behind the move to oppose the indefinite extension. Sources with in The World Trade Organization insists it would only be receptive to an extension of the ban on generic drugs for 5-7 years which poor countries are opposed to arguing that they can not build local pharmaceutical capacity for manufacturing original drugs with in that period. “This is unacceptable as the TRIPS Agreement states that upon a duly motivated request, the TRIPS council shall grant an extension. LDCs to which Uganda is categorized are justified in seeking an unlimited extension for so long as they are so classified because the suggested 5-7 years will not give us adequate time to overcome capacity constraints to develop a viable and competitive technological base.” States Mulumba Moses, Director at the Center for Health, Human Rights and Development (CEHURD). Civil society organizations in Uganda working in the area of intellectual property rights and access to medicines argue that the WTO is beholden to western interests. They have issued a letter to the WTO Council chair and Developed country Missions in Uganda to express their disapproval of the manner in which negotiations for the request to extend the time with in which Least Developed Countries (LDCs) can enforce Trade Related Aspects of Intellectual Property (TRIPS) is being handled. ‘’It is infuriating to note that over the past few months, (WTO) has been chairing informal meetings between developed countries and least developed countries where LDCs have been pressed to agree to a shorter term of 5 - 7.5 years’’ says Primah Kwagala a lawyer with CEHURD. About a quarter of the Ugandan population lives under the poverty line, according to the Uganda bureau of Statistics, and the majority can not afford to buy brand drugs manufactured by western pharmaceutical companies to treat AIDS, malaria and Tuberculosis-the three most important diseases in the developing world. With over 90% of Ugandans dependent on Indian generic drugs, outlawing these drugs would jeopardize millions of lives. An extension of 5-7 years is not a long enough period to nurture the local pharmaceutical industry and for companies such as Quality Chemicals to develop original drugs and meet the local demand for medicines in Uganda. Millions of lives depend on the decision to extend this deadline and the WTO should exercise restraint by balancing the interests of western pharmaceutical giants with the public health and development needs of poor countries. In a land mark Kenyan court ruling last year, Justice Mumbi Ngugi ruled that intellectual property rights do not over ride the right to life and health.

Saturday, May 11, 2013

Why tobacco companies target your teenage child and why an advertising ban is an imperative for Uganda

