The health sector in Uganda faced multiple challenges in 2012. At the end of the year, reports ranked Uganda's health sector as the most corrupt in the East African region, citing extensive problems with bribery and health care worker absenteeism as major contributors. Uganda also saw worrying reversals in its generally successful HIV/AIDS prevention programme, as well as outbreaks of several rare diseases, including nodding disease, Ebola virus and Marburg haemorrhagic fever. The Ugandan parliament threatened to block the entire national budget unless there was an increase in funding for the health sector, which the WHO had described as having a severe health worker shortage. For minorities and indigenous peoples, who generally have less access to health services than the general population as a result of marginalization and poverty, these nationwide health sector challenges can have an disproportionate impact.

In a shadow report to the UN Universal Periodic Review process for Uganda, a coalition of minority and indigenous rights groups highlighted concerns about health status and access to services. Major challenges included (1) loss of access to traditional medicinal herbs because of environmental degradation and land loss, as well as reduced transmission of knowledge on traditional methods of healing; (2) failures of the Ugandan health system to account for minority and indigenous peoples' needs in their policy and planning processes; and (3) lack of culturally appropriate health service provision, especially in the area of reproductive health. The coalition reported statistics that highlight disparities in health status:

'[A]mong the Batwa women of Kisoro, there are two still births out of every dozen live births (with an infant mortality rate of 17 per cent) and only five out of 10 children reach their first birthday. Further, out of those five children, few reach their fifteenth birthday. These figures are far worse than the national averages, i.e. an 11 per cent infant mortality rate, and an 18 per cent chance of dying before the first birthday.'

HIV/AIDS also often has a disproportionate impact on minorities and indigenous peoples, so increasing rates in 2012 are a concern. For many years there were substantial drops in HIV infection rates in Uganda, attributed to a high-profile public-awareness campaign, testing programmes, treatment provision, and substantial donor support. From 1992 to 2000, HIV prevalence rates dropped from 18.5 per cent to 5 per cent,[5] but data released in 2012 indicated that this trend is reversing, with a prevalence rate of 7.3 per cent. Rates are increasing across the population, in urban and rural areas, and in particular among adult married couples.

Loss of access to and control over land and natural resources are also related to health status for minorities in Uganda. In mid-2012, Uganda announced that oil reserves initially discovered in 2010 were even larger than reported, amounting to 3.5 billion barrels. The Buliisa district, inhabited by the Bagungu indigenous fishing community, has been a major centre for oil exploration, which has led to community concerns about possible environmental damage and the spillage of toxic material in the area, which could have negative impacts on health status. The oil company operating in the region has funded the construction of a local hospital (yet to open), sponsored male circumcision campaigns to reduce the risk of HIV infection, and has also trained peer health educators in local villages.


5. Uganda AIDS Commission, Global AIDS Response Progress Report – Uganda, April 2012, retrieved June 2013,….

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