Bringo Fresh-Best bet for Ugandan urbanities hoping to increase on their per capita intake of natural foods

Quackery in Uganda's health sector-putting the lives of unsuspecting citizens at risk.

Who really administers people with fake hepatitis B vaccines and gets away with it, scot free?

Could the people found in possession of falsified hepatitis B vaccines from 8 health facilities in four districts by the health ministry’s post marketing surveillance team, last year and those currently selling body parts from Mulago hospital [Uganda’s main National Regional Hospitalpossibly be real doctors- who have predisposed to unscrupulous behaviour or quacks disguised as doctors?
The latter seems more plausible.

In recent years, many quack health care providers have brazenly taken mean advantage of the country’s weak health supervisory and regulatory laws, to set up shop in many villages and urban areas, across the country.

Numerous efforts by Health Ministry officials and the country’s Allied Health Professionals Council to rein in on them have bore little fruit and as a consequence, many innocent Ugandans continue to fall victim to their fake diagnosis and prescriptions.
“At the grassroot level, quack health care providers, operate right under the noses of health officials,” Fred Nayebare, the Gomba district resident district Commissioner, says.

While, to date, there are no reliable estimates on the numbers of quack medical personnel in Uganda and the extent of their services, it is an undeniable fact that weak health regulatory mechanisms have enabled their rise.

The issue of quack medical personnel is a harsh reality, which Winne Byanyima, the Executive Director of OXFAM international-alluded to in a commentary piece, she wrote, as the Ugandan government planned to import Cuban doctors, last year.

Uganda doctors had gone on strike, demanding better pay.

Weak regulation, she wrote enabled quack doctors to play with people’s lives.
In 2017, a rapid assessment of District Health Supervisory Authorities by the Health Ministry brought to light evidence of widespread quackery in the health sector.

Little has been done, since then, however, to address the problem.

In the village of Nsotoka in Kayunga district, for instance, quack medical practice has reared its ugly head, several times.

Brenda Nabisere, 26, had jarring experience with a quack health practitioner, late, last year.

The quack doctor has since disappeared from the village after Nabisere reported him to the Police after her ordeal.

Nabisere, a mother of two had gone to seek treatment for her malaria stricken daughter.

“I went to seek therapeutics from him for my sick daughter. I could not tell whether he was genuine or not. All I know is that, his clinic was accessible and many people in the village invariably sought his services,” Nabisere recounts.

The anticlimax came when Nabisere discovered he had been giving her wrong medicines to treat her daughter.

“My daughter’s condition did not improve, so I sought help elsewhere. I went to a clinic in Mukono and I asked the doctor about the mixture of pills medications, I had been using. I showed him some of the medicines and he was aghast,” she says.

Experts from the Allied Health Professionals Council, a body mandated by the Ugandan government to regulate, supervise and control allied health professionals and to supervise their registration and licensing, acknowledge that the incidence of quacks is a major headache for the country’s health care system.

“Quack medical personnel prey on the poor and ignorant. They put the lives of unsuspecting Ugandans at risk. Nobody wants to see a scenario where Ugandans are suffering irreparable physical and internal deformities or are having their ailments exacerbated by wrong medications and ill prescribed therapeutics,” Doctor Fred Nyankori, the deputy Registrar of the Uganda Medical and Dental Practitioners Councils opines.

Why quack medical practice is rife

Several health experts are quick to point out that quackery in the health sector thrives on account of the scarcity of qualified doctors.

“A shortage of health human resources in rural areas and laxity on the part of the district health inspectors leaves most rural areas open to medical fraudsters. There is no sector free from quacks but their pervasiveness in the health sector is worrying,” Nyankori says.

“In some areas around the country, communities have been complicit in shielding quacks especially when personnel from the District Health Supervisory Authority seek to question and apprehend them. The quacks see these gaps and take advantage.”

Besides a shortage in the numbers and skills mix of human resources for health, there is also the problem of poor attitude on the part of the existing health workforce.

“The poor attitude is drawn forth by perceived unattractive remuneration, insufficient training capacity; whilst some medical personnel are indisposed to transfers. These challenges unfortunately present an opportunity for unqualified, unregistered and unregulated personnel to exploit,” David Ssekaboga, the Wakiso district health Inspector, says.

