With the numbers of coronavirus infections and deaths soaring every day, Uganda's portion of the pandemic seems to be on a steady climb and so is the scale of expenditure on government efforts to stop the spread of the highly infectious viral disease.
There have been more than 78,394 confirmed cases of Covid-19. The virus has killed more than 903, according to official statistics released by the ministry of Health on June 25.
However, the amount of money spent in the last one year and three months to stem the spread of one of the world's largest outbreaks has largely been obscured.
But aided by the ministry of Finance-sponsored report released in May 2021 titled; "Semi-Annual Performance of the Covid-19 Economic Stimulus Package, FY 2020/21 Budget Monitoring and Accountability Unit, The Observer has been able to get an insightful sneak peek into every government intervention and Covid-19-related expenditure.
We have tracked every expenditure, contractor, items or services procured. Below are some of the expenditures.
The total budget for the multi-sectoral Covid-19 response was Shs 2,221,990,315,936 (US$ 600,535,742) from March 2020 to June 2021, according to the report.
The ministry of Health received both budget and off-budget support from various funders including World Bank, Global Fund and GAVI worth about Shs 750, 404,652,823. As of March 31, 2021, the MoH had spent about Shs 617,837,683,787 (82%) of the released funds.
The ministry of Health planned a number of interventions under eight pillars: leadership, stewardship, coordination and oversight; surveillance and laboratory; case management; strategic information, research and innovation (SIRI); risk communication and social mobilization (RCSM); community engagement and social protection initiatives; logistics; and continuity of Essential Health Services.
The report defines Covid-19 spending to "include all spending that would have not occurred in the absence of Covid-19".
"For FY 2020/21, Uganda appropriated Shs 1,240,688,628,8322 on various aspects of the economic stimulus package. The expenditures were made to Ministry of Health; Ministry of Science, Technology and Innovation; Ministry of Finance, Planning and Economic Development; and Ministry of Gender, Labour and Social Development," the report partly suggests.
Under the economic stimulus package, a number of Covid-19 health-related outputs were planned. These included: Non-medical masks procured and distributed; ICU facilities in regional referral hospitals as Covid-19 treatment centers established; Covid-19 laboratory and testing kits procured; blood collection materials for Uganda Blood Transfusion Services (UBTS) procured; Personal Protective Equipment (PPEs) procured and distributed; Emergency ambulance and boats procured; Mega phones for communication procured and distributed.
Others were: Oxygen plants at Entebbe and Mulago National Referral Hospital procured and installed, furniture and fixtures procured; 20 sleeper tents procured; ICT and equipment including software procured; Border post health units including staff houses constructed; Oxygen plant house at Mulago National Referral Hospital constructed; accommodation hired to quarantine abroad returnees, Covid-19 suspects and health workers at border posts; Meals provided; fuel procured; spray pumps procured; Funds transferred to hospitals and local governments to support surveillance, contact tracing, sample collection and case management for Covid-19 patients undertaken.
The report says the above interventions were expected to translate into control of Covid-19 and reduction of transmission, morbidity and mortality in a bid to minimise the socio-economic disruption resulting from this pandemic.
The report is based on selected interventions of the Health sector that received the economic stimulus package. Monitoring involved assessment of the performance of selected treatment centres, including Mulago National Referral Hospital, Namboole National Isolation/Treatment Facility, Regional Referral Hospitals (RRHs), Testing Centres, Selected Points of Entry to Uganda and in some Local Governments (LGs) that housed quarantine centres.
It also involved assessment of Testing Laboratories such as Central Public Health Laboratories that mainly coordinated the procurement and distribution of testing kits. A total of 205 respondents from the above-mentioned facilities were interviewed.
Overall performance analysis extended to April 30 2021. Physical verification was mainly limited to the economic stimulus package extended to the Health sector under government totaling to Shs 252,004,219,6694 as at March 2021.
Here's how the ministry of Health spent the allocated money between March 2020 and March 2021.
MASKS
As a preventive measure, the MoH planned to procure non-medical masks for all individuals aged six years and above. According to the Covid-19 preparedness and response plan, the masks were expected to be procured and distributed in June, July and August 2020 and later again in March and April 2021.
The MoH signed contracts with various suppliers including Fine Spinners Ltd, Southern Range Nyanza, Graphic Systems Limited, Big Concepts Limited, Silk Events Ltd, Christex Garment Industry, Winfred Fashion Limited, among others, to produce 36,321,051 masks in various lots of which 33,728,087 masks were for community distribution, while 2,583,621 were for the candidate classes at the schools.
By 31st March 2021, the MoH had cumulatively paid out Shs 78,837,851,159 for procurement of non-medical masks, of which Shs 53 billion was paid during FY 2020/21 and Shs 25 billion paid in the previous FY 2019/20. Additionally, about Shs 594,496,282 was spent on distribution of non-medical masks to various districts.
About 36.3 millon masks were distributed to various districts across the country. Each individual, according to the report, was entitled to one mask; however some local governments distributed two masks per individual. This partially led to inadequacy of non-medical masks in various communities.
