Category: Daily Monitor

Investors at Sino-Uganda Mbale Industrial Park have urged the government to consider extending a railway siding into the park and also establish a freight yard in bid to boost import and export trade.

A railway siding is a short branch line connected to the main railway track, designed to facilitate trade, among others.

The government is currently rehabilitating the Tororo-Gulu railway line (375km) at a cost of Shs200 billion, and its completion, according to the contractor, China Road and Bridge Corporation, is scheduled for February 2026.

The investors argue that the extension of the railway into the industrial park in Mbale will facilitate movement of imports such as raw materials and the export of finished products for various enterprises in the park.

‘The Ugandan government is currently upgrading the railway mainline from Mombasa Port into Uganda. We request the government to consider extending a railway siding into the park to enhance operational efficiency,’ Mr Laurent Zhang, the administration manager of the park, said.

Mr Zhang made the remarks on Tuesday while meeting government officials from Uganda Revenue Authority (URA) and Uganda People’s Defence Forces (UPDF).

Agencies inspect park

Mr Cassette Ignatius Wamundu, the manager of Intelligence at the tax body, led the URA delegation, while Brig Gen David Gonyi, UPDF Air Force Chief of Staff, led the officials from the army.

Mr Zhang added that the capacity of the park’s current 50MW electricity substation is nearing saturation, adding that it is insufficient to meet the power demands of existing enterprise expansion and new enterprises being established at the park.

‘We request the relevant government departments to expedite the approval and construction process for the planned 240MW substation project, providing a solid energy guarantee for the park’s sustainable development,’ he said.

Mr Moses Wanjala Owino, the manager of enforcement and border control eastern region, said URA is committed to facilitating the investors in the clearance of their imports such as raw materials, and clearing their exports.

Mr Owino said the traders in the country can now buy locally made items in line with the government policy of Buy Uganda Build Uganda (BUBU) from the factories within the country.

‘For instance, more than 50 items are being produced in this park and are quality products. So, we call upon the people who still cross the border to source some of these items here locally at a very low price,’ he said.

He said they will continue guarding the border against any illicit cross-border trade that impacts negatively on the local production.

‘When goods are being brought in illegally, it distorts the market, and the fact that some of them are not paying taxes, they tend to be cheap, and it affects the production capacity of those industries,” Mr Owino said.

The eastern Uganda-Kenya border stretches over 800 kilometres, presenting a vast expanse that is difficult to monitor effectively.

Smugglers exploit this vastness, taking advantage of porous border areas, informal crossing points, and remote regions to carry out their activities.

Brig Gen Gonyi said the biggest challenge facing BUBU policy is that Ugandans still believe goods from abroad are better than the ones produced locally.

‘And yet in the actual sense, from what we have seen, we have found that the products produced in the park are actually much better than the ones that are smuggled in from the neighbouring countries,’ the UPDF Air Force Chief of Staff, said.

Recently, a representative from a Mauritius-based investment fund approached me for legal advice on obtaining recognition for their foreign investment scheme in Uganda under the Collective Investment Scheme Act.

The client was frustrated with previous legal options that relied on Artificial Intelligence (AI). They specified in the engagement terms that my advice should be based solely on my judgment and not generated by any language model, as they sought my expertise in the capital markets, not generic content.

Another Ugandan client, who exercised Employee Stock Options ‘ESOPs’ in an American Delaware-based startup, also reached out at the same time to seek my legal opinion on whether the recently publicised Uganda Revenue Authority (URA) crackdown on foreign assets held by Ugandans for taxation purposes on worldwide income-would affect him. He showed me some of the legal advice he had generated from these AI Large Language Models. After reviewing it, I had to advise him not to rely on that legal advice because it was incorrect.

I believe certain aspects of the legal profession will not be replaced by GPT Large Language Models. In fact, 65 percent of what lawyers do still remains stubbornly human, despite the fact that the consulting firm, McKinsey, estimates that 23 percent of tasks performed by a highly experienced lawyer can be automated.

I was speaking with a colleague at an international law firm based in London, UK, and he told me his firm developed a custom internal generative AI tool used by the firm’s lawyers to enhance document review, summarise legal documents, and compare inconsistencies in witness statements. This custom-made AI illustrates how various industries are reporting the risks they face that could lead to litigation.

Junior lawyers at that firm have evolved from being drafters and reviewers of documents to becoming checkers of AI output. However, verifying the soundness of contracts requires judgment that AI cannot provide.Unfortunately, fresh graduates rarely possess this skill, as it is developed through years of accumulated experience.