Experts suggest solutions

Patrick Mpiima the Registrar of the Allied Health Professionals Council says for the problem to be tackled in earnest, there will have to be a concerted effort.

“There is a need for a combined effort to rid the country’s healthcare system of frauds. The combined efforts should involve the Police, the district administrations, drug inspectors and communities. There are a big number of fake and unqualified people freely issuing medications and treating people, especially in the rural areas,” Mpiima says.

“People who pretend to practice medicine, but have no training, qualifications and registration from appropriate councils and authorities like the Health Professional Councils and the Pharmacy board should be outlawed. Anyone operating a clinic or a drug shop should be licensed by a professional body.”

Will the recently issued guidelines for Health Supervisory Authorities impact?

Doctor Katumba Ssentongo, the Registrar of the Uganda Medical and Dental Professionals Council says the guidelines issued by the health Ministry will come in handy in ensuring proper regulation of health practices in the country.

“The guidelines launched recently, outlaw any illegal medical practice. Local governments will have to step up efforts to ensure that no unauthorized drug shops or clinics operate in their jurisdictions without registration and without a license,” Ssentongo says.

“That is because there has been some laxity on their part, yet the local government Act 2001 gives them authority to manage health services in their districts. Henceforth, all local governments will be required to make a database enumerating all clinics and drug shops registered within their areas.”

In the Health Development Plan (2015-2020) Uganda’s health sector commits to ensuring provision of high quality health care for all its citizens.
Experts say if the above is to be attained; the sector must put into execution an effective supervisory and regulatory mechanism.

“Regulation of health practice and professionals is the mandate of health professional councils and the Pharmacy Board. Enforcement constraints and other challenges have however played havoc with their work and as a consequence, quack medical personnel continue to thrive. Our expectations are that these new guidelines will bring change to bear,” Ssentongo says.

Nayebare says for the quackery problem to be dispensed with, weaknesses within the District Health Supervisory Authorities will have to be addressed.

“A lack of integrity is stifling the District Health Supervisory Authorities.
How do unqualified people who on many occasions have the nerve to advertise their services operate without the knowledge of the authorities?” Nayebare asks.

“The apathy aiding this problem and the glaring other weak points especially those to do with integrity will need to be addressed. With the guidelines, our expectations are that there will now be regular and consistent crackdown on illegal drug shops and clinics run by unqualified people across the country.”

Doctor Susan Wandera, the deputy chief of party at IntraHealth Uganda; the entity that developed the guidelines and that has collaborated with the Ugandan government in training health workers, says the guidelines will strengthen health regulatory mechanisms at the national, regional, district and lower levels.

“The expectation is that the health regulations, principally those dealing with quack medical personnel will bear down. Registration and licensing of drug shops and clinics around the country is still low and that calls for action. In general, the public needs to be educated more about the dangers of seeking treatment from unqualified practitioners. The government should also disseminate helpful health information in various local languages to help people steer clear of unqualified health practitioners,” Wandera says.

Ssentongo says sustained enlightenment will be key in both rural and urban areas to enable health seekers know what to look out for whilst making up their minds on where to go for diagnosis or to undergo treatment.

Government Policies

In 2011, the government through the Uganda Medical and Dental Practitioners Councils introduced a web based system for registering all medical officers and dentists in the country.

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Always been an exercise aficionado. Read-here, how I became one


Starting an exercise regime at the beginning of 2014 seemed, hard and boring, though, on several occasions, I had gotten a feel of it, while dancing to the pulsating percussion driven-Kadodi dance of Eastern Uganda. 
It happens to be my traditional dance.

I started exercising as a way of keeping fit, cutting weight and beating off disease and mood disorders like depression.

Getting into a steady stride and making it enjoyable took quite some time, however.

When I gradually got into a stride, exercise became as normal as brushing teeth and at length, I become an exercise freak.
Practice does indeed make perfect.

I have since won several medals, as a result of running, including two medals from the last two MTN Uganda- Marathons (21kms race).

I always have this “new lease of life” feeling after I hit the road, jogging with my friends. 

In the course of time, exercise has toned different parts of my body and muscles and to date, my childhood and High school friends, wonder how I manage to stay lean and fit, while they hit their dotage.
Nor that they are too old, anyway. Most are in their mid and late 30’s.