When I was growing up as a child in the 1980s and the 1990s, the back pages of TIME and Newsweek magazines were almost always adorned with a surreal image of a trim, middle-aged white man. He was often riding on horse back with a cowboy hat as he puffed away on a cigarette, often in rugged terrain. He was known as the ‘Marlboro man’. We all wanted to be like the Marlboro man. He was cool, macho and assured. I remember plastering some of my adolescent walls with the pictures of the cool ‘Marlboro man’. It was only much later that I realized that the ‘Marlboro man’ was actually a deceptive tobacco advert aimed at getting me to buy cigarettes- an easy prey to ‘Big tobacco’s sophisticated advertising machine. But the adverts worked. They made smoking appear cool and alluring to an impressionable teenager like me at the time. And that’s the trouble with tobacco advertising, it is an ‘everyone is invited’ sport. Teenagers and young smokers are however, by far, the most sought after demographic. Tobacco advertising is about making money. Before the ‘Marlboro man’ was conceived in the US in 1955, tobacco sales were $ 5 million. In 1957, when the ‘Marlboro man’ was introduced, tobacco sales were up $ 20 million. Imagine you were launching a new soda or beer product in which and you had invested millions. Advertising and promotions are vehicles you can’t ignore. The trouble is that tobacco products are not like any other commercial product. ‘’When used exactly as intended by the manufacturer, tobacco products kill half of all their users’’ says Dr Sheila Ndyanabangi, the tobacco control focal person in the Ministry of Health. Ironically, Wayne McLaren who portrayed ‘the Marlboro man’ in print and television did eventually succumb to lung cancer in real life, on 22nd July 1992 at the age of 51. The World commemorates World No Tobacco day this month and WHO has selected this year’s theme as the ban on tobacco advertising, promotion and sponsorship. Tobacco advertising has been defined as ‘any commercial effort to promote tobacco consumption, including the display of trade marks, brand names and manufacturer logos, marketing of tobacco products and other methods’. On 24th June 2007, Uganda signed a global agenda to, among other things, institute a comprehensive ban on tobacco advertising under a treaty called the Framework Convention Alliance (FCTC) which has force of international law in 186 countries, including Uganda. ’’In the last few months we have seen unprecedented tobacco industry advertising in Uganda. It would seem this advertising is regulation-free. Companies have announced cigarette price increase in glossy full page adverts’’ says John Amanya of Uganda National Tobacco Control Association (UNTCA) ‘The tobacco industry in Uganda continues to advertise, promote and sponsor activities aimed at increasing demand for tobacco products in contravention of the ministerial directive of 1995 with no known regulatory regime to bring them to account. There have been some gains registered as tobacco advertising is less explicit than it was in years past, for instance, there are virtually no billboards advertising tobacco products. Point of sale (POS) violations do however stand out prominently’ reads the Tobacco Control Shadow report compiled by UNTCA which will be launched on 31st May 2013. The report was compiled from field research conducted in Kampala, Mbarara and Gulu to represent strategic regions of Uganda between June and August 2012. The shadow report also reveals that tobacco advertising ban violations are more rife among non-mainstream tobacco companies. The violations become more pronounced in the outskirts of towns. Tobacco advertising is especially targeted towards young people because of the opportunity of recruiting life-long clients enticed through ads that associate smoking with glamour and aroused curiosity in experimenting with things new. Unsurprisingly, scientific evidence shows that children and young people are more receptive to tobacco advertising than adults and that adolescents exposed to advertising are more likely to smoke which is why the most sought after demographic is teens and young smokers. Action on Smoking and Health’s website reveals that studies commissioned by the UK government show that ‘The balance of evidence supports the conclusion that advertising does have a positive impact on consumption” (i.e. it increases consumption). The same review also found that in countries that had banned tobacco advertising the ban “was followed by a fall in smoking on a scale which cannot reasonably be attributed to other factors’. The tobacco industry continues to find innovative ways of side-stepping the restrictions on advertising through non-traditional avenues including’ brand-stretching’ on such items as matches, lighters and key holders in the shape of cigarettes or the use of brand logos without reflecting a company name. ’’Tobacco companies in Uganda circumvent the ban on advertising through setting up events for product launches for new cigarette brands or open and blatant promotional events at recreational places such as night clubs specifically targeting teenagers and adolescents. We have also observed that tobacco companies have become increasingly reliant on displays at the point of sale to draw attention to their products and stimulate sales.’’ says John Amanya of UNTCA. Although tobacco advertising was banned in Kenya in 2007, in South Africa in 1999, the 2012 Tobacco Atlas lists Uganda among countries with a ‘complete absence of a ban on tobacco advertising’. The Uganda tobacco control bill (2012) proposes to ban tobacco companies from conducting free product giveaways, undertaking brand-stretching marketing to other products, or sponsoring events or individuals: all methods by which the tobacco industry seeks to attract new smokers. Point-of-sale displays will also be banned, which will further limit the potential for tobacco advertising. ‘’This is really about an industry that survives, and profits, from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year, an immeasurable amount of human suffering and economic loss, and a profound burden on our national health care system’ said Judge Gladys Kessler in a US court ruling in August 2006.

Saturday, April 13, 2013

Amanda Peet: What happened?

