Day 2 Keynote Address by Prof. David Serwadda


Universal Health Coverage, Resilient Health Systems and (Re) emerging global health threats/epidemics



A well-attended Day 2 of the National Symposium on Universal Health Coverage


While Uganda is suffering the burden of communicable diseases like malaria, HIV, TB and others, the prevalence of Non-Communicable Diseases like Cardiovascular Diseases is on the rise too. This raises fears concerns of a double burden of disease. There is a third layer too; that of emerging/re-emerging epidemics. Professor David Serwadda’s keynote address was meant to generate debate on what is happening in this area, what lessons can be leared and what implications this has for universal health coverage.

Although the presentation painted a somewhat gloomy picture, it provides the perfect recipe for critical thinking on these issues.

Mortality rates for CVDs and high and continuing to grow. This may partly be explained by the fact that the Ugandan population is growing and therefore the number of people affected is growing and increasing

Evidence also shows that the probability of females dying between the age of 30-70 from the 4 main NCDs is 25%. The number of obese and overweight people in Uganda is significantly higher in urban than in rural settings; a fact that was partly related to the low level pf physical activity among the urban dwellers. The warning is that with growing urbanization in Uganda and Africa generally, the risk factors for CVD increase.

The cost of management of CVD is therefore a cause for worry especially in the face of a good trend that life expectancy in Uganda is improving.


The picture with emerging and re-emerging epidemics is also an area that seems to be calling for due attention as the countries plans for universal health coverage. Professor Serwadda noted that the increase in population growth, never-ending conflicts and the threat of zoonotic diseases are areas that should raise concern. “In addition, HIV is still with us and will stay in the background for a long time”. With increased number of people accessing life-saving life-long treatment, the investment from the perceptive of UHC will be substantial. Additionally, UHC desires that all people in need of HIV treatment should be put on the treatment they should be getting.

All these challenges are nested within the human resources for health challenges. “Are we training the specialists we need for the next fifty years? Do we have the infrastructure we need in place to address the challenges? Do we have reference laboratories for epidemics?”


Professor Serwadda delivering his address


The lack of accountability by leaders to their constituents (and here symposium participants agreed leadership at all levels; technical and non-technical) needs to be addressed.

The discussion that followed focused on critically considering investment in primary health care as a foundation for building systems for the realization of universal health coverage, lessons that can be learned from other countries and adapted to the Ugandan context, and securing and ensuring accountability from leaders of different categories and levels in the provision of health for all.


Some of the District Health Officers attending the national meeting. With the implementation of Universal Health Coverage, a lot of work will fall in their docket