The Government of Uganda and the Food and Agriculture Organization of the United Nations (FAO) oriented critical decision makers in key ministries and agencies on international Health Regulations (IHR, 2005)/Joint External Evaluation (JEE) to improve their understanding of the modalities and their expected responsibilities towards enhancing national health security; especially the integration of the agriculture, livestock industry and fishery sector to One Health mechanism. The high-level orientation meeting also delved into discussions that aimed at enhancing coordination across various sectors of national health security in anticipation of the 2^nd IHR/JEE assessment for Uganda slated for 23-27 October 2023.

The International Health Regulations (IHR) are mandatory guidelines requiring all countries to build core capacities to prevent, detect, and respond promptly topublic health emergencies and threats (PHE&T).  JEE is part of the monitoring and evaluation framework of the country's capacities to comply with the IHR 2005. Uganda is a signatory, in addition to self-assessments, after-action reviews and simulation exercises.

During the meeting, the Prime Minister of Uganda, Robinah Nabanja, represented by the Minister for East African Affairs, Rebecca Kadaga, affirmed the government's commitment to safeguarding the health of its citizens and preventing the spread of diseases. She appreciated the key role of JEE exercise in assessing the country's capacity to prevent, detect and promptly respond to PHE&T. Identified gaps and recommendations from JEE will inform Uganda’s next National Action Plan for Health Security (NAPHS). Hon Nabanja highlighted the multisectoral effort required during the upcoming exercise and called for MDA’s active participation.

"I look forward to receiving the recommendations from the JEE exercise on behalf of the Government of Uganda. These recommendations will help enhance our national capacities for health security," said the Prime Minister.

“In the 2017 JEE, Uganda scored 65% and will now be compared with the gold standard,” said Dr. Yonas Tegegny, WHO country representative in Uganda, the custodians of the   IHR, 2005). In the upcoming 2nd JEE assessment, nineteen (19) technical areas will be evaluated. Due to increased interactions among humans, animals, and the environment, as well as globalization, a multisectoral approach is necessary for effective engagement.

“The IHR are a critical tool for preventing and responding to global health threats,” said Antonio Querido, the FAO representative in Uganda.  “We are pleased to work with the Government of Uganda and partners to support this exercise because we believe that prevention, detection, containment, and elimination of animal risks and diseases has a direct effect to human life, livelihoods, food security and trade in food and agriculture sectors.” Through the FAO-USAID partnership, FAO is supporting the implementation of Uganda’s National Action Plan for Health Security (NAPHS) implementation through several technical action packages, including Antimicrobial Resistance, Zoonotic diseases, Biosecurity and Biosafety, National laboratory systems, Surveillance and workforce development.

 “On-site visits of Ministries that are key in detection and responding to PHE&T showed that only 40 % of the activities under the nineteen (19) technical areas to be assessed had funds allocated while 17% and 43% had no funds and partial funding, respectively,” said Mr Timothy Lubanga (Commissioner for Monitoring and Evaluation, OPM). 

 “Uganda made a commitment from the previous JEE to license all laboratories, including those from the animal sector, build capacity at 5 points of entry (POEs) and decentralize OH in 50 districts by 2024 (but only 34 districts had been covered).”

Implementation of the of the NAPHS (2018-2023) has brought several positive effects as shared by the different key ministries and agencies, including; the Ministry of Agriculture, Animal Industry and Fisheries (MAAIF), Ministry of Health (MOH), Ministry of Water and Environment (MWE), Uganda wildlife authority (UWA), Office of Prime Minister (OPM), president’s office (OP), Ministry of Gender and Labour service development (MGLD), Public health operational emergency Centre (PHEOC), Ministry of trade and wildlife antiquities, Ministry of Finance (MoF), Baylor-Uganda, Ministry of Defence (MoD), Uganda people’s Defence force (UPDF), IDI, CDC, USAID and WHO.

These efforts include: amendment of the Public Health Act,  Animal Diseases Act, strengthening zoonotic disease surveillance through electronic reporting tools and standard case definitions, strengthening of laboratory systems; including establishment of a biosafety level 2 laboratory at Queen Elizabeth National Park (and working towards accreditation in April, 2024) and six regional referral laboratories from MoH, safe water provision and  water testing in MWE, ecosystem restoration, designation of eight points of entry, implementing the 3rd Edition of the Integrated Disease Surveillance and Response, institutionalizing the 7-1-7 global timeliness framework for response to disease outbreaks , establishment of  regional Public Health Emergency Operation Centers and occupation safety and health department, Veterinary drug and  agrochemicals authority, establishment of operational chemical database and development of bio-risk policy, 2021 and review of Wildlife policy, 2014 and development of nuclear and radiological act.

There have been improvements in detecting and responding to public health emergencies and threats (PHE&T) due to various efforts. However, there are challenges in implementing the NAPHS, which include limited or delayed release of funds, prolonged use of draft frameworks and guidelines during activities, limited coordination among critical sectors, and issues with human resources and monitoring and evaluation.

At the same meeting, the prime minister also launched the internal self-assessment slated for 25-29 September 2023, ahead of the JEE in October 2023. Dr Dan Kyabayinze, the Public Health Director, MoH, urged relevant stakeholders to provide all necessary documentation to ease and fasten the exercise.