The report says a total of 3.5 million masks were procured and distributed over and above the population projections. The MoH attributed this to two reasons:
a) Variances between UBOS population projections and that on ground. ".... Oftentimes, population figures on ground are higher than the UBOS projections numbers; that is why we procure items including mosquito nets slightly above the projections to ensure that everybody is covered....." Commissioner Planning, MoH.
EMERGENCY AMBULANCE, BOATS PROCURED
About 38 ambulances worth Shs 11 billion were procured by M/s AutoZone Armor Processing Cars L.L.C through M/s City Ambulance Limited. As at 31st December, 2020, the ambulances were delivered and most deployed to various referral hospitals with each facility receiving at least two ambulances.
The three boat ambulances were, however, not yet deployed by February 2021 and were docked at Munyonyo under the custody of the ministry of Internal Affairs. Cumulatively, the MoH had received 104 ambulances as at 31st March 2021 supported by both the GoU and development partners.
Covid-19 TESTING KITS
In order to achieve the Covid-19 testing targets, the MoH planned to procure a total of 2,804,515 testing kits and sample collection materials throughout the Covid- 19 response period. As at 31st March 2021, the MoH had committed and spent about Shs 29.7 billion on procurement of test kits and sample collec- tion materials for Covid-19 screening.
The service providers were Africa Bio System Uganda Limited; M/s Microhaem Scientifics and Medical Supplies Limited. The Africa Bio System Uganda Limited procured kits worth Shs 4.6 billion and delivered them to UVRI in September 2020. The UVRI also received Shs 146,400,000 for testing kit's evaluations (tests for the validity and reliability of test kits).
M/s Microhaem Scientifics and M/s Medical Supplies supplied kits worth Shs 6.6 billion to MoH, part of the deliveries were used to test samples collected from the Community Transmission Survey.
The MoH in addition signed two contracts for procurement of Altona Covid-19 laboratory testing kits (bundle) for mobile laboratory testing and reagents for the samples at the Points of Entry facilities, the report says.
The contracts worth Shs 4,609,181,250 and Shs 2,858,250,000 were signed between MoH; M/s Microhaem Scientifics and Medical Supplies Limited on September 8 2020 and September 30 2020 respectively. All deliveries were expected by January 31, 2021, according to the report. The latter was delivered by March 31 2021, while the former had not been delivered.
Overall, as at March 31, 2021, testing kits worth Shs 16,717,432,250 had been delivered to the Central Public Health Laboratories, Butabika and distributed to various Covid-19 testing laboratories including Tororo-Malaba, Adjumani–Elegu, UVRI, and Makerere University College of Health Sciences, among others.
"Overall, the MoH received over 1.8 million various types of testing kits and sample collection materials from both GoU and development partners. The biggest contributor to procurement of testing kits was Global Fund at 28%, followed by GoU," the report says.
PERSONAL PROTECTIVE EQUIPMENT (PPES)
The PPEs included surgical and N95 masks, cover overalls, aprons, gloves, cotton, and boots. Contracts worth Shs 8.5 billion were procured from various service providers. By March 31, 2021, the procured PPEs were delivered. Service providers included: National Medical Stores (NMS), JMS, SA Field Industrial Logistics, and N2M Company Ltd, among others.
Through development partners - Islamic Development Bank, Global Fund, World Bank, GAVI, UNICEF, UNTAID, WHO, Private Sector, LifeBox Foundation, CNOOC, CHAI, JICA, and IOM Japan, among others, PPEs worth over Shs 30 billion were procured, delivered and distributed to various entities.
SLEEPER TENTS PROCURED
The MoH contracted M/s Lumious Uganda Limited on June 22, 2020 at Shs 3,846,800,000 with an expected delivery date of July 15, 2020. Each of the 100-capacity tents was procured at Shs 163m. As at 31st December 2020, twenty (20) tents were delivered at Namboole stadium.
It was however, established that the stadium's turf was inappropriate for anchoring the sleeper tents. They were thus redeployed to the regional referral hospitals and other entities. Three were sent to the UPDF, one at Entebbe Isolation ward, one at Entebbe GH, one at Hoima RRH, while Soroti, Lira, Gulu, Arua, Moroto, Kabale, Fort Portal each received two tents.
Installation differed by hospital, with some installing one while others had both tents installed.
None of the tents was utilised due to the decline in number of Covid-19 patients, lack of space for full installation in some hospitals, and absence of concrete slab/ platform to anchor the tents. Laboratory Medical Sundries (test kits reagents, etc) cost Shs 30 billion.
And spent about Shs 23 billion on allowances for health workers. The ministry also spent about Shs 12 billion on fuel and lubricants from VIVO Energy as at March 31, 2021. Accommodation for returnees and contacts (Quarantine facilities) chewed Shs 3.5 billion.
The MoH quarantined various people in Kampala, Entebbe and various local governments as a prevention measure. Cumu- latively, the ministry accommodated over 2,500 Covid-19 suspects and returnees in various institutions.
The institutions included: Fisheries Training Institute, Dairy Development Authority (DDA) Training Institute, Institute of Surveys and Land Management, and National Meteorological Training School, among others. Others were accommodated at hotels and hostels.