Before I began my exercise regime, I was a slouch with a lot of body fat around my mid section [midriff area of the body].

For the most part, even when I played basketball in High School and during school holidays, my leg and hand muscles were frail.

Having a well toned body and strong muscles means spells stronger bones, fewer injuries and healthy bone density.

I may not be as chiseled as Shaun T, the American fitness trainer and choreographer, but you can bet your bottom dollar, I will be like him, in a few years, as long as I maintain the spirit.

Ten to one, I will and if you maintain the spirit, too, chances are high; you will achieve the same results.


A doctor friend by the names of Fred Womudenyi, who is a physician in Mbale, in the East of Uganda, advised me to get a medical evaluation before I embarked on my fitness regime.

“It is the right thing to do, though few people do it. It is good to evaluate how much and how often, you will exercise, depending on your health status. People with cardiovascular [heart] problems particularly, should get approval from their physician, first before beginning an exercise regime,” Womudenyi said.

“Before beginning a fitness program, consider also basic factors like intensity {how hard you are going to work out}, frequency, the type of exercise and duration {how long you are going to work out}.
For total fitness, an exercise program should include exercises for endurance, muscular strengthen and flexibility.

“Endurance is the ability to do something difficult for a long time, while flexibility refers to the range of movements in joints and muscles.
Exercises for endurance include jogging, swimming, bicycling and aerobics.
Exercises for flexibility are mostly stretching exercises. These are necessary to improve and maintain the range of movement in muscles and joints,” Peter Kityo, fitness instructor in Kira, Wakiso district, says.

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I never knew my enjoyment of certain foods would come at a price, laments Simon Kuloba, a 36 year old Car Mechanic plying his trade in Mbale’s boisterous industrial area. “Soon after eating some foods, i experience pain, discomfort and an acidy feeling around my chest and upper abdomen. my productivity has steadily been going down. While many may dismiss it as a minor condition or more than just another uncomfortable inconvenience, Physician Steve Wantenyeli of Mukhuwa Health center, Mbale says heartburn acid reflux should not be treated lightly especially when it occurs frequently.
“Heartburn is a serious condition that should not be ignored. it affects 2 out of every 25 people in Uganda, at a rate of at least twice a week. digestive acids or bile in the stomach trigger heartburn by making contact with the lining of the esophagus.”
These digestive acids, Wantenyeli points out, are meant to stay in the stomach and not to go flow back to the esophagus.
“When digestive acids frequently go back to the esophagus, the delicate lining of the esophagus is slowly destroyed”.
Heartburn as a condition has nothing to do with the heart, Wantenyeli asserts. “It’s in effect a digestive problem that can lead to a more serious condition called barrett’s esophagus or cancer of the esophagus if a physician is not consulted.”
He adds that if heartburn is temporary, it can dealt with some simple dietary and lifestyle changes.
Dietian Omoding Samuel of Namakwekwe health clinic, Mbale stresses that if heartburn becomes chronic, it can lead to gastro esophageal reflux disease, disease he says occurs when acids from the stomach literally burn the esophagus(tube running from the throat to the stomach).

Heartburn occurs when people consume or partake on foods that are acid forming such as citrus fruits, tomatoes, fried and fatty foods, caffeine and garlic. Omoding states. “when highly acidic gastric juices from the stomach spurt up through one’s esophagus, irritation normally occurs,resulting in a pain (heartburn).”

Over eating, Omoding says is also one of the major causes of heart burn. “When one over eats, the stomach takes longer to digest the food resulting in stomach acid returning back up to the esophagus. This spawns an acidic reflux or heartburn”.
Some foods trigger heartburn more than others.
“If you partake on too much fast food, chocolate, consume to many fizzy drinks and combine these with either smoking or drinking alcohol, you increase your risk of developing heartburn” states omoding
Certain gastrointestinal disorders aggravate or make heartburn worse. physician Steve Wantenyeli says heartburn can be triggered off by a hiatal hernia which is where the stomach protrudes a little into the chest through the diaphragm.


