The IDI Global Health Security (GHS) programme goal is to support health systems in Uganda and the rest of Africa to develop capabilities to prevent, detect and respond to infectious disease outbreaks and biologic threats. The programme continued to support the Ministry of Health (MoH), Ministry of Agriculture, Animal Industry and Fisheries (MAAIF) and other government departments to fill gaps identified by the 2017 Joint External Evaluation (JEE) while maintaining gains achieved in implementation of the Global Health Security Agenda.

Accelerating implementation of the International Health Regulations (2005)

Through the RESOLVE project, the programme supports the GoU to accelerate progress to comply with the IHR 2005. Technical support is provided through an Acceleration Team and resources are made available to complement investments made by the Government of Uganda and her partners for areas identified with no capacity status during the country 2017 Joint External Evaluation.

Laboratory Systems Strengthening

Leveraging on capacities strengthened through PEPFAR, the CDC funded Global Health Security Partner Engagement Project and the Fleming Fund Country Grant laboratory capabilities for the detection of priority diseases particularly zoonotic diseases and antimicrobial resistance were strengthened. This involved the improvement of microbiology testing capacities through Laboratory Quality Management Systems, infrastructure and equipment enhancement.

Biosafety and Biosecurity

GHS supported the Ministry of Science, Technology and Innovation to advocate for the development of a legal oversight system for biosafety and biosecurity to promote a shared culture of responsibility, reduce dual use risks, pathogen control measures and mitigate the risk of their deliberate and or accidental spread to human and animal populations. The National Biobanking Policy guidelines were developed, and the Annual Biosafety and Biosecurity audit supported.

Prevention of Antimicrobial Resistance

During the period, the National Action Plan for AMR (2018-2023) was launched with the help of IDI. The framework for the One Health AMR governance structures which includes One Health and sector specific Technical Working Groups was also described. Normative documents for AMR Surveillance were developed. These include the Human Health AMR Surveillance Plan (2019-2013), Clinical Protocol for Case Based and Syndromic AMR Surveillance, Site Manual for implementation of AMR surveillance; Animal Health AMR Surveillance Plan and the MAAIF protocol for Implementation of AMR Surveillance in poultry. Uganda for a 2nd year running managed to report country AMR surveillance data to the WHO Global Antimicrobial Surveillance System (GLASS). The programme also supported the 2019 National IPC Assessments and the 3rd in-depth AMU/C survey at 6 Regional Referral Hospitals.

Disease Surveillance, Preparedness and Response

During the year, GHS supported GoU efforts in preparedness, prevention and control measures for outbreaks including Ebola Virus Disease (EVD). Following the spill-over of an EVD case from DRC into Kasese, an innovative IPC approach informed by risk mapping based on population movement and connectivity assessments was conducted in 21 EVD high risk districts. Lessons from Kasese were integrated into the West Nile One Health project to develop a district-based model for preparedness and response. This model consists of 4 key components: Activation and strengthening of district preparedness, response and coordination structures; case management and IPC; surveillance and border health and laboratory systems strengthening.

Through the JMEDICC and CAPA-CT projects, the programme established a core team that can integrate with national outbreak response teams to support clinical management of severely ill patients with infections of outbreak potential. A capacity-building model for acquisition of competencies for enhanced laboratory biosafety and infection prevention and control for case management was developed and tested through drills and simulation exercises. Over 41 health workers were trained as part of efforts to build a surge response force. The programme also supported the CCHF outbreaks in Masindi and Jinja and Anthrax in Kween.

2019/2020 plans

The programme seeks to scale up sustainable infection prevention and control models to other areas of the country in the face of existing and emerging infectious diseases, and standardize surveillance of antimicrobial resistance and acute febrile illness with emphasis on improving data quality and sharing through advancing electronic systems. Plans are underway to acquire ultra-modern equipment for identification of bacteria, fungi and other organisms and fast-track CAP accreditation of the NMRL at UNHLS.