Analysis focused on the quarantined period March 2020 to December 2020, the rest were assessed during the first Covid-19 Monitoring exercise done in FY 2019/20. The following was established: Although the ministry of Health had suspended quarantine facilities and introduced home-base quarantine and isolation, there was continued engagement of hotels from July to December 2020.
The MoH attributed this to inadequate space at Namboole National Isolation and Treatment Facility at the time of arrival of some returnees.
"For example, as at 31st December 2020, Grand Global Hotel had received Shs 380,769,480 for full board accommodation for Saudi Arabia returnees from 28th July to 5th September 2020 and 180 deported returnees from Saudi Arabia. Additionally, M/s Douglas Villa Hostel Ltd was paid a total Shs 374,598,080 for accommodation of returnees from 3rd to 19th July 2020," the report partly reads.
"The MoH also accommodated health workers at two POEs; these were: Happy Home Guest House-SMC Limited which
as at 31st December 2020, received Shs 227,976,000 for the accommodation services of health workers at Malaba Port of Entry in Tororo district. La Palm Suites & Spa Limited as at 31st December 2020, had received Shs 113,988,000 for the accommodation services to health workers at Busia."
MEALS GIVEN TO Covid-19 SUSPECTS
"The MoH contracted M/s Keba Investments Limited to provide meals to the National Taskforce, quarantine and treatment centers through a framework contract. The MoH had as at 31st March 2021 cumulatively spent Shs 6,316,971,269, of which Shs 3,874,370,881 was paid for catering services provided between July to December 2020 for quarantined people and health workers at Entebbe RRH, MoH Call Centre, Fisheries Training Institute, DDA Training Institute, National Meteorological Training School, Institute of Surveys and Land Man- agement, Namboole, Kabanyole, outside catering for the National Task Force (NTF) meetings NTF sub-committees, incident management, among others.
FUEL PROCURED
"Cumulatively as at 31st March 2021, the MoH had paid M/S Vivo Energy Uganda Limited Shs 11.66 billion to supply fuel for Covid-19 operations. These included support supervision, evacuation of patients and suspects, among other activities, across the country.
SPRAY PUMPS PROCURED
The contract was awarded to M/s N2M Company Limited at a sum of Shs 530m in June 2020. The pumps were meant to aid disinfection of places, materials of Covid-19 confined places, treatment centers, homes, ambulances, among others. These included: 80 mist sprayer, 99 power sprayers and 19 transport jet pump. These were supplied to various CTUs across the country.
ICT AND EQUIPMENT
The MoH renewed the Anti-Virus Licenses for 450 users from Tech Man Computer Solutions Limited on 28th May 2020. Five desktop computers were procured from M/s Kamage Enterprises Limited at Shs 24.3m. ICT equipment was also procured for Points-of-Entry at border facilities by Nutu Investments Limited. Development of E-card for fleet management was also done.
Mutukula and Katuna Points-of-Entry (POE) confirmed receipt of ICT supplies from the MoH.
BLOOD COLLECTION MATERIALS
Due to bans on large gathering, travel restrictions, closure of all schools and other social institutions caused by the pandemic, the UBTS could not effectively undertake its blood collection mandate.
It's against that background that the MoH contracted M/s Medical Solutions Uganda LTD to supply medical supplies worth Shs 2.2bn to ease blood collection by UBTS. These were supplied and included; hand gels, blood collections bags, hand sanitizer, liquid soap, and cotton wool among others.
The MoH also supported the UBTS by paying allowances to health workers that were involved in blood collection at various centres.
The additional supplies, according to the report, partly enabled the UBTS achieve its blood collection targets as well as attainment of its overall planned outputs and outcomes to 71% during FY 2019/20. No additional support was received during the period under review.
SURVEILLANCE, CONTACT TRACING, SAMPLE COLLECTION
As at 31st March 2021, the MoH had cumulatively transferred Shs 12,713,640,000 to hospitals and selected local governments.
In FY2019/20, the MoH transferred to each of the 16 RRHs Shs 270 million and Shs 165 million to each local government for Covid-19 surveillance, contact tracing, sample collection and case management. During FY2020/21, the MoH additionally transferred Shs 8.228 billion to selected LGs, regional, and national and RRHs.
The transferred funds were mainly used to pay arrears for allowances for frontline health workers, food, accommodation for both patients and health workers incurred between January 2020 and June 2020 except in a few instances activities undertaken from July to December 2020.
PRESIDENTIAL SCIENTIFIC INITIATIVE ON EPIDEMICS
During FY2020/21 scientists working under the Presidential Scientific Initiative on Epidemics (PRESIDE) were allocated Shs 31 billion towards research and development for Covid-19 response tools.
By 31st December 2020, Shs 25.87bn had been released to MoSTI, of which Shs 15.787bn is for equipment for Covid-19 research and development, and Shs 10.084 billion disbursed to PRESIDE secretariat for recurrent expenses of 23 research projects.
Procurement of equipment under PRESIDE was executed by Ministry of Science, Technology and Innovations (MoSTI). But one year and three months later, no tangible results have been realized.
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