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Item Limited health insurance coverage amidst upsurge of non-communicable diseases in Uganda(Economic Policy Research Centre, 2019) Mpuuga, Dablin; Mbowa, Swaibu; Odokonyero, TonnyThis brief uses the 2016/17 Uganda National Household Survey (UNHS) and the World Development Indicators (WDI) to show the extent of health insurance coverage for non-communicable diseases (NCDs) such as diabetes, high blood pressure and heart diseases among others. Results indicate that: (i) NDCs affect people of all socio-economic groups; (ii) more Ugandans suffering from NCDs are willing to pay for health insurance, but very few are holders of insurance policies in this regard; (iii) other diseases like malaria are more easily insured compared to NCDs, an indication that the providers of health insurance services are not keen to insure sufferers of NCDs; (iv) there are regional differences in health insurance coverage as well as prevalence of NCDs, with the burden of NCDs more intense in the Bukedi, Busoga and Teso sub-regions, whereas NCDs are least prevalent in Kigezi and Ankole sub-regionsand (v) NCDs are likely to erode gains in poverty reduction at household level, because it is equally high among poor households with the least capacity to afford health insurance. We there by, recommend establishing special screening centres for NCDs in public health facilities especially health center II’s and III’s. This will promote early detection and early treatment hence curbing expensive costs for treating severe and chronic NCDs. Preventive measures need to be emphasized as well. These include regular body exercises and monitored nutrition which all lower the risk of NCDs. We further suggest incorporating and prioritizing NCDs into the proposed national health insurance scheme.Item Mycobacterium tuberculosis Microbiologic and Clinical Treatment Outcomes in a Randomized Trial of Immediate versus CD4+ -Initiated Antiretroviral Therapy in HIV-Infected Adults with a High CD4+ Cell Count(Clinical infectious diseases, 2010) Chamie, Gabriel; Charlebois, Edwin D.; Walusimbi-Nanteza, Maria; Mugerwa, Roy D.; Mayanja, Harriet; Okwera, Alphonse; Whalen, Christopher C.; Havlir, Diane V.In a prospective randomized, controlled trial in Uganda comparing the efficacy of antiretroviral therapy during tuberculosis therapy with the efficacy of tuberculosis therapy alone in HIV-infected patients with tuberculosis who have a CD4+ cell count >350 cells/µL, it was found that antiretroviral therapy did not accelerate microbiologic, radiographic, or clinical responses to tuberculosis therapy: 18% of participants had sputum smears positive for Mycobacterium tuberculosis after 5 months of tuberculosis therapy, despite having had negative culture results.Item Transcriptional Activity, Chromosomal Distribution and Expression Effects of Transposable Elements in Coffea Genomes(PLoS One, 2013) Lopes, Fabrıcio R.; Jjingo, Daudi; da Silva, Carlos R. M.; Andrade, Alan C.; Marraccini, Pierre; Teixeira, Joao B.; Carazzolle, Marcelo F.; Pereira, Goncalo A. G.; Pereira, Luiz Filipe P.; Vanzela, Andre´ L. L.; Wang, Lu; Jordan, I. King; Carareto, Claudia M. A.Plant genomes are massively invaded by transposable elements (TEs), many of which are located near host genes and can thus impact gene expression. In flowering plants, TE expression can be activated (de-repressed) under certain stressful conditions, both biotic and abiotic, as well as by genome stress caused by hybridization. In this study, we examined the effects of these stress agents on TE expression in two diploid species of coffee, Coffea canephora and C. eugenioides, and their allotetraploid hybrid C. arabica. We also explored the relationship of TE repression mechanisms to host gene regulation via the effects of exonized TE sequences. Similar to what has been seen for other plants, overall TE expression levels are low in Coffea plant cultivars, consistent with the existence of effective TE repression mechanisms. TE expression patterns are highly dynamic across the species and conditions assayed here are unrelated to their classification at the level of TE class or family. In contrast to previous results, cell culture conditions per se do not lead to the de-repression of TE expression in C. arabica. Results obtained here indicate that differing plant drought stress levels relate strongly to TE repression mechanisms. TEs tend to be expressed at significantly higher levels in non-irrigated samples for the drought tolerant cultivars but in drought sensitive cultivars the opposite