What new things did you learn during this lock down?

COVID-19 INSIGHTS

Soon, countries will begin to thaw from the COVID-19 global lockdown. Research and Academic journals will be flooded with all sorts of studies about the impact of the COVID-19 on a wide range of issues, from causation, pathogenesis, management to the economy, human rights violation, mental health, etc.

Ugandans will consume this literature passively. Personally, I have read quite a bit and participated in so many webinars initiated by academics, researchers, and professionals from various fields. The might of this pandemic has been hegemonic, freezing the world’s economy and consumptions. It has also stretched healthcare systems and placed spotlights on many social and historical inequalities in society.

In Europe and the US where its impact remains dramatic, we saw different people affected differently. The poor and the blacks were reportedly suffered a disproportionate level of hospitalization and mortality compared with other races. The bottom line is that COVID-19, as we know, is not a “cold-hearted” killer as such. It kills those already riddled with certain degrees of disadvantages – older, frail, pre-existing conditions, oppressed, and lacks access to medical care.

In Europe, countries have some sort of universal health coverage. This every person can access timely healthcare services they need. In the US, the story is different; fewer people have health insurance and more so, the poor Blacks, Hispanics and a sizeable proportion of rural white population.

The US is the leader of neoliberal economic ideas – where the government is forced out of providing health care and private providers are given the mantle. The colonial healthcare systems that Uganda inherited, was not structured the US way or now the Museveni-era healthcare. The colonial-era healthcare was financed directly by the state from taxpayers’ money, and there was no cost-sharing or discrimination based on ability to pay.

During colonial times, the formal sector was made to privilege colonial workers, most of whom were serving the colonial agenda. Health care and education were part of the reward for their loyal services. Housing was part of the package for teachers, doctors, nurses, soldiers, Police, Prisons, and the Senior Management Team of various state ministries and agencies.

The health service privileges were extended to the general workers in the formal sector, only employ about 10% of the population or less, while most Ugandans were rural-based farming privately to augment raw materials for European civilization. These farmers also produced cash crops and food crops to sustain the colonial state labour force and paid taxes. A healthy rural reserve sustained a steady supply of labour for expanding mining and industrial work. This post-war social policy was consistent with the Colonial Development and Welfare Act, 1940, and amended in 1945.

The Museveni-era liberalization of the economy dismantled that. They imposed cost-sharing, reduced the size of government workers at first, to shed off “Obote’s loyalists”, before expanding it irregularly with a loyal ethnic-based cadership.

The Museveni regime reducing the proportion of its health spending on health neglected its management and maintained a stockout of essential medicines to about 80%. It is only recently that they have mooted a National Health Insurance System, copying from those in capitalist countries.

 Most industrialized capitalist countries offer healthcare based on health insurance policies, mostly related to labour attachment. But there are many different models. In Canada, only the state can buy health insurance, thereby reducing market competition – the type in the US where individuals and companies buy health insurance from the same market. In Switzerland, insurance companies cannot make a profit, except on supplemental plans; Japan, Germany, UK, and others have their own systems tailored to the typology of their welfare state systems. Rwanda, our next door has its own locally made success story.

During this COVID-19, I learned that liberalized healthcare may be a façade that cannot sustain frequent pandemics of our generation. There is a need to rethink seriously of universal healthcare as a public good and rights of the people, not a market commodity for those who can afford it.

End.