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No Inflated COVID-19 Fees, No ISO Investigation – MoH

The Health Ministry has described as false media reports that it’s officials are under probe by the Internal Security Organisation (ISO).

According to a statement issued on Monday, the Health Ministry Permanent Secretary, Dr Diana Atwine, says an article by ‘Sunday Monitor’ that ministry officials were under investigation over COVID-19 tests are fictitious.

“As far as Ministry is concerned, no inquiry or probe or any form of request as purported by the Sunday Monitor article has been received to-date from ISO and their co-investigators,” the statement says in part.

It adds, “Ministry of Health has not in any way been informed by these investigations and would therefore request Monitor Publication Ltd (the authors of Sunday Monitor) and their co-investigators to provide evidence of His Excellency the President’s instruction to share, in case we did not receive any correspondence.”

Diana has since appealed to the media to support the health ministry efforts to curb coronavirus instead of diverting its attention to fake news.

“The Ministry therefore calls upon the voices of reason especially media houses like Monitor Publications Ltd to support all our efforts rather than draw away the public from accessing care and build confidence in the services that we provide. We continue to remind everyone that nobody is above the law. If the report is genuine, it should be published and we clearly see the author and also subject the purported culprits to the arm of the law,” Diana says.

FULL STATEMENT BELOW

UPDATED RESPONSE To SUNDAY MONITOR ARTICLE ON COST OF coviD-19 TESTS BY PERMANENT SECRETARY.

Kampala; 14 September 2020- The Ministry’s attention has been drawn to an article titled “ISO investigates officials over COVID-19 testing kits” in the Sunday Monitor which was published on 13th September, 2020.

The Ministry of Health would like to categorically state as follows:

I, As far as Ministry is concerned, no inquiry or probe or any form of request as purported by the Sunday Monitor article has been received to-date from ISO and their co-investigators.

Il. Ministry of Health has not in any way been informed by these investigations and would therefore request Monitor Publication Ltd (the authors of Sunday Monitor) and their co-investigators to provide evidence of His Excellency the President’s instruction to share, in case we did not receive any correspondence.

  1. We are concerned by the unprofessional conduct exhibited by Monitor Publication Ltd. The article claims that Ministry of Health officials were “unreachable” at the time of publishing. We have a functional communication system in place, a Senior Public Relations Officer, who was also never contacted. Therefore, this article was written in bad faith and intended to malice the sector.
  2. There has been consistent misleading articles by the Daily Monitor intended to cause mistrust and portray a negative image of the Ministry of Health
  3. The article is full of inconsistencies and inaccuracies as to who exactly sanctioned the inquiry as there has been no evidence to that effect.

The article stated that that the ‘PCR test is fast and inexpensive technique’ while quoting Kary B. Mullis, who was awarded a nobel prize for Chemistry in 1993. However, this quote was quoted out of context with an intent to mislead the public.

The Ministry of Health would like to clarify as follows:

PCR is one of the most high end priced and time consuming (test results take a minimum of 4 hours) even in high subsidized tests like HIV. It ranges from USD 11$ (for HIV which has been highly subsidized) to USD 120$ for Hepatitis B. Therefore, this is very misleading to say that these test kits are inexpensive and fast.

With the emergence of COVID-19, pre-existing PCR equipment was already in place. These included: Roche at CPHL, Gene Xpert machines all over the country, aBi at Makerere and UVRI, mobile labs that use Altona. Abbott currently being used came onboard recently in August 2020. These use the World Health Organization (WHO) and FDA approved test kits to carry out COVID-19 tests. However, the Ministry of Health agrees with the author that PCR is the most important scientific advance in molecular biology. The recommended diagnostic technique by WHO for diagnosis of COVID-19 is the PCR test. Even after repeated assessment by WHO, the latest guidance issued on 11 th September, 2020 continues to emphasize the use of PCR as opposed to the so called cheap, affordable the famous “Nsereko” Rapid Antibody Diagnostic Test that has been pushed by so many middlemen in Uganda which has resulted in continuous social media attacks on Ministry of Health.