pattern was shown with irrigated samples showing significantly higher TE expression. Thus, TE genome repression mechanisms may be finely tuned to the ideal growth and/or regulatory conditions of the specific plant cultivars in which they are active. Analysis of TE expression levels in cell culture conditions underscored the importance of nonsense-mediated mRNA decay (NMD) pathways in the repression of Coffea TEs. These same NMD mechanisms can also regulate plant host gene expression via the repression of genes that bear exonized TE sequences.Item Prediction of Transposable Element Derived Enhancers Using Chromatin Modification Profiles(PLoS ONE, 2011) Huda, Ahsan; Tyagi, Eishita; Marino-Ramırez, Leonardo; Bowen, Nathan J.; Jjingo, Daudi; Jordan, I. KingExperimentally characterized enhancer regions have previously been shown to display specific patterns of enrichment for several different histone modifications. We modelled these enhancer chromatin profiles in the human genome and used them to guide the search for novel enhancers derived from transposable element (TE) sequences. To do this, a computational approach was taken to analyze the genome-wide histone modification landscape characterized by the ENCODE project in two human hematopoietic cell types, GM12878 and K562. We predicted the locations of 2,107 and 1,448 TE-derived enhancers in the GM12878 and K562 cell lines respectively. A vast majority of these putative enhancers are unique to each cell line; only 3.5% of the TE-derived enhancers are shared between the two. We evaluated the functional effect of TE-derived enhancers by associating them with the cell-type specific expression of nearby genes, and found that the number of TE-derived enhancers is strongly positively correlated with the expression of nearby genes in each cell line. Furthermore, genes that are differentially expressed between the two cell lines also possess a divergent number of TE derived enhancers in their vicinity. As such, genes that are up-regulated in the GM12878 cell line and down-regulated in K562 have significantly more TE-derived enhancers in their vicinity in the GM12878 cell line and vice versa. These data indicate that human TE-derived sequences are likely to be involved in regulating cell-type specific gene expression on a broad scale and suggest that the enhancer activity of TE-derived sequences is mediated by epigenetic regulatory mechanisms.Item Phylogenomic analysis of Uganda influenza type-A viruses to assess their relatedness to the vaccine strains and other Africa viruses: a molecular epidemiology study(bioRxiv, 2021) Nabakooza, Grace; Owuor, David Collins; Laurent, Zaydah R. de; Owor, Nicholas; Kayiwa, John Timothy; Jjingo, Daudi; Nyaigoti Agoti, Charles; Nokes, David James; Kateete, David Patrick; Mulindwa Kitayimbwa, John; Frost, Simon David William; Lutwama, Julius JulianGenetic characterisation of circulating influenza viruses is essential for vaccine selection and mitigation of viral transmission. The current scantiness of viral genomic data and underutilisation of advanced molecular analysis methods on influenza viruses circulating in Africa has limited their extensive study and representation in the global influenza ecology. We aimed to sequence influenza type-A viruses (IAVs) that previously circulated in Uganda and characterised their genetic relatedness to the vaccine viruses and publicly available Africa IAVs. Methods: This was an observational study nested to the Uganda national influenza surveillance programme. We used Next-generation sequencing to locally generate genomes from 116 A(H1N1)pdm09 and 118 A(H3N2) viruses collected between 2010 and 2018 from 7 districts across Uganda. A total of 206 hemagglutinin (HA), 207 neuraminidase (NA), and 213 matrix protein (MP) sequences were genetically compared to the WHO-recommended vaccines and other viruses isolated from Africa since 1994. Viral temporal and spatial divergence and circulating genetic clades were characterised using phylogenetic methods. Findings: We successfully generated gene sequences for 91·9% (215/234) viruses. Uganda A(H1N1)pdm09 and A(H3N2) virus HA, NA, and MP proteins had 96·36-99·09%, 96·49-99·39%, and 97·48-99·95% amino acid similarity, respectively, to vaccines recommended from 2010 through 2020. The local viruses incorporated amino acid substitutions (AAS) in their antigenic, receptor binding, and glycosylation sites each year causing them to antigenically drift away from vaccines. For seasons when vaccine formulations differed, Uganda IAV antigenic sites had 1-2 extra AAS relative to the Southern than