The World Health Organisation has approved the establishment
of a regional centre in Uganda to test and determine the
presence of hemorrhagic fevers in the East and Central Africa
region. This will lead to a significant upgrade of the facilities
at the Uganda Virus Research Institute (UVRI).
The development will also stop epidemiologists from Uganda,
Kenya, Tanzania, Rwanda, Burundi South Sudan and Democratic
Republic of Congo taking samples to the US, before determining
a disease outbreak.
According to a senior epidemiologist at the WHO, Dr. William
Mbabazi, the development follows the persistent outbreaks
of severe fevers such as Ebola, Marburg and Hepatitis-E
in the region.
The new centre, to be named the ‘Regional Centre
for Epidemic and Ecological Surveillance’, will be
established in the present premises of the UVRI, at Entebbe,
over the next three years.
This follows regular disease surveillance studies which
showed that five new diseases have emerged in Uganda over
the last two years alone.
These are; new strains of Meningitis in Yumbe and Nakapiripirit,
Ebola in Bundibugyo, Hepatitis-E in Lira and Pader, as well
as Marburg fever in western Uganda.
The initial government response was to establish an epidemic
surveillance department in the Ministry of Health, with
senior epidemiologist Dr. Oscar Kamukama as head. He was
deputised by three other epidemiologists, and a bio-statistician.
However, Dr. Kamukama died last year, and two of the three
epidemiologists resigned, leaving the department originally
meant to have seven specialists with just one epidemiologist
and the bio-statistician.
To make matters worse, the department, which is supposed
to monitor disease outbreaks across the 80 districts in
the country on a daily basis, had been running on a miniscule
Shs 70 million budget, so most of the work reverted to the
World Health Organisation, in coordination with the US-based
Centre for Diseases Control.
“You see medical work is by nature labour-intensive,
so the lack of manpower was a major impediment in the implementation
of the department’s efforts.” Dr. Mbabazi said.
By coincidence, the WHO surveys also showed that there
were similar disease outbreaks in Kenya, Angola and the
DR Congo over the same period.
Dr. Mbabazi’s office began looking at new strategies
to deal with a common problem.
“We realised that if we established a regional hub
to deal with hemorrhagic fevers, it would allow us to tap
into the available manpower in the region, with each country
contributing,” he explains.
Dr. Mbabazi is particularly keen that more trained personnel
be made available to augment the WHO efforts in disease
surveillance and detection.
According to the Ministry of Health spokesman, Paul Kaggwa,
Uganda had to deal with insufficient technical expertise
in diagnosing Ebola last September, so it was at the forefront
in lobbying to have the equipment brought into the country
“During the first Ebola outbreak, they had brought
the equipment from the US, and after the epidemic was tackled
that equipment went back. But this time it is here, and
will be used to detect all sorts of hemorrhagic fevers,
right from Bird Flu to Ebola,” Kaggwa said.
But that is only the first stage of the process. The second
process involves upgrading the present laboratory at UVRI
from its present state of Bio Safety Plus-Level-2 to a higher
level called Bio-Safety Plus Level-3.
Africa has only one laboratory elevated to Bio-Safety Plus
Level-3, able to carry out specialised investigations, like
those involved in the detection of hemorrhagic fevers in
specimens, and it is in South Africa.
Maintaining such a facility requires a capital injection
of $1million per annum, excluding remuneration of staff
According to the WHO, the Uganda Virus Research Institute
is only at Bio Safety Plus-Level-2, but also requires some
refurbishment. Maintaining the refurbished facilities would
require up to $150,000 per annum.
By offering the UVRI for upgrade to Bio-Safety Plus Level-3,
the government is hoping that the centre will benefit from
resources available in the region, including monetary contributions
for the construction, as well as manpower and more resources
Presently the UVRI is already carrying out regional surveillance
and research on Polio, HIV and Measles among other diseases
in collaboration with the CDC and the Medical Research Council
of UK, as well as Kenya, Tanzania, Rwanda, Congo Republic
and the Democratic Republic of Congo.
The move to expand UVRI into a regional hub to look at
hemorrhagic fevers will see the new centre expand its scope
into looking at various human diseases, as well as other
diseases that may result from human interaction with ecological
agents such as birds (bird Flu) and other animals.
For now the effort to upgrade the facilities in Entebbe
has already received both the Uganda Government and WHO
support. The design stage is presently underway at the Regional
WHO office in Brazzaville.