I keep getting amused by people who say current AI models will replace judges entirely. Don’t dream about that. When a judge or magistrate sits down to make a judgment on your case, they go beyond just using syllogistical or inferential logic that these AI models excel at; they also use more of abductivee reasoning, which is much harder to programme and relies on instincts and cultural nuances.

All AI models excel at “reckoning,” not “judgment.” Trust me, if current AI models were to perform judicial functions, it would occasion even more injustice. For now, A I models are just “speed reading plagiarists” that can synthesise large volumes of data sets in less time than a human being ever can, but can’t replace the function of human judges in courts.

Even multi-layered deep neural network AI models with machine learning capabilities that utilise ‘Back propagation’ and ‘Gradient descent’ aren’t a substitute for human judicial officers. Judges and lawyers do much more than being ‘speed reading plagiarists.’

I will conclude with the important lessons from former Soviet Lt Col Stanislav Petrov, which emphasise the significance of abductive logic in the everyday work of a lawyer.

On September 26, 1983, Petrov averted World War III when the “Oko” early warning system, a primitive AI, mistakenly detected five US intercontinental ballistic missiles due to sunlight reflecting off clouds.

Using abductive logic, Petrov deduced that a genuine US strike would involve hundreds of missiles to breach Soviet defenses. He correctly identified this as a false alarm and chose to override the warning system. This incident underscores the critical role of abductive logic in legal judgement and advice.

A section of police officers under the Directorate of Fire Prevention and Rescue Services on Wednesday started training to upgrade, and learn new firefighting, emergency and rescue skills under the guidance of the Japan Firefighters Association.

The training is part of the grant, Assistance of Grassroots Recycle Project, where Japan is provisioning second-hand ambulances and fire trucks in two cities and 11 districts, worth over Shs1.8billion.

Uganda Police Force welcomed the intervention as timely for Uganda to close both skills and equipment gaps in the department.

Speaking at the launch of the training in Kampala on Wednesday, Deputy Inspector of Police in charge of Human Resource Development and Training, Moses Kafeero, who represented IGP Abas Byakagaba, appreciated the government of Japan for supporting police. Their intervention, he said has greatly improved the national capacity to respond to fire incidents.

‘The equipment will fill the gaps that we had. Uganda is a growing population, now exceeding 46 million people, but when you compare the few firefighters we have and then the equipment, that is not enough, and yet we are prone to fires,’ he observed.

The eight-member team that will train the officers for six days is led by Shinsuke Sato, the Director General of the International Division at Japan Firefighters Association, and comprises fire fighters with up to 25 years of experience, fire trucks drivers/operators, trainers and mechanics.

The training targets personnel responsible for maintenance of the equipment, drivers and operators of the vehicles

Deputy Head of Mission of Japan to Uganda, Yoshida Norimasa said the Asian country boasts a seasoned and proficient fire and rescue force ably responding to numerous natural disasters the archipelago faces, and international emergencies in Asia, Europe and Africa.

Japan seeks to share these extensive skills and experience with Uganda to enhance bilateral cooperation.

‘I hope this training will also be an opportunity to glean fresh insights of fire prevention and rescue work,’ he said

Since 2019, 18 fire trucks and 37 ambulances have been donated to Uganda, with 8 expected to be arriving in the country today.

The Japanese diplomat also told the applauding officers that an extra 8 firetrucks and 9 ambulances will be delivered next year.

‘We are confident the training and provided vehicles will contribute to the Uganda Police Force’s goal to provide timely and effective fire prevention and rescue services in each district in Uganda’ Norimasa said

Challenges

Uganda still faces glaring gaps in its emergency, fire and rescue services increasing the risk of loss of lives and property in case of outbreaks. Ugandan homes, commercial buildings, workplaces and public institutions are prone to fire incidents, according to officials.

‘Most of our cooking is by firewood, then sometimes the electrical installations are not effectively done by professionals, therefore we still have a lot of vulnerability to fire,’ AIGP Kafeero said.

‘Some of our growing towns have not put the physical planning component in line with the firefighting. Some of these people, sometimes firefighters, lack fire hydrants, where to feed,’ he added.

Previous reports by the Office of Auditor General have also highlighted limited financing, limited human resource equipment and absence of fire stations in some districts as key challenges.