Northern hemisphere vaccine viruses. All Uganda IAVs carried the adamantine-resistance marker S31N but not the neuraminidase inhibitor (NAI) resistance markers H274Y and H275Y. However, some A(H1N1)pdm09 viruses had permissive substitutions V234I, N369K, and V241I typical of NAI-resistant viruses.Item On the presence and role of human gene-body DNA methylation(Oncotarget, 2012) Jjingo, Daudi; Conley, Andrew B.; Yi, Soojin V.; Lunyak, Victoria V.; Jordan, I. KingDNA methylation of promoter sequences is a repressive epigenetic mark that down-regulates gene expression. However, DNA methylation is more prevalent within gene-bodies than seen for promoters, and gene-body methylation has been observed to be positively correlated with gene expression levels. This paradox remains unexplained, and accordingly the role of DNA methylation in gene-bodies is poorly understood. We addressed the presence and role of human gene-body DNA methylation using a meta-analysis of human genome-wide methylation, expression and chromatin data sets. Methylation is associated with transcribed regions as genic sequences have higher levels of methylation than intergenic or promoter sequences. We also find that the relationship between gene-body DNA methylation and expression levels is non-monotonic and bell-shaped. Mid-level expressed genes have the highest levels of gene-body methylation, whereas the most lowly and highly expressed sets of genes both have low levels of methylation. While gene-body methylation can be seen to efficiently repress the initiation of intragenic transcription, the vast majority of methylated sites within genes are not associated with intragenic promoters. In fact, highly expressed genes initiate the most intragenic transcription, which is inconsistent with the previously held notion that gene-body methylation serves to repress spurious intragenic transcription to allow for efficient transcriptional elongation. These observations lead us to propose a model to explain the presence of human gene-body methylation. This model holds that the repression of intragenic transcription by gene-body methylation is largely epiphenomenal, and suggests that gene-body methylation levels are predominantly shaped via the accessibility of the DNA to methylating enzyme complexes.Item Mammalian-wide interspersed repeat (MIR)-derived enhancers and the regulation of human gene expression(Mobile DNA, 2014) Jjingo, Daudi; Conley, Andrew B.; Wang, Jianrong; Mariño-Ramírez, Leonardo; Lunyak, Victoria V.; Jordan, I. KingMammalian-wide interspersed repeats (MIRs) are the most ancient family of transposable elements (TEs) in the human genome. The deep conservation of MIRs initially suggested the possibility that they had been exapted to play functional roles for their host genomes. MIRs also happen to be the only TEs whose presence in-and-around human genes is positively correlated to tissue-specific gene expression. Similar associations of enhancer prevalence within genes and tissue-specific expression, along with MIRs’ previous implication as providing regulatory sequences, suggested a possible link between MIRs and enhancers. Results: To test the possibility that MIRs contribute functional enhancers to the human genome, we evaluated the relationship between MIRs and human tissue-specific enhancers in terms of genomic location, chromatin environment, regulatory function, and mechanistic attributes. This analysis revealed MIRs to be highly concentrated in enhancers of the K562 and HeLa human cell-types. Significantly more enhancers were found to be linked to MIRs than would be expected by chance, and putative MIR-derived enhancers are characterized by a chromatin environment highly similar to that of canonical enhancers. MIR-derived enhancers show strong associations with gene expression levels, tissue-specific gene expression and tissue-specific cellular functions, including a number of biological processes related to erythropoiesis. MIR-derived enhancers were found to be a rich source of transcription factor binding sites, underscoring one possible mechanistic route for the element sequences co-option as enhancers. There is also tentative evidence to suggest that MIR-enhancer function is related to the transcriptional activity of non-coding RNAs. Conclusions: Taken together, these data reveal enhancers to be an important cis-regulatory platform from which MIRs can exercise a regulatory function in the human genome and help to resolve a long-standing conundrum as to the reason for MIRs’ deep evolutionary conservation.Item Genetic Diversity of Bundibugyo