11 August 2022 (updates 12 August to correct Sam’s district)

I had an exciting meeting today with Sam Opio, an elected Member of Parliament (MP) representing the Kole District of Uganda, which is in the North. His office is in the building across the street from the Parliament Building in downtown Kampala. Sam is a pharmacist and I’ve known him since 2012, when we met on my 2nd trip to Uganda. He served as the Secretary of the Pharmaceutical Society of Uganda (PSU) for many years and in that role was extremely industrious and passionate about advocating for the implementation of pharmaceutical care and clinical pharmacy in Uganda, to help improve patient outcomes. PSU carries out the regulatory function for pharmacy in Uganda (writes the registration and intern examinations) as well as is the professional organization for pharmacists in the country. It is like our USA NABP (National Association of Boards of Pharmacy) as well as the APhA (American Pharmacists Association) combined. He only left PSU a year or so ago to pursue his elected position to Parliament. Sam knows that to really effect change in Uganda regarding the policies and improvement of pharmacy practice and medicine’s use, you need a seat at the table. I enjoyed hearing all about the work he has accomplished so far as an MP for healthcare as well as his agenda for the future. He is only 1 of 2 pharmacists who are MP’s. He has a passion for improving health care but he also works hard to ensure a better life for his constituents in the Kole District. That area was know for its cattle ranching before the war. One of the things that has adversely affected the economic situation in this area, is the loss of 90% of their cattle during the war. I’m not sure which war he is referring to, but this has caused economic hardship. In his first year, he has been able to secure government compensation for some of this loss.

One of the issues before Parliament now is an act to allow organ transplantation. Currently, there is no option for organ transplants such as the life saving procedures of kidney and heart transplants that are common in the USA. If someone has kidney failure, they must try to live on dialysis or go to another country at a great cost for a kidney transplant. This is not an option for most people. Some external funding agencies are trying to help Uganda develop the capacity to do in-country organ transplants but they first need a law to allow it. If this becomes a reality, it will also have to come with the capacity to provide the immunosuppressant drugs that are crucial to keep the patients from rejecting the transplanted organs and those drugs often are dosed specifically for patients based on their blood level of the drugs. This is also a lab test that is not readily available in Uganda. So, there is much to change if transplants are to become an option for Ugandans.

We spent a good amount of time discussing the issue of Antimicrobial Resistance, which is a critical problem facing Ugandans. Antibiotics are dispensed over the counter without the need for a prescriptions and this is contributing to the fact that many of the infections are caused by microorganisms that are now resistant to most of the drugs that Ugandans have access to. People are dying on a daily basis because the antibiotics in the hospital no longer work. This is one of Winnie’s passion areas, to improve antibiotic use and decrease resistance. However, Uganda needs to recognize the importance of utilizing their pharmacists during patient care to help make sure the antibiotics prescribed are both necessary and the best for the patient’s infection. Most of the people in the position to recognize this role for pharmacists unfortunately see pharmacists only as dispensers of meds at the pharmacy or working to improve the supply chain of drugs. These are certainly important functions but there are pharmacists who want to work as a member of the healthcare team, at the patient beside, advocating for the rationale use of drugs and improving patient care. There are many pharmacists trained in clinical pharmacy in Uganda from either out of the country or at Mbarara University of Science and Technology’s Masters of Clinical Pharmacy program but no one is hiring them for this role. Winnie worked for 4 years as a VOLUNTEER at the Neurosurgery Unit at Mulago National Referral Hospital alongside the neurosurgeons who truly valued her assistance in helping to improve patient care but still they have not created this job position.

In the afternoon, I was able to formally hand over the Video Conferencing Equipment to the Department Head of Pharmacy, Mr. Robert Otto. Kalidi, Winnie, and I were able to get it up and working. I’m so excited about how this will advance our current research as well as enable other collaborations such as Binghamton Students learning with Makerere Pharmacy students.