I first noticed Amanda Peet in 'Changing Lanes'. Her brief restaurant scene with Ben Affleck-after disclosing that she long knew about the Ben Affleck character's infidelities was touted as Oscar-worthy. And I agreed. I still recall the screen play or.. some of it ''... at my father's level of the game. I could have married a professor of middle english if he had tenure at Princeton. But I married you. A wallstreet lawyer...'' That alone would have made history for the shortest skit to be judged as worthy of an Oscar. I immediately liked Amanda Peet and thought she was headed for critically-acclaimed success. She was a promising actress. Then last week, I went to Cineplex-Oasis Mall Kampala after a long-day to catch some escape to catch 'Identity Thief'. It turns out, Amanda Peet was playing house wife in some nondescript role. And I began to ask myself, what happened to Amanda Peet. The Amanda Peet of 'Changing Lanes'? The one who chewed up a scene in a short skit tipped for an unprecedented Oscar? I began to notice it may not go too well for her, in career terms, when the movie she did with Jack Nicholson followed. It turns out career choices are every bit as important as grinding out a truly fine performance. Now I am not writing this to belittle Amanda Peet. In fact, she had me at hullo in 'Changing Lanes'. She is clearly made for some truly authentically deep stuff and she can still redeem her career. I am not naive about studio politics and all the intricacies of who is cast in which role to satisfy which demographic and the like. Even in this complex, muddled, 'man eat man' world, Amanda Peet can still curve out a role worth of her exceptional talents.

Why heart diseases and cancers are the new AIDS for the Ugandan middle class.

You wake up in the morning to a full English breakfast-or something akin to it. An early morning pot of milk tea ,a pair of beef sausages,fried eggs,white bread toast with butter and passion fruit juice with a generous taking of white sugar. You then walk the two metres to the garage and switch on the ignition key to your saloon car and connect to the pollution-infested streets brought on by a grid-lock jam- your ritual one-hour jam from Ntinda to your sixth floor office at Crested Towers. You then sit at your desk for three hours and slave away at a your desktop computer. Then it is break time. You hop over to the office canteen and help yourslef to two tea cups of 'African tea' with two chappatis and a pair of beef samosas. You walk back to your desk and type away at that report that your boss needs for the 3pm staff meeting. Two and a half hours later it is lunch time. Dennis from Accounts comes over, ''There is this great place in town with absolutely the best buffet in town'. Thirty minutes later you, Dennis and Pamela from IT are driving in your saloon to Dennis's 'best buffet' place in Kampala. The buffet is everything it was billed to be. A serving of tasty beef stew, fried chicken, white rice, fried fillet and some matooke. Then there is the best part.Chocolate iced cakes. Hmm yummy. The lunch hour is soon over. You pile into your Premio and drive back to the office. You sit at your computer and finish the report. At 3pm it is meeting time. You walk the three yards to your Boss's office for the staff meeting. A text arrives mid way 'Pork in Najjera at 7pm. My treat'. You drink with your buddies till eleven pm as you dread drive back home. Okay, you get the point. Sedentary life styles and foods high in saturated fat. Sedentary activities have been defined as sitting, reading,watching television and computer use for much of the day without vigorous physical activity. Uganda is in the throes of a non-communicable diseases epidemic of cancers and diseases of the heart and blood vessels. Many middle-class Ugandans have adopted western lifestyle and comforts but this has come with a heavy, at times fatal price. The cases of high blood pressure, type 2 diabetes and kidney disease have dramatically shot up according to statistics from Mulago Hospital. Diseases of the heart and blood vessels (cardio-vascular diseases) are often refered to as 'silent killers' because often there are no symptoms or warning signs and these only come pronounced when it is already late. According to Dr Omagino, these diseases are often detected at routine tests if one bothers to do regular medical check ups. Many Ugandans pay more faithful attention to the regular service of their cars than their own health. The number of Ugandan elite succumbing to non-communicable diseases in their 50s and 60s is staggering. More than three cabinet ministers have died recently from 'lifestyle' diseases pointing to a national crisis.