 
  

The article claims that the highest cost for testing COVID-19 was attributed to sample collection, transportation media and triple packaging

In response to the above, the Ministry would like to provide a detailed breakdown of the cost per person as per our procurement as of June 2020 as follows:

  • Nasal pharyngeal (nasal swab) — USD 1.80
  • Oral pharyngeal swab — USD 1.80
  • Triple packaging — USD 2.25
  • Universal Transport media- USD 8.50

Total                                                USD 14.35$

Additionally, other costs are due to freight and insurance. Whereas transport medium is regarded as a dangerous substance that should be transported only by sea, there was need to airlift these particular consumables because of the urgency at the time. However, in normal circumstances, it would have been much cheaper to transport this liquid substance via the sea. Therefore, this was the biggest cost driver then (April to June 2020) which unfortunately the investigator intentionally ignored.

Although, the authors were quick at condemning the key players as corrupt, at the time when Uganda was faced with the challenges that arose from the global lockdown, Ministry of Health together with the National Task Force were challenged with securing and transporting test kits in-country even to the extent that H E the President had offered his private jet to transport the test kits.

Government further explored the option of using Uganda Airlines to transport the test kits in order to continue COVID-19 testing in the country. However, we noted that it was not economically viable to charter a plane only to transport 500kg of the test kits.

Fortunately, the supplier finally secured a plane to transport the kits. Instead of appreciating these efforts to save lives of Ugandans, the investigators have selective amnesia and chosen to forget that H E the President in his numerous addresses to the nation referred that one of the biggest challenges facing the response was scarcity and transportation of test kits.

After realizing the high cost of transportation, Thank God for our scientists in the laboratory who developed a locally made transportation media that has since relieved Ministry from spending millions of shillings. I appreciate the patriotic scientists.

I recall when we were in a crisis at one time, we approached one of the sister countries to borrow supplies as we waited for ours to arrive. The supplies were delivered at the border point of entry at 2:00am. This underscores the fact that we did not want to create any gap in the COVID-19 response.

Ministry of Health is keen to get evidence to this effect as opposed to speculative and malicious statements against the sector.

The article claims that Uganda has received donations for COVID-19 testing from WHO, UNCIEF, Jack Ma and the public has not been informed of the quantities and exact materials donated. It further claims that the tests carried out so far have been carried out using donated kits and not procured kits.

The Ministry of Health would like to state as follows:

Much as it is not mandatory to announce every donation to the public, Ministry of Health set the standard of declaring all donations received both in-kind and in cash. This was intended to foster accountability and transparency.

For the first time in the history of Uganda, as a Government agency, Ministry of Health set the precedence of delivering public accountability for all COVID-19 funds on Sunday 21st June,2020 which was aired nationally, included partner contribution. Furthermore, the Ministry of Health is accounting through the constitutionally recognized bodies of financial accountability.

However, since the so called ‘investigative journalists/ authors’ missed out these details, the summary of donated test kits to-date is as follows:

Using the UN Consortium chaired by the WHO, the following PCR tests were secured:

  1. World Health Organization donated 40,000 tests that have since been delivered to UVRI
  2. UNITAID delivered 5000 to UVRI
  3. UNICEF delivered 8,000 to UVRI
  4. GAVI offered 80,000 tests. However, only 32,000 tests have been so far delivered

Other test kits donated included:

  1. Islamic Development Bank donated 50,000 tests which are yet to be received
  2. NSSF donated 10,000 tests and were delivered to UVRI
  3. Chinese Government donated 10,000 tests which were delivered to UVRI
  4. Jack Ma/ Ali Baba donated 38,000 tests that were delivered in two consignments to UVRI
  5. Government of Uganda through MTEF procured 40,000 tests
  6. Government of Uganda procured 100,000 tests
  7. East African Community provided 900 tests
  8. Global Fund has also supported Government of Uganda with 185, 141 test kits.

Therefore, the total tests received so far are 469,041 and total committed is 911,185. Of these, 434,243 tests have so far been carried out. It should be noted that some tests have not yet been delivered. It is suffice to note that some of these donations that were received by Government as indicated above were incomplete and required Government to procure the necessary consumables to enable full performance which additional costs were incurred by Government.

The ‘investigative journalists’ deliberately omitted the fact that 50% of the tests were procured by Government to cause mistrust, rage and mislead the public.

I also urge the ‘investigative journalists’ to verify the respective contributions from our partners.

The article states that “as of June 2020, public funds to a tune of USD 4.2M has been Zost on account of highly inflated sample collection and transportation kits”.

We wish to categorically state that the above statement is false, malicious and imaginary as it was merely based on assumptions by the authors. I therefore request the authors to provide the documentary evidence of the stated loss

According to the authors and their investigators, they quote Beijing Genomics Institute (BGI) as their reference in relation to the costs.