Ebolavirus from Uganda and the Democratic Republic of Congo(bioRxiv, 2021) Omara, Isaac Emmanuel; Kiwuwa-Muyingo, Sylvia; Balinandi, Stephen; Nyakarahuka, Luke; Kiconco, Jocelyn; Kayiwa, John Timothy; Mboowa, Gerald; Jjingo, Daudi; Lutwama, Julius J.The Ebolavirus is one of the deadliest viral pathogens which was first discovered in the year 1976 during two consecutive outbreaks in the Democratic Republic of Congo and Sudan. Six known strains have been documented. The Bundibugyo Ebolavirus in particular first emerged in the year 2007 in Uganda. This outbreak was constituted with 116 human cases and 39 laboratory confirmed deaths. After 5 years, it re-emerged and caused an epidemic for the first time in the Democratic Republic of Congo in the year 2012 as reported by the WHO. Here, 36 human cases with 13 laboratory confirmed deaths were registered. Despite several research studies conducted in the past, there is still scarcity of knowledge available on the genetic diversity of Bundibugyo Ebolavirus. We undertook a research project to provide insights into the unique variants of Bundibugyo Ebolavirus that circulated in the two epidemics that occurred in Uganda and the Democratic Republic of CongoItem Effect of the Transposable Element Environment of Human Genes on Gene Length and Expression(Genome biology and evolution, 2011) Jjingo, Daudi; Huda, Ahsan; Gundapuneni, Madhumati; Leonardo Mari o-Ramırez, Leonardo Marin˜ o-Ramı´rez3,4, and I. King Jordan; Jordan, I. KingIndependent lines of investigation have documented effects of both transposable elements (TEs) and gene length (GL) on gene expression. However, TE gene fractions are highly correlated with GL, suggesting that they cannot be considered independently. We evaluated the TE environment of human genes and GL jointly in an attempt to tease apart their relative effects. TE gene fractions and GL were compared with the overall level of gene expression and the breadth of expression across tissues. GL is strongly correlated with overall expression level but weakly correlated with the breadth of expression, confirming the selection hypothesis that attributes the compactness of highly expressed genes to selection for economy of transcription. However, TE gene fractions overall, and for the L1 family in particular, show stronger anticorrelations with expression level than GL, indicating that GL may not be the most important target of selection for transcriptional economy. These results suggest a specific mechanism, removal of TEs, by which highly expressed genes are selectively tuned for efficiency. MIR elements are the only family of TEs with gene fractions that show a positive correlation with tissue-specific expression, suggesting that they may provide regulatory sequences that help to control human gene expression. Consistent with this notion, MIR fractions are relatively enriched close to transcription start sites and associated with coexpression in specific sets of related tissues. Our results confirm the overall relevance of the TE environment to gene expression and point to distinct mechanisms by which different TE families may contribute to gene regulation.Item Health Spending in Uganda Implications on the National Minimum Health Care Package(ACODE, 2016) Lukwago, DanielThis policy brief is part of Public Expenditure Governance (PEG) study of the health sector in Uganda. The overall objective of the research was to examine the links between public spending, governance, and outcomes in the health sector and the specific objectives of the study were to identify the actors and their roles in decision making regarding budget allocations and service delivery, develop indicators for assessing expenditure governance in the health sector, Identify and assesse the effects of budget allocation decisions on health sector performance and finally to identify and assess the efficiency of accountability mechanisms, including community participation, sanctions and rewards. Funding remains the single most important constraint facing the health sector in Uganda. Although the Government budget allocation to the health sector has increased from UGX 660 billion in 2010/11 to UGX 1,271 billion in 2015/16, the sector share of the total national budget averaged 7.8% during the same period which is 2 percentage points short of the HSSIP target of 9.8%.Item Building Effective Drinking Water Management Policies In Rural Africa: Lessons From Northern Uganda(CIGI-Africa Initiative, 2012) Opio, ChristopherThe importance of providing clean, safe drinking water and sanitation to rural inhabitants of developing