Dietian Omoding says factors such as age, lifestyle, family history and other medical conditions determine the severity of heartburn in most people.
In most cases however, many people experience the same symptoms as enumerated below.
• Pain caused by heartburn, Omoding says will be at varying levels. anywhere from your stomach upward, but most commonly in the throat.
This sporadic pain Omoding says can come and go or be constant, or be degenerate.
Where severe heartburn is experienced, the pain experienced by some people can be unbearable.
• A burning sensation caused by acids coming back up into the esophagus.
Omoding says the burning sensation comes in the form of a burp that gives a burning feeling.
• Heart burn Omoding says can make the throat become painfully sore with a burning sensation due to the constant aggravation of the stomach acids.


To steer clear of heartburn, Wantenyeli says, eat more frequently but in smaller portions. Overeating he says triggers heartburn. “try eating six smaller meals throughout the day. eating smaller portions enables your body to digest food more easily”.

To forestall heartburn, meals close to bed time should be avoided. Having one’s last meal about two to three hours before going to bed is important in stemming a heartburn tide, Wantenyeli adds.

Carrying excess weight around your middle section spells pressure on your stomach especially after eating.
This pressure, Wantenyeli says can eventually lead to or aggravate one’s heartburn condition.

Fried, greasy and fatty foods are foods one should stay away from as they cause or exacerbate heartburn.
Fats, Wantenyeli says weaken the lower esophageal sphincter muscle. As a consequence, stomach acids flow back up into the esophagus. This, at length, causes heartburn.

Over the counter acid reflux antacids can also be effective in alleviating heartburn.
“Antacid tablets like ranitidine, cimetidine, famotidine, and omeprazole magnesium are not only a good economical choice but therapeutic as well. if they are taken before bedtime, they come in handy in subduing heartburn. Wantenyeli stresses.

If you’re a smoker/drinker and suffer from heartburn more often, break your habit or cut down on alcohol or nicotine considerably.
Nicotine from cigarette smoke, Wantenyeli adds tends to irritate the lower oesophageal sphincter, which is a valve that stops stomach acids from rising up and irritating the esophagus.

Invariably keeping your head up, especially when eating, drinking or sleeping, can help subdue heartburn. Dietian Omoding Samuel says lying down 1 to 3 hours after eating and drinking increases the likelihood of heartburn occurring.
Another good remedy for that nagging heartburn can be got from your kitchen cabinet in the form of a tablespoon of both honey and apple cider vinegar in a cup of warm water. Omoding says a few common kitchen spices like cinnamon, ginger or sage tea, as well as cardamom in baked goods or cereal, can aid with chronic heartburn.
Heartburn, Omoding asserts can also be cooled off with stomach soothing drinks like papaya, guava, pear, or mango juice. “aside of that, a cold glass of buttermilk and foods such as blanched almonds, brown rice, soda crackers, and apples can be helpful. regular intake of milk however should be avoided especially if one suffers from lactose intolerance.”

Try as much as possible to avoid carbonated drinks such as energy drinks or juices, soda coffee, wine, etc. Omoding says carbonated drinks contain phosphoric acid, which in the course of time,causes burping. burping he says sends stomach acid to the esophagus, possibly forming cancerous lesions. This reflex eventually causes heartburn.

Chewing gum especially that without peppermint and spearmint, Omoding says is another effective way of subduing heartburn acid reflux.
Chewing gum he adds contains baking soda which is a natural heartburn remedy
“Chewing gum for about half an hour, after a meal produces saliva that counteracts stomach acids. this prevents heartburn”.
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Belly fat could end your life

Shedding off this excess abdominal fat is going to be my highest priority from now on,” says 34-year-old Wilson Nambafu, a middle class Mbale urbanite. His belly bulge has got his folks and friends talking. “They all say I have ‘fallen in things’ (meaning life is good), yet this is far from the truth. My belly fat worries me because I could develop health problems in the future,” Nambafu says. Physician Fred Wamudenyi of Bumboi Health Centre in Mbale, says, whilst some amount of abdominal fat may be normal, excess belly fat is unhealthy. Health risks “Carrying extra fat around one’s midsection is not only unflattering in terms of appearance, but it also poses a huge health risk. Visceral abdominal fat, which gives most men apple-shaped beer belly appearances, is particularly dangerous because it releases inflammatory molecules into one’s body on a consistent basis,” he says. These inflammatory molecules, Wamudenyi points out, adversely affect the proper functioning of the heart and eventually infiltrate the liver. Wamudenyi says that a big waistline greatly increases the risk of developing heart disease, metabolic syndrome, osteoporosis (a medical condition in which bones become fragile from loss of tissue), diabetes, high blood pressure, strokes, sleep disorders, various forms of cancer and other degenerative diseases.” “Men and women with a circumference of more than 40 inches around the waist run a higher risk of contracting the above conditions. The appropriate waist line should be 33 to 35 inches,” Wamudenyi notes. He adds that skin fold thickness around the midsection for teenage boys should be less than 3/5 inches and less than 1 inch for teenage girls. - See more at:




A few days ago, Jacob Wabuyi rose with the lark. He said a prayer and embarked on his journey, hoping to make it in time for his 9 o’clock Job interview at Housing Finance bank nearKololo Airstrip. Ill fatedly however, Jacob got caught up in an early morning traffic jam at Kubiri, just a stone’s throw away from Wandegeya. At length, Jacob arrived at Housing Finance but he had missed the interview. The ordeal left a depressing damper on Jacob’s spirits. Being prone to low feelings and depression from stressful experiences like Jacob’s is common place but the effects of stress on somebody, Doctor Andrew Bunoti, a Mbale based Stress Psychotherapist notes are dependent in part on his or her inherited strengths, weaknesses and physical condition.

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 It is decline of evening, the silence is deafening, the bird chirps dying down. Whilst the village kids frolic, deeply engrossed in their play time. Without a shadow of a doubt, this Village provides the best and widest view of that famous Mbale landmark-mountain Wanale.

It is said a traveler without observation is like a bird without wings. Was i about to be that bird? No, so i kept moving, whilst at the same time, my eyes cast about keenly observing. As i traverse further through Mango Village, Namalogo Parish, Bumboi, Mbale, my eyes bask in a glow, as they feast on lots of interesting sights and sounds. The pity however that later stares me In the face when I come across frail, disheveled and diseased 27 year old Waniaye Yassin threatens to ruin my hitherto placid and enjoyable sojourn. On the face of It, Waniaye is awkwardly emaciated. He is clearly out of sorts with a sickness that is eating away both his legs. Saddled with this depreciating Illness, one would assume, Waniaye Is out of humor and despondent. On seeing him, I thought he was a Kill joy.

Waniaye however Is a far cry from that and hardly fits that stereotype of a very sick person. 

“To me, despondency with my kind of condition and circumstances, Is only Ingratitude, the hope I have now will help me overcome my situation”, Waniaye asserts The Illness has not locked away Waniaye’s smile, nor has It deprived him of his cheerfulness, buoyancy, warm-heartedness and courtesy.

It Is all evident as Waniaye welcomes me with a crack of a smile, I can only describe as hale and hearty. What Is apparent Is Waniaye’s frailty and illness has not dampened his spirits. The physical fatigue that however has come with his illness Is discernible. As It seems, his body has expended a great deal of energy fighting the Illness.

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The Ministry of health in Uganda has secured $20 million from the Global Financing Facility to foster the result based financing initiative, which aims at improving the quality of health care at health facilities country wide.
Prof. Anthony Mbonye, the Director of health services in charge of Clinical and Community Health in the Ministry of Health revealed this while addressing Journalists at the first national symposium on universal health coverage that took place last week at Silver springs Hotel.

“The hope is that more private and public health facilities will get accreditation because the more a facility avails services to pregnant women and children of immunisable age, the more funding it gets. This performance based funding is meant to improve quality of care at health facilities and to make sure health workers get allowances, uniforms and buy supplies. This will be one of our stronger paths to universal health coverage,”He said.

 At the symposium, there were further earnest deliberations on how best Uganda can build an understanding on attaining universal health coverage. Universal health coverage, according to the World Health Organization (WHO) is the goal that all people have access to health services and do not suffer financial hardship in paying for them. It ensures that all people have access to needed promotive, preventive, curative and rehabilitative health services of sufficient quality. The symposium was convened by Makerere University School of Public Health under the umbrella of the Supporting Policy Engagement for Evidence-based Decisions (SPEED) project- an initiative that focuses on advancing Universal Health Coverage in Uganda.

