Saturday, April 23, 2016

Rwanda Army Joins Battle Against Malaria


Rwanda Army Joins Battle Against Malaria

Thursday, March 31, 2016

Medics tipped on professionalism

PUBLISHED: March 28, 2016 in The New Times - Rwanda  By: STEVEN MUVUNYI

Minister Binagwaho (C)speaks as Prof. Rwamasirabo (L) outgoing chairman, and Dr
Rudakemwa, the new chairman look on during the meeting in Kigali. (Steven Muvunyi)

Medics have been urged to improve their profession by prioritising the common good
of the medical practice.
The call was made by the Minister for Health, Dr Agnes Binagwaho during the
election of the National Council of the Rwanda Medical and Dental Association.
Minister Binagwaho told the medics to positively brand their profession, despite the shortage of doctors and teachers’ in the country.
“We need to consider how we want the population to perceive us. We have to prove
that we are the right people at the right place, with the right knowledge, right ethics
and the right morale,” she said.
Binagwaho asked medics to be humble in order to deliver correctly.
“The improvement of our profession is a continuous process. Gone are the days a
doctor did and knew everything. A good doctor has to learn every day since science is
an evolution,” she added.
The elected national board that will serve a four-year term is composed of Dr
Emmanuel Rudakemwa, the chairman, Dr Jean Claude Byiringiro, the vice
chairperson, Dr Albert Nzayisenga, the secretary as well as Dr Kaitesi Mukara Batamuriza, the treasurer.
The national board also includes representatives of the public medical and dental schools, dental and private practitioners among others.
The voters were twenty nine provincial representatives. Prof. Emille Rwamasirabo,
the outgoing chairman of the council was pleased by the progress made during his
tenure and advised the new committee to work hard to impact Rwanda’s medical
“Many professional malpractices were solved, but we still need to work on the improvement of uncaring doctors and increase the training,” he said.
Dr Rudakemwa, a radiologist, newly elected chairman of the council said the new committee will work hard for quality improvement in medical practices.
“With the partnership and cooperation with the Ministry of Health and the
outgoing committee, we hope to take this institution to greater heights,” he said.
Established in 2003, Rwanda Medical and Dental Council is responsible for the regulation of medical and dental practice in Rwanda.
It is in charge of registering and licensing all medical and dental practitioners.

Experts discuss health financing

Published in The New Times -Rwanda on March 31, 2016 by HUDSON KUTEESA

Minister Binagwaho (R) explains the need to finance the health sector as Minister Gatete (C)
and Jesse Joseph of USAID look on during the meeting in Bugesera. (Doreen Umutesi)
Local and international experts on health financing are meeting in Nyamata, Bugesera District to discuss the desired health financing modifications and how they can be aligned with the Sustainable Development Goals.
The two-day conference that opened yesterday is held under the theme: “Health financing reforms in the eve of sustainable development goals.”
The conference attracted over 150 participants, including experts from Senegal, Sierra Leone and Ethiopia, deliberating on how current health financing policies can be a stepping-stone toward achieving the SDGs.
The national and international experts, especially those who have contributed in the design and implementation of health financing reforms in Rwanda are sharing current state of health financing policies and brainstorming about the future directions.
Minister Gatete explains the challenges of priotising finance in the health sector.
Dr Agnes Binagwaho, the Minister for Health in an interview with journalists said the conference would come up with ideas on how to generate finances for the health sector and look at ways of using it efficiently.
“Rwanda has achieved the SDGs, but to us, it is not enough. We want more achievements and it needs money.
So these health financing experts are gathering to come up with innovations of financing the health sector and how we can use the finances efficiently.We need innovation for example electronic medical records which use ICT linked with diagnostics. Such innovations reduce the money spent or bring efficient spending. We hope to come up with solutions for the future in the global architecture of health.”
Claver Gatete, the Minister for Finance and Economic Planning emphasised the importance of financing the health sector which he described as the foundation of all development in Rwanda.
“The health sector is an area that we can’t avoid because it will come back and haunt us. It is the foundation of all development in Rwanda.The topic of health financing is very timely. It comes at a time when we are looking at what we have achieved in vision 2020. So, it will help us to see ways of financing the health sector and how we can work with the other financing institutions to contribute to the sector,” he said.
“Investing in health sector is very important.For instance if we invest in health equipment, there will be no more going to India for surgeries and other complex medical processes.And this can save a lot of money and even bring in forex when neighbouring countries send their patients for treatment here.”
He also called for innovation that will see Rwanda be able to finance such institutions without depending on support from outside countries, citing an example from last year’s budget where 66 per cent was from domestic resources, 14 percent borrowed and 20 per cent from grants.
“We should think differently. We cannot expect that money will always be coming from outside all the time.We have to think innovatively towards health financing by working with partners, tapping into the private sector institutions and most importantly engaging the population.”
He expressed hope that by working together, the health system can change for the better and thanked the financing partners working with the ministry of health including Global Fund, the US government, Bill Gates Foundation, Rocke Fella Foundationand bilateral donors like the Belgians among others.
The Rwanda Vision 2020 considers health financial accessibility as a key priority among its strategic direction
Among the anticipated outcomes of the meeting are understanding the current status of global health financing reforms in the areas of universal health coverage and quality assurance approaches; reviewing of different approaches to ensure sustainable quality improvement and exploration of ways to link financial reforms with quality assurance and improved initiatives.
The discussions from the meeting will feed into the current government process of developing a health sustainability plan for the whole health sector.