countries is widely recognized. The United Nations (UN) General Assembly, for instance, declared 2008 the International Year of Sanitation, and the World Bank has been increasing financial assistance to developing countries in support of water supply and sanitation improvements (Cho, Ogwang and Opio, 2010). Despite the Millennium Development Goal (MDG) to reduce, by half, the number of people without sustainable access to clean and safe drinking water and basic sanitation by 2015 (Cho, Ogwang and Opio, 2010; Opio, 2010), most countries in Sub-Saharan Africa are not on track to meet the widely adopted deadline (Harvey, 2007; United Nations Children’s Fund [UNICEF], 2012; Abenaitwe, 2012).Item Universal Health Coverage in Uganda: The Critical Health Infrastructure, Healthcare Coverage and Equity(SPEED Initiative, 2017) Odokonyero, Tonny; Mwesigye, Francis; Adong, Annet; Mbowa, SwaibuUniversal Health Coverage (UHC) has gained popularity within the global health policy and academic circles as countries strive to meet the UHC target established under the Sustainable Development Goal agenda. To accomplish this goal, developing countries such as Rwanda, Ghana and others have pursued bold policy initiatives including the introduction of health insurance schemes. In addition to financing, presence of critical health infrastructure and Human Resources for Health (HRH) are crucial to achieving UHC. Using administrative data from IntraHealth Uganda Country Programme (as well as document review) and the Demographic & Health Survey data, this paper analysed Uganda’s critical health infrastructure (including HRH) needed to attain sustained progress towards UHC. It also reviewed UHC progress and analysed equity by computing Composite Coverage Index (CCI) and Coverage Gap Scores. Results show fundamental challenges with the health infrastructure needed to deliver UHC in Uganda. Spatial inequality exists in health facility population coverage and private sector health infrastructure investments. Low health workforce density imply that the existing health workforce is deficient and unable to expand populationbased healthcare services. Progress towards UHC [considering reproductive, maternal, new-born, and child health (RMCH) interventions] has improved marginally over the reviewed period, although the CCI remained low, and regional and socio-economic disparities in coverage remained. Findings also demonstrate that improved healthcare coverage corresponds to better health outcomes. Accelerating progress towards UHC require; increased investments in health infrastructure and strengthening Public Private Partnership arrangements to establish health infrastructure in disadvantaged regions; and improvement in health workforce density by reviewing current staffing norms for critical cadres as well as increased deliberate investments in HRH using similar initiatives like the HRH programme model of Rwanda. To scale up healthcare coverage for RMCH, interventions should aim to maintain successes obtained for immunization and address existing gaps in lagging intervention areas. These objectives can only be achieved if the country institutes and effectively implements a coherent set of health sector policy reforms, regarding health financing, for instance, while drawing lessons from the successful policy efforts observed in the Rwandan case scenario.Item Overcoming Shortcoming in Monitoring Retention in Option B+(SPEED Initiative, 2018) Kiwanuka, George; Ssennyonjo, AloysiusThe retention in care is a serious pointer of achievement for the Prevention of Mother to Child Transmission(PMTCT) care program. The level of retention of women under PMTCT care program at the different time points of the cascade of the elimination of mother to child transmission (EMTCT) cascade is critical to treatment outcomes. The current methods of measuring retention in care, at health facility level are reported to under-estimate overall retention since several women self-transfer to other facilities without being accounted for. Individual health facility retention is used in care assessment and no attention is paid to transfers. This policy memo provides information on the alternative courses of action that may be taken to mitigate this issue of retention in care, clearly stating the pros and cons of each course of action. It also gives a recommendation for the best course of action that should be taken.Item Expanding HIVAIDS prevention programmes through Safe Male Circumcision and Voluntary Counselling and Testing in Uganda(2013) Ahaibwe, Gemma; Kasirye, Ibrahim; Barungi, MildredAlthough