Monday, April 1, 2013

Political stallement amidst Kenyatta poll and court wins

I was in Busia, Kenya about two weeks to attend an in-law's burial. The mass poverty and dejection in this part of Kenya rivaled the wretched of the earth I have seen in Uganda's most desperate parts. No wonder these Kenyans have consistently voted against the ethnic alliances of the day which have most often than not had the Kikuyu-backed coalition win the day. The idea that the Kikuyu (and another large ethnic group will always win national elections is one that doesn't bode well for Kenya. Parts of Kenya will always feel marginalized and the violence we witnessed in 2007 will always be a possibility because of the simmering ethnic tensions that are almost always benign but alive nonetheless. Ironically electoral democracy may not solve's Kenya's political questions because the Kikuyu will always win as long as they ally with another major ethnic group. Governing coalitions are what Kenyans need. Coalitions that are ethnically broad based not winner takes all electoral contests. The fact that Uhuru Kenyatta and Ruto will always win votes because they are assured of a numeric advantage is a defeat of the spirit of electoral democracy.

Friday, March 29, 2013

Chinua Achebe and the passing of a generation of Africa's literary icons

It has been a tragic year for African literature thus far. First it was Francis Imbuga. The Kenyan dramatist of the ‘Betrayal in the City’ fame succumbed to a stroke in Nairobi recently. Francis Imbuga’s Betrayal in the City is a 1976 satire about disillusionment with post-independence Africa. It is a tale of corruption, mal administration, political thuggery, mass poverty and social exclusion told through a fictional account of a country called Kafira,a set play for my O’ level literature in English. Then last week, Chinua Achebe, that behemoth of the imoko tree fell to a thundering thump felt around the world. Chinua Achebe’s No longer at ease and Arrow of God were set novels for my literature in English classes- the latter, at A’ level. In many ways their passing marks a generational transition of post-independence ‘African writers of English expression’. As many of the ‘grand fathers of African literature’ age and many pass on, I feel a responsibility to applaud African writers who reclaimed the telling of the African discourse. They restored our faith in the ability of the African people to tell their own story, a discourse hijacked from them by aliens with imperial ambitions. They told a story of Africa by Africans, for Africans- and non-Africans alike. ‘The writer is often faced with two choices: turn away from the reality of Africa’s intimidating complexity, or conquer the mystery of Africa by recognizing the humanity of African people’ wrote Chinua Achebe in a foreword for Richard Bowden’s Africa: Altered States, ordinary Miracles. In nursery school we recited ‘Pussy, pussy cat where have you been’, sang ‘Jack and Jill’, ‘ba ba black sheep’ and laughed at ‘humpty dumpty. As a child growing up, my father brought home countless abridged works of English literature. Works that included the illustrious names of Charles Dickens, George Orwell, William Shakespeare, Thomas Hardy and Jane Austen. Later on at Namilyango Junior Boys’ School, Robert Stevenson’s Treasure Island was required reading by the late Mr. Mayanja, my primary four English class teacher. For a while I thought that English was only a white man’s language and so was imagination and thought. That white men were the ‘owner of words’ to use an Achebe expression. We saw the world from English lenses even when we were black Africans resident on this native of continents. No wonder many children in our primary schools feel strangers in their own skins. Then at secondary school we were introduced to Chinua Achebe’s No longer at ease, Wole Soyinka’s The trials of Brother Jero and Okot P’ Bitek’s Song of Lawino and Song of Ocol . Suddenly, literature in English was no longer the preserve of the white man. Alas, Africans could be writers too! We read African stories with African protagonists, African names, African idioms and proverbs and English written with an African accent. African culture was no longer a dirty word. The African existence was told with understanding and empathy. It was a process of re-africanization after years of de-Africanization. And credit here goes to Ugandan education curriculum authorities of the time. They helped restore our self esteem as a people and re-kindled a new belief in the ability of the ‘native tribes’. Works like Chinua Achebe’ Arrow of God, beyond being works of literature, have a critical anthropological value. For some of the richest collection of African proverbs and idioms you need not look elsewhere. Chinua Achebe later recounted that these he owed mostly from his own grand mother. It is a shame that the African literary scene is not as vibrant as it once was in the 1960s and that the Chinua Achebes, the Wole Soyinkas, the Ngugi Wa Thiongos, the David Rubadiris, have not found many worthy successors although a few names such as Chimamanda Ngozi Adichie seem to suggest it is not all a hopeless cause. It is an even worse shame that the post-independence disillusionment and hopelessness that post-independence African writers wrote about has not abated. Have we turned the corner after the ‘wrong turn’ that most of Africa took in the 1960s? But that’s material for the next breed of African literary greats.