Senior Commissioner of Police, Engineer Franklin Kugonza, the Deputy Director at the Directorate says the situation has improved.

‘We have equipment that we use and we have trained personnel and we are distributed all over the country,’ Mr Kugonza said, adding that their response time is now not beyond 15 minutes, despite repeated concerns of delayed responses. He further explained the department works 24/7 with a call center [0800121222 or 999]and teams always on standby.

‘Whenever there is a call, not more than three times, it will be picked. And that call will be attended to. In the next ten minutes, a team will be responding and dispatched,’ he said

Eng Kugonza said the latest donation by Japan will go to districts that have not been having fire equipment like Moyo, Nebbi, Kapchorwa, and areas like Nansana.

This is arguably the week Ronald Rugumayo has been preparing for his entire golfing life.

Uganda’s lone ranger on the Sunshine Tour and now a second-time starter on the DP World Tour, the man nicknamed Mayo tees off Thursday in Johannesburg carrying not only his clubs-but the weight of history and national pride.

His entry into the Alfred Dunhill Championship that runs until Sunday did not come by invitation or luck. It was carved out by sheer execution and nerve.

At Monday’s pre-qualifier at Benoni Country Club, the Johnnie Walker and MTN Uganda-sponsored star delivered a bogey-free round of 67 (-5), finishing tied fifth in a brutal field of 85 professionals fighting for only 10 slots. Only one non-South African-Frenchman Pierre Viallaneix-joined that elite group.

Evident evolution

From being known as a slow starter to now a player who controls rounds with calculated aggression, Mayo’s evolution has been evident all season. His team credits this to relentless work: hours on the range with his coaches, detailed analytics reviews, strength and conditioning upgrades, and smart caddie management that has turned him into a more complete and composed competitor.

Today, the Tooro born and bred golfer ranked 2060 in the world lines up in Game 39 at 1:20 pm, opening his campaign off the first tee alongside South Africans; Jordan Burnand and Musiwalo Nethunzwi, a former national amateur star. For Mayo, this is golf’s version of stepping into the lion’s den – and loving every moment of it.

Outside chance

If he finishes in the top five, he will automatically earn a spot in the next DP World Tour event, the Mauritius Open (December 18 – 21). His manager, Peter Mujuni, admits it’s ‘a tall order’ but adds: ‘He is in good form and anything can happen.’ The rest of the DP World Tour’s Southern Africa calendar includes the SA Open (February 26 – Mar 1) and Joburg Open (March 5-8), events Mayo also hopes to break into.

Even the DP World Tour itself has noticed his rise. In a post on X, they reminded fans of his history-making cut at the 2024 Magical Kenya Open and welcomed him back to the big stage: ‘It’s good to see you back, Ronald.’

For Mayo, these are the moments that define careers. For Uganda, this is a player finally pushing down the doors that once looked permanently shut.

‘I feel great because of the work I have put in for the last couple of months, and it’s now rewarding. I’m thankful to God for seeing me reach this stage of my career. I’m looking forward to an exciting week,’ said the 32-year-old.

TALKING POINT

Why It Matters. For a country with no DP World Tour pedigree and limited golf infrastructure, Rugumayo’s breakthrough is seismic. He stands as proof that a Ugandan can rise through Sunshine Tour hardships, qualify on merit, survive pressure cauldrons, and earn a seat at golf’s global table. His run could spark the next generation, re-energize local federations, and reshape how sponsors view golf investment in Uganda.

How He Qualified

· Bogey-free 67 (-5) in the pre-qualifier

· Finished T5 in field of 85

· Only Top 10 advanced

Mayo’s Tee Time

Game 39: 2:20 pm, First Tee

Playing Partners: Jordan Burnand (RSA), Musiwalo Nethunzwi (RSA)

EVENT INFO

Name: Alfred Dunhill Championship

Venue: Royal Johannesburg Golf Club – East Course

Dates: Dec 11-14

Rounds: 4

Prize Fund: pound 1,500,000 / 12,000 pts

Uganda Ladies Golf Union (ULGU) president Rita Okot Apell is full of optimism for the future of the game of swing in the country after she, on Thursday, unveiled a new Stanbic Annual Junior Golf Championship.

The tourney, whose inaugural edition will be played at Uganda Golf Club (UGC) in Kitante on Sunday, is set to run thanks to main sponsors Stanbic Bank and Krystal mineral water from Hariss International.