The authors implied that BGI is one of Ministry of Health suppliers which was not the case. Furthermore, they claim to have obtained the data from online sources.

The authors should have endeavored to establish the companies that supplied to Ministry of Health as of June in order to obtain better comparison, instead of benchmarking on a company that is yet to be pre-qualified by international regulators.

Ministry of health test kits are procured from Germany and the United States (US) because at the time, these companies were prequalified by WHO and FDA as of by June.

Ministry of health would like to clarify that the said company quoted by the authors has never been pre-qualified by the about authorities. It is important to note that BGI Europe, which is different from the one referred to in the article, was prequalified recently in August therefore it could not have been available to provide the kits by June.

It is therefore misleading to rely on a company that has not yet attained full pre-qualification. As custodians of Ugandans’ health, Ministry of Health ensures that all products imported the country for diagnostic purposes are validated and meet international Standards prior to use.

Therefore, Ministry of Health, advises all companies interested in procuring and supply of test kits in Uganda must ensure that all due processes both local and international are complied with.

The authors quote Ahmad Sayed, the regional Sales manager of Beijing Genomics Institute (BGI), and assert that the price of the sample collection, transportation medium and triple packaging is 22USD per test per person. We welcome the finding and solution as advanced by the authors but we cannot purchase as long as they have met international standards. At the same time, the test kits should be compatible with available in country equipment

Mismatched comparison

We appreciate the information of the cost of transport media ranging from USD 0.3 to 3 per kit. Therefore, would like to educate that authors that the comparison of Genexpert consumables and conventional PCR is a mismatch.

This juxtaposition was not only erroneous but misinformed. Therefore, the assumption of the said loss due to an inflated cost of USD33.69 per test per person, leading to purported loss of USD 4,232, 912 as of June, was built on wrong assumption. If the authors sought expert opinion from the scientists, it would have helped them with accurate information to the public.

With the above compounded allegation of loss worth USD 4.2 million, we request the authors to provide documentary evidence of this gross loss inform of a report otherwise this article will simply be regarded simply as malicious. The Ministry of Health open to provide all documentary evidence as provided in the Access to Information Act.

The Ministry of Health would like also to clarify on other outstanding issues as picked from social media:

Rationational for cost recovery Testing (65USD)

Contrary to what was reported by Monitor article, Uganda has the cheapest cost of testing per person in the region. However, this will change as cheaper options become available and other cost drivers such as transport reduces.

We have taken note with concern that the public has suffered at the hands of extortionists in the name of testing for COVID- 19. The Ministry would categorically wish to state that anyone who presents to the Government designated testing sites with symptoms, or are contacts of confirmed cases are tested FREE OF CHARGE. However, any person/ agency who wishes to test routinely or at leisure will be expected to pay USD 65$ (UGX 240,500). The public is therefore advised that they should NOT pay an individual to get a COVID- 19 test. All payments should be made at Stanbic Bank or their (Stanbic Bank) authorized agent and should present at the designated sample collection sites.

The account details are:

BANK NAME:         STANBIC BANK UGANDA

ACCOUNT NAME:    MOH coviD-19 TESTING FUNDS

ACCOUNT NUMBER: 9030017657983

Those who wish to undergo testing at the accredited private laboratory facilities which are: MBN Laboratory, Lancet, Medipal International Hospital and Makerere University Hospital are advised to do so and pay accordingly.

The Ministry has been notified of a one Jimmy-Jim on +256-785-142-165 who is NOT a staff member of the Ministry of Health. Anyone who deals with him does so at their own risk.

If you have been asked to pay cash for a COVID-19 test, kindly contact Emmanuel Ainebyoona on 0779-220-588 to enable Ministry of Health follow up the fraudsters and refund the affected individuals.

In conclusion, Ministry of Health wishes to assure the entire Government and the public in general that we are committed to transparency, accountability and value for money in all what we do. It is at such a time when we are faced with a global pandemic that threatens every citizen’s life, that we need utmost support because this a pan-war.

The Ministry therefore calls upon the voices of reason especially media houses like Monitor Publications Ltd to support all our efforts rather than draw away the public from accessing care and build confidence in the services that we provide. We continue to remind everyone that nobody is above the law. If the report is genuine, it should be published and we clearly see the author and also subject the purported culprits to the arm of the law.

The struggle continues, Stay safe.

Thank you.

Dr. Diana Atwine

PERMANENT SECRETARY

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