Thursday, February 7, 2013

The price of sex in Uganda: unsafe abortion deaths and life-long scarred lives

More than a half of all pregnancies in Uganda are un-intended and nearly a third of them end in abortion, according to survey results unveiled by Dr Kiggundu Charles, a consultant Gynecologist at Mulago Hospital.

‘’Probably half of  all of you seated in front of me today were not intended by your parents’’ Dr Kiggundu told a fully- packed Palm conference room at Kabira Country Club on the outskirts of Kampala which had  gathered to hear the highly anticipated results of the study

The study results released by the US-based, Guttmacher Institute and the Center of Health, Human Rights and Development, also reveal that Ugandan women on average wished they had at least two children less, a phenomenon also called ‘excess fertility’.

On average, each woman in Uganda gives birth to 6.7 children which is high even by Sub-Saharan African standards. The study results which were released are based on analysis of Uganda’s 2011 Demographic and Health Survey(UDHS).

At the centre of the millions of un-intended pregnancies in Uganda is  essentially non-use of contraception.

Only an estimated 25% of women in Uganda have access to modern contraception methods pointing to a staggering lack of access to modern and safe contraception.

One in three married women in Uganda had an unmet need for contraception according to the survey results.

‘‘It is also a question of having less options of contraception’’ added Dr Frederick Mugisha, a health economist who maintained that Ugandan women do not have many choices when it comes to contraception.

Clearly, investments targeted at increasing access to family planning and contraception for women of reproductive age in Uganda would save the country phenomenal sums of monies spent on treating post abortion complications and having fewer mouths to feed, educate and would be kinder to the environment.

If all Ugandan women had met their wish of having two children less than they currently have the population of Uganda would have been undoubtedly impacted with gains in per capita income and a better quality of life achieved for millions of Ugandans. Indeed

It emerged at the meeting that myths and misconceptions about modern contraception methods as causing cancer and fibroids is widespread and is a barrier to contraception utilization by Ugandan women.

‘’The traditional medicine men have hijacked contraception education. There are several programs on local radio and television stations that are misinforming many women on safe contraception in preference for crude, riskier methods’;

Dr Zainab Akol, of the Ministry of Health regretted that the medical profession in
Uganda has ceded the ground for offering scientific and evidence-based contraception information to misinformed ‘medicine men’ on whose inaccurate advice many rural and uneducated women depend for decisions on birth control and family planning.

 ‘’Unsafe abortion and contraception is a human rights, public health, legal and moral issue in Uganda  that must be addressed’’ emphasized Moses Mulumba, head of the Centre for Health, Human Rights and Development who revealed that 26% of all maternal deaths  are attributed to unsafe abortion.

Prof Ben Twinomugisha,Dean of the School of Law at Makerere University emphasized that human beings have a right to enjoy sex and then when debating issues surrounding abortion ‘the woman should be at the centre’ of the debate.

Studies done by the Guttmacher institute show that there is a co-relation between restrictive laws on birth control and increased abortion. Countries, especially in Europe, which have a liberal stance on birth control have fewer deaths from unsafe abortions and spend less on post abortion complications.

Dr Mugisha’s results show that Uganda spends about 4.7% of the national health budget on post abortion complications money which could be used to treat more deserving natural conditions.

 Annociata  Kampaire, head of Alliance for integrated Development and Empowerment called for the legalization of abortion in Uganda which according to Article 22 of the Uganda constituion is illegal except ‘under conditions’ provided by law.

Uganda is a conservative country and Prof Ben Twinomugisha reminded those present that the religious and conservative lobby defeated attempts to legalize abortion in the Kenyan constitution of 2010.