‘Golf is a big deal for us but it is a big day for us because of the customers we serve and in this case, for the children of our customers,’ remarked Stanbic Bank’s head of affluent banking Arthur Kiwanuka.

‘Customers come to us for growth. They also come to us for legacy, this is part of legacy. The kids are our legacy,’ he added.

‘Together with Stanbic Bank, we are shaping a future where every child and young adult -whether a beginner or a rising star – has a chance to learn, compete, and thrive,’ said Apell.

A field of 160 youngsters is expected to compete in three categories at the par-72 course at the championship expected to be one of the most inclusive youth golf events of 2025.

The tournament’s main category will have players of ages four to 18 with established handicaps while there will also be a skills-test category for those new to the game.

And the championship will have a subsidiary event for youth aged 19 to 35, a launch-pad into more competitive golf.

‘When they (young golfers) clock 19, they have to join the clubs and play competitively and we introduce a youth event of 19-35 to cater for the growing interest among young adults,’ stated Apell.

‘As the Union, we are constantly looking for ways of attracting juniors and one of the ways is through families. It’s really a family day, as we look at nurturing the game,’ she added.

Stanbic’s contribution is Shs25m in cash as well as logistical support.

Anger and frustration filled the air outside the High Court on Thursday as downtown Kampala traders protested the continued delays in their case challenging alleged illegal construction works on the Nakivubo Drainage Channel.

Many traders arrived carrying placards with messages such as ‘Judges treat all Ugandans equally,Judges stop working from orders above, and Judges stand on your own. They said the slogans reflected their growing fear that justice was slipping further out of reach.

The matter, filed by two traders’ associations seeking an injunction against businessman Hamis Kiggundu, Kiham Enterprises Ltd, the National Environment Management Authority (NEMA) and Kampala Capital City Authority (KCCA), had been scheduled for mention. However, the trial registrar, Simon Kintu Zirintusa was said to be handling other administrative duties, prompting yet another adjournment this time to February 24, 2026.

One of the traders, Justine Nabirye, expressed deep disappointment over the repeated postponements.

‘The last time we came to court we were told that the judge is not around, that he was away on leave, yet he is the same judge who gave us the date without anyone forcing him,’ Nabirye said.

She said traders were increasingly unsure of where to turn.

‘Many traders downtown lost their property while others lost their lives. We are asking ourselves who is going to compensate us. Our hope was in court but they are tossing us up and down. We do not know which the right thing is.’

Nabirye added that flooding had severely affected their livelihoods.

‘Our property was spoiled by water and we were not compensated, yet UIRA were compensated. Our children have not gone to school. We are asking, as traders, are we Ugandans or not? Does the law work on everyone or only the rich? Where shall we run to? We are oppressed.’

The application was filed by the Kampala Arcaders Traders Association (KATA) and UNATA Traders Association Uganda Limited, representing hundreds of traders operating around Nabugabo Street, Shauri Yako, Channel Street, French Plaza, Pentagon Arcade, BMK Plaza, Mukwano Arcade and Magoba Arcade.

The traders accuse Kiggundu and Kiham Enterprises of beginning construction on the Nakivubo Drainage Channel in August 2025 without the required environmental and physical planning approvals from NEMA and KCCA.

Kiggundu, through his lawyers, states that the traders have no legal basis to challenge the developments and that the case amounts to an abuse of court process. He is asking the High Court to dismiss the suit in its entirety.

Uganda Police has assured the public that 10,000 police constables currently undergoing training ahead of the January 15, 2026 elections will not be armed while on duty at polling stations.

Speaking on Thursday in Kayunga District, Joseph Oduma, Ssezibwa Regional Training Officer, said the recruits, who are specifically prepared for election security, will carry only batons for personal protection and basic crowd control.

‘They will not be allowed to be armed with guns. The only tool they will carry is a baton for protection in case of any eventuality,’ Oduma said.

He emphasized that their role is primarily to maintain order, guide voters, safeguard electoral materials, and ensure peaceful conduct during voting.

Fully trained and armed officers will be stationed to supervise and respond to emergencies when needed.

‘Each polling station will have officers who are trained and armed to respond to any incident. The recruits are to support, not confront the public,’ Oduma added.

Over 2,000 constables are currently in training in the Ssezibwa region, forming part of the nationwide effort to prepare 10,000 recruits to assist the Electoral Commission in delivering a credible and peaceful election.

The training stresses human rights observance, lawful use of force, crowd management, election security protocols, and community engagement, according to police sources.