Speaking on the opening day of the symposium, Prof. Freddie Ssengooba of the Makerere University School of Public Health, College of Health Sciences (MakCHS) noted that the trajectory towards achieving universal health coverage in Uganda is gaining momentum, notwithstanding the many challenges, the country faces.  "As a nation, we need to begin positioning ourselves on how best to achieve this development agenda. Universal health coverage is central to the question of how health should be represented in the new development agenda that will succeed the Millennium Development Goals this year," said Ssengooba.

"The process of developing the new Health Sector Strategic and Investment Plan (HSSIP) of 2015-2020 by the Ministry of Health is a welcome development and a step in the right direction. The goal of Universal Health Coverage which is being inserted into Uganda's health policy is still new to many. These deliberations are meant to help us understand the idea of Universal Health Coverage and what its implications are for the different stakeholders like the government, the private sector and academia."

       Whilst everyone acknowledges that the goal of attaining universal health coverage will be no mean feat, the government seems intent on making it feasible and bringing changes to bear especially as regards the provision of cost effective health interventions for the poorest of its citizens, a key prerequisite if the programme is to fall in line with the requirements of the WHO. Mbonye noted that the government was obliged to provide interventions such as antenatal care, family planning, curative and rehabilitative care to all its citizens. "In South Eastern and Eastern Uganda, a Voucher system has been introduced to enable poor pregnant women to access antenatal and delivery health care services at every visit. A woman will only be required to pay 3000 shillings. The Voucher scheme will be rolled out in the next six months countrywide," Mbonye said.

"The pilot project registered many successes. It is on the basis of that, that we were able to get funding from the World Bank for the scheme. We are also working on the National Health Insurance Initiative, which essentially aims at improving our health indicators. It is now with the Parliamentary council and there is green light from the Ministry of Finance regarding funds for it."   Dr. Patrick Kadama, the Executive Director of the Platform on Human Resources for Health at the African Centre for Global Health and Social Transformation underscored that for Uganda to accelerate towards universal health coverage (UHC), a number of critical reforms need to be put forth to achieve equity.  "There is need for reforms to manage the social determinants of health through stronger inter-sectoral action. We also need reforms to introduce patient centered or family based health care services, and reforms to strengthen health governance and management," Kadama explained.


Low access to safe, clean drinking water and sanitation

          Dominic Kavutse, an engineer from the Directorate of Water Development, Ministry of Water and Environment noted that the current access to safe water supply and sanitation in Uganda stands at 65%. 
          "That leaves 35% of the Ugandan population with access but not safe access.  That translates into 10 million Ugandans exposed to water-borne diseases due to consuming unsafe water. There are 110,000 water points in the country.  Out of the budget we have we are able to produce new water sources for about 800,000 people per year but the population increases by at least 1.2 million people per year. At the present rate of investment, the coverage of water supply and sanitation is going down," Kavutse said.

The inaptitude of the health system in Uganda

            Dr. Stephen Lock, the acting head of Cooperation, Delegation of the European Union noted that whilst there have been notable declines in the infant mortality ratios and HIV related deaths, the health system in Uganda is still lagging behind in terms of providing 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. There are still pertinent questions to answer regarding the functionality of public hospitals which are the most visible aspects of health system capabilities," Lock stated.
Out of the pocket payments as a major barrier to health access
       "Direct payments have serious implications for health. Making people pay at health facilities or other points of delivery dissuades them from using services (particularly health promotion and prevention). That in essence means they do not receive treatment early and they steer clear of health checks. The absence of financial protection in Uganda's health system calls for concerted action aimed at reducing the large proportion of out-of-pocket payments currently present in total health financing." Ssengooba observed.

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Thirty one years after the discovery of HIV, a cure still remains a distant reality.
The very complicated nature and variety of HIV has meant that the virus has resisted even the most vigorous of attempts by scientists to eliminate it and to quell its spread.
That a cure has eluded scientists this long, is in a way, an indictment in itself, but it is worth noting that there have been real glimmers of hope, in recent years, principally in the area of scientific research on drugs to mitigate and suppress the deadly virus.
Those glimmers of hope have manifested in the radical advances made by scientists in developing antiretroviral therapies that control HIV viral replication in a person’s body and allow an individual’s immune system to strengthen and regain its capacity to fight off infections.
The antiretroviral therapies may not be curative but they have, by and large, led to favourable outcomes amongst many people living with HIV, not only in Uganda but world over.
The upshot has been many of them living longer.

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