He called for a  human rights-based approach to the debate of  contraception and abortion in Uganda by respecting both sides of the spectrum- a woman’s right of  access to safe abortion and a right of a woman to continue to full term with an un-intended pregnancy on religious and moral grounds.
‘’unintended pregnancy is the root cause of most abortions-and the injuries and deaths that often follow-providing better family planning services would dramatically improve maternal health in Uganda’’ said Moses Mulumba.

Wednesday, January 30, 2013

Madam Speaker, pass the Uganda Tobacco Control bill 2012

On  4th February 2013, the Ugandan parliament will reconvene from an eventful recess in which a head-on collision between two competing arms of government was averted through  the choice, by one arm, of ‘ a path of least resistance’.

More earnestly, today is an opportune moment for our August house to reflect on the task before them especially of dispensing with a long queue of backlog bills, about 23 of them inherited from the 8th parliament alone.

These include; the controversial anti-homosexuality bill, the anti-counterfeit bill, Plant Varieties Bill and the critically important Industrial properties bill which could help legalize generic HIV drugs on which millions survive.

But first, the Tobacco control bill 2012.

Since the bill was first introduced to parliament, 13,500 Ugandans have died from tobacco-use diseases-according to credible statistics by the Center for Tobacco Control in Africa (CTCA).

The Ugandan tobacco industry continues to engage in unprecedented open print media advertising in blatant contravention of a 1995 Uganda government directive banning tobacco advertising, promotion and sponsorship with no regulatory regime to bring the industry to account.

Children as young as six can buy, unfettered, a stick of cigarette at kiosks and stalls across the country.

Cigarette sales in Uganda have been rising consistently for the past three years. BAT (Uganda) in its published report in 2011 announced a 29% increase in cigarette sales. Little wonder then that western tobacco giants see unregulated Africa as the lucrative alternative to dwindling profits in  heavily regulated western markets.

Smoking among middle-class young females in Uganda is visibly on the increase with many’ sophisticated’ young Ugandan women tragic victims of the industry’s peddled myth of ‘smoking is cool’.

Smoking of ‘shisha’ has become a craze in up market bars in Kampala and the growing exotic community, with smokers deluding themselves that it is harmless to them and those around them.

Tobacco farmers in Arua, Kanungu and Masindi continue to live a life of extreme poverty and bondage by the tobacco industry which enslaves them with loans for agricultural inputs such as fertilizers while paying them a paltry sum for their hard-labour produce.

In the Tobacco growing areas in Kanungu district which I personally witnessed, widespread use of fertilizers for the tobacco crop has literally poisoned the waters for people, animals and crops alike.

Any concerned Ugandan can do a random sample of ten bars in Kampala and light up (even when ‘no smoking’ signs are erected) and you can be sure no one will stop you. The truth is that smoking in public places in Uganda is banned by law (since 2004), although not a soul has been charged in court for this widespread offence.

I am a perennial visitor to the Uganda Heart Institute at Mulago and anyone can see that an unprepared Uganda is already in the throes of an epidemic of diseases of the heart and blood-vessels and a study we did last year confirmed that a significant percentage of those attending the institute have a history of smoking, our lifestyles aside.

The lung cancer case load at Uganda Cancer Institute is swelling. A study done by Fredrick Musoke of Makerere University shows that 75% of oral cancer patients at Mulago Hospital have a history of tobacco-use and that it takes as little as three years to contract oral cancer.

The tobacco control bill 2012 proposes a committee with statutory powers and oversight function on tobacco control in the country with sufficient regulatory flexibility to respond to changes in the industry. It prohibits tobacco advertising, promotion and sponsorship; it protects individuals from exposure to second hand smoke; provides for price and tax measures for tobacco control; prohibits sale to and by minors; calls for alternative livelihood crops for tobacco farmers.

The Ugandan tobacco industry has sponsored a sustained a media campaign against the bill through tobacco ‘farmers’ front groups and peddling falsehoods which include that the bill bans tobacco crop  growing.