Oduma said the decision to deploy unarmed recruits is deliberate to reduce risks and prevent escalation during voter interactions.

‘These recruits are trained on human rights laws and the proper conduct expected of officers in a democratic election. Their presence is to create a sense of safety, not fear,’ he said.

Ssezibwa Police Spokesperson, Ms Hellen Butoto, explained that the recruits were sourced from within local communities, with verification by local leaders, and will serve in areas where they are familiar, enhancing trust and cooperation with residents.

Training is expected to continue for several weeks before the recruits are deployed nationwide, ahead of Uganda’s general elections where voters will decide both the presidency and parliamentary representation early next year.

The presidential race has eight candidates including incumbent Museveni, his closes challenger in the 2021 poll, Robert Kyagulanyi, and former military chief Mugisha Muntu.

Bardege-Layibi Division Member of Parliament, Martin Ojara Mapenduzi, has spoken out about allegations linking him to the violence against the National Unity Platform (NUP) presidential candidate Robert Kyagulanyi Ssentamu’s campaign in Gulu City over the weekend.

Mr Kyagulanyi, popularly known as Bobi Wine, campaigned in Gulu on Saturday, December 6, 2025, but his visit was marred by violence unleashed by armed security operatives and non-uniformed individuals armed with sticks.

Joint security forces comprising the Uganda People’s Defense Forces (UPDF) and the Police, engaged his supporters in running battles, beating several of them as Bobi Wine attempted to address crowds in the city where he was scheduled to hold a campaign rally. Amid the heavy security deployment, groups of youth reportedly took to the streets, assaulting anyone dressed in red headbands, headgear, or clothing (NUP colours) with protection from security operatives.

The youth, estimated to be between 50 and 90, moved in a single line through the central business district carrying sticks. The office of the Resident City Commissioner says it has not yet received formal complaints regarding property looting, but confirmed one death resulting from the scuffle.

A 16-year-old student succumbed to injuries after he was hit on the head with a blunt object.

The incident has drawn widespread criticism from the public, with religious and traditional leaders calling for free and peaceful elections in 2026.

Fingers have been pointed at Mr Mapenduzi, who recently joined the ruling National Resistance Movement (NRM) party and other government officials for orchestrating the violence against the opposition leader and his supporters.

Addressing journalists at Taks Arts Centre in Gulu City on Wednesday afternoon, Mr Mapenduzi-who is seeking reelection for Bardege-Layibi Division-described the incident as ‘regrettable and unfortunate.’

He noted that although some members of the community were blaming him for planning the chaos that compromised public safety, he was engaged elsewhere with boda-boda operators on business and development matters at the time.

The former Forum for Democratic Change (FDC) member explained that before Bobi Wine’s scheduled rally, he had arranged a meeting with boda-boda riders to encourage each of the 2,000 cyclists to save at least Shs1,000 daily to eventually purchase their own motorcycles instead of resorting to exploitative loans.

He said he mobilised 300 boda-boda operators-mostly stage leaders from Gulu East-and provided each with one litre of fuel and 5,000 shillings for lunch, since no meals had been served at the meeting venue at St Monica Tailoring School.

About 500 meters from his meeting site, Mr Kyagulanyi was yet to arrive at Awere Playground when the cyclists took to the streets in what appeared to be a coordinated move to disrupt the NUP candidate’s entry into the city.

‘If anybody would want to blame Mapenduzi that day, then I would ask you if it was wrong to support the boda-boda in their businesses. If the NUP is blaming me for denying them boda-boda from whom they wanted to move with their President, it’s their problem,’ Mr Mapenduzi said.

He acknowledged the challenges Bobi Wine and his supporters faced in Gulu City and called on security agencies to investigate and prosecute those responsible.

‘I am not the security officer; I am not the police officer; I am an elected leader who was meeting his people. I can’t account for what happened but there are those who did it. Some are known, so let them be brought to book. I never got involved in any planning,’ added Mr Mapenduzi, who joined Parliament as an Independent candidate in 2021 after quitting the opposition FDC.

The Deputy Resident City Commissioner for Laroo-Pece Division, Peter Banya, described the violent events that unfolded during the campaigns as ‘regrettable’ and attributed them to gaps in the security measures deployed.

‘There was a gap and we apologize for whatever happened, but the security acted in the public interest to protect the citizens and their property. Yes, the forces couldn’t do everything enough. There were lootings, but sadly, the schoolboy died later after the assault,’ Banya said.