Uganda initially registered large reductions in HIV/AIDS prevalence rate during the 1990s, the rate of new HIV infection is on the rise across the country. At least 1.2 million Ugandans are infected with the HIV virus1 . Recent evidence from the 2011 Uganda AIDS Indicator Survey revealed that the HIV/AIDS prevalence rate had increased from 6.4 percent in 2004/5 to 7.3 percent by 20112. The trends in new HIV infections in figure 1 suggest that the annual number of new HIV infections increased by 11.4 percent from 115,775 in 2007/08 to 128,980 in 2010/11, despite the huge amounts of resources earmarked for HIV/AIDS related expenditures. The increase in the HIV/AIDS prevalence has been blamed on the complacency of Ugandans with the availability of anti-retrovaral therapies (ARTs)— especially regarding sexual behavior.Item Better nutrition for children in Uganda The policy makers role(Economic Policy Research Centre (EPRC), 2012) Kasirye, IbrahimUganda has made tremendous progress in improving welfare outcomes in the past 20 years, some key welfare outcomes especially regarding nutritional status have performed dismally. For instance, the proportion of poor persons reduced from 56% in 1992 to 25% by 2010. Also, the infant mortality rate (IMR) reduced from 81 to 54 death per 1000 live birth during 1995-2011. Similarly, the HIV/AIDS prevalence rate reduced from 30% in the early 1990s to 6.7% by 2011. On the other hand, Uganda continues to maintain a large population of malnourished children and women and this dents the country’s impressive human development record. According to population based data from Uganda Demographic and health Surveys (UDHS) of 2006 and 2011, 2,314,620 children under the age of five are too short for their age (stunted). An estimated 250,000 children under the age of five suffer from severe acute malnutrition annually and are in need of medical treatment. However, the most recent estimates from the 2011 UDHS indicate that child stunting rates have declined in the past five years. The proportion of children aged below 5 years classified as stunted declined from 38% in 2006 to 33% by 2011 (Figure 1). Furthermore Figure 1 shows that Uganda has registered mixed progress regarding child nutritional health indicators and the country may not meet the Millennium Development Goal (MDG) 1 target of halving Uganda’s underweight levels from 25% in 1990 to 12% by 2015. Worse still, Uganda appears to off the mark with regard to the target of halving the population below the minimum level of dietary energy consumption— the level of food insecurity has remained above the 60% mark since the 1990s.Item Addressing the Poor Nutrition of Ugandan Children(Economic Policy Research Centre (EPRC), 2012) Ssewanyana, Sarah; Kasirye, IbrahimOne out of every three young children in Uganda are short for their age, according to the 2011 Uganda Demographic and Health Survey (UDHS); and the incidence of poor nutritional status is highest in the relatively better off sub region of South Western Uganda. Although poor child nutrition status is a pervasive global problem, it is mainly concentrated in a few developing countries. According to the United Nations Children’s Fund (UNICEF) 24 developing countries account for over 80 percent of the world’s 195 million children faced with stunting. Out of the 24 countries, at least 11 are from Sub Saharan Africa (SSA). Furthermore, countries in SSA have made the least progress in reducing stunting rates—from 38% to 34% between 1990 and 2008—compared to a reduction of 40% to 29% for all developing countries. Uganda is among the developing countries with the largest population of stunted children—an estimated 2.4 million children aged less than 5 years in Uganda are stunted and this places the country at the rank of 14th—based on the ranking of countries with large populations of nutritionally challenged childrenItem Reclaiming public health services in Uganda(Economic and Social Rights Advocacy (ESRA), 2021) Nabwowe Kasule, Angella; Mncwabe, NokukhanyaThe Covid-19 pandemic has reinforced the importance of strong public health services to deliver equitable healthcare. The countries that most successfully navigated the pandemic tended, overwhelmingly, to have entrenched and resilient public health systems. The clarion call for “health for all” – regardless of ability to pay - is thus unsurprising. The global pandemic has seriously underscored the need for strong public health systems and strong government stewardship of healthcare-related infrastructure, human resources and financing. Calls to address