A week ago, the UW’s Amy Hagopian, Peter House and Bert Stover headed to Uganda to coordinate a study aimed at resolving a fierce debate in global health.
Since arriving in Uganda, the UW researchers and their co-workers have had to deal with escalating violence which most observers blame on the government’s attempt to quell public protests and calls for political reform.
As the BBC reports, eight people have been killed and about 250 people injured so far.
“We’re staying in contact with them and trying to monitor the situation,” said Scott Barnhart, director of health systems strengthening for the UW’s I-Tech program. “They’re watching the protests closely.”
Hagopian, who with Barnhart is co-principal investigator on the Uganda project, sent an email this weekend to let folks back home know that they are continuing with the research preparations such as training data collectors, evaluating survey designs and generally just plodding ahead as planned.
A UW medical student working on the project reported having to remain inside a Kampala church for safety for a few hours and hearing the police firing tear gas outside at protesters.
Who said data collection is boring?
Oh, what are they actually trying to do amid the growing political unrest in Uganda? One of the big arguments in global health today is whether major health campaigns in poor countries focused on solving a single problem, like HIV/AIDS, end up undermining health overall.
Critics say that donor-funded, single-disease campaigns against AIDS, malaria or whatever tend to divert talent and resources away from the more basic (under-funded) health services in poor countries. Advocates of these targeted programs say they can work to lift all boats, improving overall services even if focused on one problem.
It’s chronic debate that, frankly, lacks evidence on both sides.
The UW researchers, with funding from U.S. Centers for Disease Control, intend to study the impact of PEPFAR (the President’s Emergency Plan for AIDS Relief) on other health services in Uganda — maternal health, childhood vaccinations and other aspects of basic care.
“We hear a lot of people saying they’ve lost health staff to PEPFAR and other NGOs,” said Barnhart. “But you also hear that PEPFAR has created a much stronger medication supply change.”
The goal of this research project, he said, is to look for evidence of such positive and negative impacts at 350 sites throughout Uganda. The Obama Administration has already decided it wants to take a more comprehensive and “country ownership” approach with its Global Health Initiative but has little evidence on which to base many policy decisions already made, Barnhart said.
“Basically, we want to make sure the gains made in HIV aren’t coming at the expense of other health needs,” he said. “And to see if there are any spillover benefits from PEPFAR.”
The study is just beginning and political turmoil always tends to have a negative effect on health, especially in poor countries. What happens politically in Uganda is already complicating the UW study. How the current battle for political reform plays out in the longer-term could be the determining factor.