On December 9, 2025, Ker Kwaro Acholi issued a statement condemning the incident and calling for a thorough investigation by the police and other security agencies. Okello Okuna, the Public Relations Officer for Ker Kwaro Acholi, said it was wrong for both sides to involve vulnerable youth in election-related violence, which resulted in the loss of a young boy’s life and the looting of property belonging to the business community. He appealed for peaceful campaigns as the 2026 elections draw closer.

Negotiations between the Ugandan and United States (US) governments on a new health-financing model yesterday culminated in the signing of a memorandum of understanding (MoU).

In a landmark effort to strengthen Uganda’s health system and counter global disease threats, the two nations signed a five-year, $2.3 billion (about Shs8 trillion) bilateral health cooperation agreement that also obligates Uganda to share vital health data with the US. The MoU was signed yesterday afternoon at the Ministry of Finance headquarters in Kampala.

US Ambassador William Popp, Uganda’s Finance Minister Matia Kasaija, Health Minister Jane Ruth Aceng, and other dignitaries attended the ceremony. The MoU that will run from 2026 to 2030 requires the US to commit up to $1.7 billion (over Shs6 trillion) to priority programmes, including HIV/Aids, tuberculosis, malaria, maternal and child health, polio eradication, global health security, disease surveillance, and emergency preparedness. Uganda, on the other hand, pledges to increase domestic health spending by more than $500 million (Shs1.7 trillion), gradually, and later assume greater financial responsibility as US support tapers.

A joint statement by the two parties said the co-investment model aims to sustain health gains and empower Uganda to steer its own health agenda. Ambassador Popp indicated that the agreement marks a pivotal shift toward Ugandan self-reliance while advancing shared priorities in infectious disease control. ‘This agreement represents a significant commitment by the United States and Uganda to co-invest in our shared global health priorities,’ Amb Popp said.

‘Today, we are building on prior successes and making a significant shift toward promoting self-reliance in the health sector through strong community health systems, clear performance metrics, and a foundational commitment to data systems and global health security that will prevent and stop outbreaks from threatening Uganda, the United States, and the world,’ he added.

Minister Kasaija echoed the sentiment, emphasising the pact’s dual focus on disease-specific outcomes and systemic improvements.

‘The Government of Uganda acknowledges the critical importance of preventing the spread of emerging and existing infectious disease threats globally. In this regard, the Government of Uganda notes the United States Government’s commitment to support Uganda with a budget allocation of $1.7 billion for the period 2026-2030,’ he said.

‘This collaboration will yield not only disease-specific outcomes but also significant improvements in national systems, institutions, and workforce capacity. This is highly commendable,’ he added.

A cornerstone of the MoU is its emphasis on sustainability. The US, the agreement stipulates, will gradually transition procurement of medical commodities to Uganda and strengthen supply chain systems. Frontline health workers currently funded by the US will be mapped to Ugandan government payroll cadres, ensuring long-term employment stability. Significant investments will also enhance Uganda’s data ecosystem, advancing electronic medical records (EMRs) and integration with the national data warehouse.

In the MoU, faith-based healthcare providers, a critical component of Uganda’s health delivery network, will receive targeted support through performance-based service agreements, increased primary healthcare grants, and initiatives for digitisation and community health insurance. This inclusion underpins the MoU’s holistic approach to leveraging existing infrastructure. The agreement builds on decades of US-Uganda health collaboration, with the US remaining Uganda’s largest bilateral and multilateral health partner. It also aligns with the America First Global Health Strategy, prioritising disease prevention to protect both nations.

Amb Popp emphasised that government-to-government collaboration, rather than reliance on non-governmental organisations (NGOs) as in prior frameworks, will streamline implementation and accountability.

Public engagement gaps?

Leaders of NGOs and other key players in the health sector that Daily Monitor approached yesterday for comments said they couldn’t comment about the matter because some of them had neither seen the draft nor the signed MoU. Our attempts to get a copy of the signed MoU from the government were also futile by press time yesterday.

‘I don’t know what came through (what the two countries agreed upon) and so I can’t give comments,” said Noor Nakibuuka Musisi, the deputy executive director at Centre for Health, Human Rights and Development (CEHURD).

Dr Andrew Kambugu, the director of Infectious Diseases Institute at Makerere University, said he also does not know the content of the MoU nor seen one. ‘We have a meeting with the [US] Embassy tomorrow, and I think they will tell us, so I cannot comment now,” he said. Other lawyers, who have been following the discussion, also said they have not yet seen the MoU, but indicated they are looking for the documents.

