Speech by Dr. Stefan LOCK
Acting Head of Cooperation
Delegation of the European Union to the Republic of Uganda
At the first National Universal Health Coverage Symposium (SPEED project),
26 August 2015
- The Honourable Minister of Health, Dr Elioda Tumwesigye
- Director General Ministry of Health
- Vice Chancellor (s)
- Principal – College of Health Sciences,
- Executive Director Mulago Hospital
- Deans and Head of Units and centers
- Representatives of SPEED Partner Institutions
- Ladies and Gentlemen in your various capacities
On behalf of the European Union (EU) allow me to warmly welcome you all to the first National Universal Health Coverage symposium, which we are honoured to support through the SPEED project.
The European Union acknowledges that Health, Education and Social Protection are the foundation for inclusive economic growth of any nation. However, Uganda has registered mixed performance in the attainment of the millennium development goals (MDGs). Notably is the decline in infant mortality ratio to 54/1000 live births and HIV no longer a death sentence as before. These are very positive developments arising from the health system. But you will agree that, the health system in Uganda still has a long way to go to provide assurance to Ugandans of adequate social protection. Deaths for example related to pregnancy and child birth remain unacceptably high with an estimated 20 women dying daily while giving birth in Uganda.
Policy (an important component of the SPEED project) has a major stewardship function for society. In Uganda as in many other developing nations, the science of policy analysis and evaluation is not well developed. This presents a major constraint in improving the prerequisite governance processes necessary for sound decision-making and for fostering stewardship. As Government works to attain Vision 2040, more consideration needs to be made to ensure improved coordination between the various stakeholders and the private sector. However, major policy questions need to be addressed.
- What are the health priorities to which public resources should be targeted?
- What is the institutional framework in which the system and its many actors should function?
- Which activities should be coordinated with other systems outside the realm of health care, and how (e.g., highway safety, food quality control)?
- What are the trends in health priorities and resource generation and their implications for the next 10, 20, or even 30 years?
- What information is needed and by whom to ensure effective decision making on health matters, including prevention and mitigation of epidemics?
Additionally, there are still pertinent questions to answer regarding the functionality of public hospitals which are the most visible aspects of health system capabilities representing the social safety net of the poor and vulnerable in society. Such questions as these that remain unanswered need to be addressed.
- How are the hospitals being financed efficiently?
- Do the hospitals have the required professional workers?
- How are the health workers being trained?
- Are the wages attractive to keep the workers well motivated in rural settings and ‘in country’?
More recently still, epidemics like Ebola in West Africa demonstrated how sustained weaknesses in the health systems can shut down the entire economic and governance systems of nations and even threaten regional and global security. Uganda’s role during the recent Ebola outbreak emphasizes further the importance of a consistent policy and response plan in any Health system. Policies that support health system strengthening and resilience are therefore vital to economic transformation of countries like Uganda, her neighbours and the global community. Government of Uganda and her development partners all stand to benefit by investing sufficient resources into health system strengthening, prevention and early detection of epidemics and social protection programs.
With this background, a country like Uganda with meagre resources can therefore not afford to make investment decisions without good evidence of the benefits and costs. Governments in the European Union have established policy advisory centres that feed decision makers with the evidence they need to make such tough investment decisions. Universities are key players in this role and they advise governments and monitor policy implementation arrangements. This kind of capacity still needs to be built up adequately in Uganda, and we are glad that we can support one step in that direction with the SPEED project.
As I conclude, allow me to mention that the European Union Delegation in Uganda is proud to be associated with the work that lies ahead of us on this journey to the attainment of Universal Health Coverage. The SPEED project will strengthen the capacity of the selected Universities and stakeholders in undertaking policy analyses and providing policy advice to government and partners. We therefore expect to see the Universal Health Coverage agenda in Uganda built on sound and locally feasible alternatives and solutions.
Coming together (in this symposium) and building an understanding of Universal Health Coverage and generating evidence about what options Uganda can take on this journey is an important first step. Finally, I salute the Government of Uganda, the Ministry of Health and Makerere University on this occasion and wish you very fruitful deliberations.