Uganda is already behind its East African counterparts; Tanzania and Kenya (in 2007) which have already passed tobacco control laws.

Monday, January 7, 2013

Forget the statistics: I recently lost a friend to Tuberculosis

When I went to see him in his tiny hospital room at Makerere University hospital, in the outskirts of Kampala, he had easily lost a third of his normal body weight. 

Tugume Benon was still his old cheerful self. Cracking jokes even when he was in excruciating pain, physically a shadow of his former self. As if to defy the fate that grounded him to a rickety old hospital bed for days on end he kept cheering me  up instead.

‘''’Tell people not to worry about me. I will be fine and out of hospital in a few days.’’ he said. He told me he had been diagnosed with Tuberculosis (TB) and was on the dreaded six months- long DOTS regimen- the known treatment for TB.

True to his word, he was finally discharged from hospital. Well, not in a few days as he had predicted but in a matter of months.

'See, I told you. I told you I would be out of hospital. How is everyone? I am going around the office saying my hellos to friends'.

That was the last time I saw my friend alive.

About a month later, I got phone call  in the middle of the night to announce that Benon had finally succumbed to TB.

I was astounded. Benon had been on treatment and he been discharged from hospital and was making plans for the future and trying to resume his degree program.

Benon Tugume was in his mid forties-in the prime of his life. With a young wife and family. He had even gone on to study for a Bachelors degree two decades after his peers. He was in the second year of a three-year Bachelors' degree at Makerere University.

Many regard TB as an old vanquished disease. But TB is on the rise in Uganda.

According to UNAIDS, TB is the leading cause of death for people living with HIV/AIDS.

''Why spend billions of dollars on treating HIV/AIDS and let people die eventually of TB'' asks Prof Lee Reichmann, head of the New Jersey Global TB institute.

According to Dr Adatu, head of Uganda's national TB program, 60% of all people diagnosed with Tuberculosis in Uganda are also HIV positive.

The increasing prevalence of HIV/AIDS rates in Uganda, now projected at 7.3% compared to 6.4 in 2005, has driven up TB cases in the country and led to a re-emerging TB epidemic in the country.

People living with HIV are especially prone to Tuberculosis due to weakened immunity. According the International Union against Tuberculosis and Lung Disease, a third of healthy humans live with the TB bacteria in their bodies but are able to suppress it due to healthy immunity levels. This situation is similar to Candida in women which comes to the fore mostly when women’s' immunity levels decline.

Because of the widespread TB-HIV co-infection, a joint, integrated treatment is now standard procedure-according to the World Health Organization.

It is now advisable to test all those with TB for HIV and all those diagnosed with HIV for Tuberculosis.

How I wish I had had the guts to task my friend to go for an HIV test. Benon Tugume may still be alive today.

Thursday, January 3, 2013

Sentimental as I clutch the last print edition of 'Newsweek'.

I am feeling sentimental as I clutch my copy of the very last print edition of Newsweek magazine. Truly the end of an era.

As a child, my father brought copies of Newsweek  at home. It was the days of bold font. I recall images of Ronald Reagan and 1980's America on one of the covers.

Newsweek was always there every single week. Nothing would beat a serene Saturday afternoon at Serena hotel reading Newsweek with its cousin TIME magazine . They always made for  terrific company. Unrivaled in many ways.

I still keep land mark copies of these magazines going back in time. A testimony to the timeless writing and journalistic standards set by these American imports.

Even when I was worked up and needed to unwind, a fine edition of Newsweek would do it for me in a way several pints of bear would do it for an Irishman after a long day at the office.

For expert analysis of current affairs, global events and those land mark events such as the 9/11 attacks, the Fall of the Berlin wall, the 2008 global financial meltdown. Newsweek was there for us.

Well  Newsweek is  not actually dead,  as it transforms into a  new digital life on ipads. In Uganda where we still like it in hard copy, this almost an obituary. The vagaries of modern commerce and changing consumer tastes, e-everything couldnt spare our beloved Newsweek. The end of an era indeed.