Targets

Dr Aceng explained what Ugandans stand to gain in this new agreement.

‘There’ll be more doctors, nurses, midwives, and Community Health workers, who are well trained, motivated, and equitably distributed. Upgraded laboratories, functional health facilities throughout the country, and resilient supply chains,’ she said.

She also highlighted stronger disease surveillance, diagnostic capacity, and rapid response readiness as some of the targets in the agreement. ‘There will be a renewed momentum to mitigate HIV/Aids as a public health threat. Eliminate malaria and match confidently towards universal health coverage. We shall have healthier mothers and children and a stronger shield against future pandemics,’ she added.

Data sharing concerns

A contentious issue, data sharing, drew scrutiny from lawyers in Uganda as the government negotiated with major concerns around the risk of losing data sovereignty, privacy violations, and legal clashes. But Uganda’s Ministry of Health clarified that data will be shared in compliance with national laws, with only aggregate data provided to the US Congress for planning and oversight. Amb Popp declared some of the data they will require Uganda to share with them and the rationale.

‘On the data element again, this is not personally identifiable information; this is data and information that is at a national level. Incidents of HIV, rates of maternal and child mortality, those things of macro-level information,’ he said. He explained that this will ensure that ‘we’re achieving the performance and the results-based measurements to underscore the impact of our resources, to justify to our Congress, to explain the impact that we’re having with these Investments and to the Ugandan people and the American people as well.’

‘So that data is not about individual people’s information. The privacy rules and requirements, and laws of Uganda are, of course, going to be respected. This is about having the broad information to know that the systems and the investments that we are building together are having the impact that they promised to give,’ he emphasised. We couldn’t find the signed MoU, but the draft MoU indicates that the United States was interested ‘specimen sharing agreement .. for the purpose of providing physical specimens and related data, including genetic sequence data, of detected pathogens with epidemic potential to the United States within five (5) days of detection.’

In the draft MoU from the US government, ‘Both parties intend that this specimen sharing agreement will continue for [twenty-five (25)] years.’ The partner country can negotiate and adjust the terms. Earlier, critics warned the agreement could hand the US government unchecked access to sensitive health records, sidelining Uganda’s own regulators and laws. Mr Gilbert Ssettuuma, the legal officer at the government’s Personal Data Protection Office (PDPO), described the US government’s proposal as a power grab. Mr Ssettuuma said then that the deal demands ‘real-time access to our health information systems,’ yet it ignores Uganda’s new Digital Health Guidelines, released in September by the Ministry of Health. It is unclear what the final position of the government is, since we did not see the signed MoU.

Dr Aceng, during the signing of the agreement, explained why they are open to sharing data and information with the US government.

‘Uganda repeatedly served as the global first line of defence. Our ability to rapidly detect, diagnose and contain outbreaks is a global public good,’ she said.

‘A central pillar of this new collaboration is, therefore, a modern, respectful framework for sharing data and related information for public health purposes. And to be more unequivocal, Uganda’s sovereignty over its biological resources and health data is invaluable and non-negotiable,’ she added.

Dr Aceng said they will ensure no violations, but aim to optimise benefits from the data sharing agreement. ‘We have left behind outdated, extractive models of the past. All sharing will rest on three non-negotiable principles: Mutual benefit, and equitable access to resulting knowledge, vaccines, and therapeutics,’ she said.

‘Prior Sovereign consent, full transparency, and compliance with Ugandan laws and ethics. Three is timely, responsible action towards emergencies to protect both Uganda and the world. This framework proves that respect for national sovereignty and global solidarity are not opposites; they are the very foundation of a trustworthy corporation,’ she added.

Doctors have asked patients with sickle cell disease to monitor their uptake of hydroxyurea, a common drug used to reduce the complications associated with the disease, after a TikTok user was admitted.

Timothy Kayanja, 23, also known as Jayden, was last Friday wheeled into TMR International Hospital, after a distress call was placed to the facility, suggesting that he was having ‘chest pain’ and ‘trouble with breathing’.

‘When he arrived, he was in severe pain, struggling to breathe, and his oxygen saturation was critically low at 70%. He was rushed to the intensive care unit (ICU) and placed on oxygen therapy. A healthy adult requires levels above 95%,’ Dr Erasmus Okello, his assigned critical care physician, said on Tuesday.