this need were prevalent at the 73rd World Health Assembly, which was characterized by heated debates on healthcare access and health as a global public good, which were particularly animated during the drafting of a Covid-19 resolution. Discussions centred on a just, post Covid-19 economic recovery also reignited public debate about the chronic underfinancing of public health; with increasing pressure exerted on governments to “build back better,” by, among other things, reclaiming public services to make them not only the first, but more importantly, the most responsive health system, especially for poor and vulnerable persons.Item Getting it Right: Uganda’s Proposed National Health Insurance Scheme(2015) Nabwowe, Angella; Mncwabe, NokukhanyaGlobally, the World Health Organization (WHO) has been pushing for universal health coverage. According to WHO, the goal of universal health coverage is to ensure that all people obtain the health services they need without suffering financial hardship by having to incur out of pocket expenses to pay for said services. Looking at the post 2015 health agenda, WHO notes that universal health coverage is a way of ensuring continued progress towards the current health Millennium Development Goals (MDGs), while also helping countries address the growing threat of non-communicable diseases, mental illness and injuries. The Ugandan Ministry of Health is currently awaiting a certificate of financial implication from the Ministry of Finance, Planning and Economic Development in order to proceed with the proposed National Health Insurance Bill 2012, which once adopted, will operationalise the National Health Insurance Scheme (NHIS). This is a commendable step towards the realization of the right to the highest attainable standard of physical and mental health in the country. However, as the process unfolds, the Initiative for Social and Economic Rights (ISER) deemed it fit to speak to a number of stakeholders to ensure representation of their priorities and concerns.Item A Looming Crisis? An analysis of the health sector budget performance for the financial year 2012/13 and allocations for 2013/14(Initiative for Social and Economic Rights, 2013) Initiative for Social and Economic RightsOver the years, the government of Uganda has committed to improving the health sector service delivery through a number of interventions and policies. The health sector has been identified as one of the key priorities in the National Development Plan (NDP) and it contributes to all NDP objectives, although it is particularly focused on objective 4 - “Increasing access to quality social services". This is through provision and utilization of promotive, preventive, curative and rehabilitative services, and involves Strengthening Health Systems and ensuring universal access to the Uganda National Minimum Health Care Package (UNMHCP). The UNMHCP as provided for under the Health Sector Strategic Plan (HSSP) consists of the most costeffective priority healthcare interventions and services addressing the high disease burden that are acceptable and affordable within the total resource envelope of the sector. Universal access is one of the key underlying principles for delivery of the UNMHCP.Item Addressing Inequity and Discrimination in the Delivery of Health Services in Uganda(Economic and Social Rights Advocacy (ESRA), 2014) Kwemoi, CharlesHealth reports in Uganda are often characterized by aggregated statistical data showing progress on particular indicators such as maternal mortality, infant mortality, life expectancy, HIV/AIDS prevalence and so on. However, what the statistics fail to reveal are the individuals and groups of people excluded from the system, who are denied life saving services because of who they are or where they live. In applying a human rights perspective, it is imperative for policy makers to persistently peer behind the veil of lump-sum statistics and to test the universality and equitability of healthcare access and services. This is the second issue of the Economic and Social Rights Advocacy (ESRA) Brief published by the Initiative for Social and Economic Rights (ISER). The ESRA Brief is dedicated to Economic and Social Rights (ESRs) advocacy in Uganda but draws on key lessons from the broader East African Community. The Brief is intended for policy makers, civil society actors, development partners and the donor community as it provides insight into the debates and steps currently being undertaken by Ugandan organizations individually and collaboratively to achieve the full realization of ESRs.