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.