Tests revealed that he experienced an acute vaso-occlusive crisis, acute chest syndrome and had a history of using hydroxyurea, which was no longer responding to and had caused him ‘complications’.

Dr Okello described hydroxyurea as ‘a very vital drug in the care of people with sickle cell disease’, saying it helps the bone marrow produce a more resilient type of haemoglobin to assist patients to live a fairly stable life without complications or significantly reduce complications.

‘However, the drug comes with side effects, including depressing the ability of the bone marrow to rapidly produce certain cells, which preferentially increases the production of the fetal haemoglobin, the main oxygen-carrying protein in fetal red blood cells.

‘In the case of Jayden, when he was placed on hydroxyurea on four attempts, each time, his bone marrow’s ability to produce blood cells got significantly depressed, beyond what is expected, suggesting that his bone marrow is not very reactive in producing red blood cells,’ Dr Okello explained.

Adding: ‘This is a very delicate balance between having sickle cell disease and not being able to compensate by producing normal red blood cells; so, it was deemed that the drug was becoming far more toxic to him than would benefit him, and it was discontinued.’

According to Dr Okello, Jayden has been receiving folic acid, among other medications, to sustain his blood levels.

‘In the first world, there are other medications that have been developed but are still being studied and not widely used here; so, we don’t fully know their application in the clinical setting.’

Such medication, Dr Okello says, is meant to improve sickle cell disease; however, we don’t have them available in Uganda, and are not even used in the first world where they are available and are extremely expensive.

‘Hydroxyurea remains the cornerstone for treatment of sickle cell disease patients, but the side effects have to be monitored closely by your doctors, while the patients are supposed to periodically be reviewed,’ Dr Okello further explained.

The reviews will guide on how the drug is helping to build up the patient’s fetal haemoglobin in preference to sickle haemoglobin, if there are any side effects of significant bone marrow suppression from the drug, and other side effects that could cause a reduction or discontinuation of the dose.

It is unclear for how long Jayden used hydroxyurea, but he told this publication that he had previously been at Mulago National Referral Hospital and has been treating sickle cell disease for the past 20 years.

Shortage of haematologists

Dr Oscar Mugerwa, an attending physician at the same health facility, said Jayden no longer responds to hydroxyurea, and a bone marrow transplant is now the best chance to significantly improve his quality of life, and has linked him to haematologists.

Haematologists are medical specialists focused on diagnosing and treating blood disorders, including both cancerous and non-cancerous conditions.

Dr Mugerwa, however, says Uganda has not more than five haematologists, but they scheduled appointments with three, possibly on Wednesday (today), to prepare him for the bone marrow transplant.

Dr Daniel M. Talemwa, the Executive Director of TMR International Hospital, said they will continue supporting Jayden as he prepares for a bone marrow transplant, including conducting all necessary tests for him and the potential donor to maximise the chances of a successful outcome.

‘The cost of the bone marrow transplant ranges from between $ 40,000 (about Shs141.88 million) and $150,000 (about Shs532 million),’ Dr Talemwa said. However, as of Tuesday, Shs76.71 million and a similar amount in dollars ($21,677.3) had been raised through mobile money and a GoFundMe page, among other channels.

‘We encourage continued support as the fundraising effort aims for $100,000 (about Shs354.7 million) to cover the cost of both the transplant and the vital post-transplant care, which is crucial to reduce the chances of complications as well as rejection by Jayden’s body and ultimately, transplant failure,’ he added.

According to the World Health Organisation (WHO), globally, the prevalence of the sickle cell trait is estimated at 7% of the world’s population, translating to between 300,000 nd 500,000 children born annually with the disease.

Africa, according to the same agency, bears 80% of the global burden, while between 50% and 80 percent of the affected children die before their fifth birthday.

Uganda is said to rank fourth after Nigeria, the Democratic Republic of Congo (DRC) and Tanzania, with between 20,000 and 25,000 new-borns diagnosed with sickle cell disease each year.

The Ministry of Health has been rolling out awareness campaigns in both urban and rural areas, urging couples to include sickle cell testing in routine health checks.

Dr Roseline Achola, a technical officer at the Ministry of Health, says sickle cell is becoming a serious national health burden. ‘For those intending to marry, screening for the disease is critical to prevent further spread,’ she says.

In Uganda, the highest burden is in northern and eastern Uganda, where between 15 percent and 20 percent of the population carries the trait.