Undergrad Interns for Rwandan Health Minister

University of Vermont  University Communications


Sarriera and Binagwaho
Just before this photo was taken in March 2015, Gabriela Sarriera ’17 dared to ask Rwanda’s minister of health for a job or internship or some way to contribute to the global health leader’s work. One year later, she’s living in Kigali, helping Dr. Agnes Binagwaho research policy that affects equal access to healthcare. (Photos courtesy of Sarriera)

As one of six kids, Gabriela Sarriera '17 is practiced in the art of speaking up and asking for what she wants. So when the microbiology major heard the Rwandan minister of health deliver a moving talk at the Global Health and Innovation Conference at Yale last year, she waited patiently in the long line after the keynote — not to ask for a photo as others had done — but to ask for a job.
“I want to know how can I help,” she remembers telling Dr. Agnes Binagwaho, a pediatrician who returned to her home country after the genocide and has helped recover a ravaged health system. Sarriera, who attended the conference as a member of UVM’s global health club, MedVida, also has plans to pursue medical school and become a pediatrician. But beyond just a career role model for Sarriera, Binagwaho is an inspiration.
The minister is the 2015 winner of the Roux Prize for her work to rebuild trust in the Rwandan health system and her contribution to initiatives that have increased the country’s life expectancy by 20 years, drastically dropped the maternal mortality rate, and, now that people are living longer, is expanding care for non-communicable diseases, as well. The Atlantic has called it a historic recovery — one the U.S. could learn from.
Sarriera promised the minister that if she accepted her help, she would find a way to get to Rwanda. FaceTiming from Kigali nearly 12 months after the Yale conference, Sarriera makes clear the gratitude she has for Binagwaho, who, amazingly, took a chance on the undergrad by offering her an internship, exposing her to work normally reserved for graduate students.

Healthcare for all

For three months now, Sarriera’s been immersed in learning the history of the Rwandan legal system. Why law when it’s medicine she wants to pursue? Her project expands on Binagwaho’s doctoral research, which uncovered troubling limits the colonial-influenced legal system puts on ensuring all citizens have the same access to healthcare. The path forward in the health sector means fully understanding policy that’s been shaped by a complex history.
Sarriera’s work began Christmas day with a flight to Europe, where the English minor began her internship with a document search, trying to trace the history of the book of laws that’s the basis for Rwanda’s legal system.


Saturday, September 26, 2015

Vaccines in Rwanda

Please see this piece on vaccines in Rwanda recently published by Vaccineswork.  It was a pleasure working on this article with Anisha Hedge, a medical student at the University of Virginia who spent the past summer in Rwanda.  Here, we provide an overview of the benefits of vaccines in our efforts to improve the health and well-being of Rwanda. Please see the entire article here:

Rwanda’s sustainable strategy for saving lives

Agnes Binagwaho, Ministry of Health Rwanda and Anisha Hedge, University of Virginia School of Medicine.
Rwanda has demonstrated the value of vaccines over the past 15 years, as the rollout of new and underused vaccines has helped us reduce under-five mortality by two thirds, and achieve the fourth Millennium Development Goal (MDG) along the way. This year, as the world transitions to the Sustainable Development Goals (SDGs) and partners aim to end poverty by 2030, immunisation must remain at the core of the health agenda. As well as saving lives, the benefits of vaccination programmes stretch beyond immunisation to improving health services and promoting social integration, and Rwanda is the case study to prove it.

1. Vaccination campaigns at the centre of societal development

Rwanda has increased basic vaccine coverage (DTP3) from 77% in 2001 to 99% in 2014. In the last seven years Rwanda has introduced new and under-used vaccines against pneumococcus, rotavirus, rubella and human papillomavirus (HPV), and maintained high rates for traditional vaccines. Vaccination campaigns present the opportunity to reach out to the population with a range of other health services. During the pneumococcal campaign in 2009, advice was given on causes and symptoms of pneumonia to facilitate early detection and access to treatment. Community health workers also educated parents on good health practices such as breastfeeding and wholesome nutrition.

2. Achieving equality in healthcare 

To encourage equal access to health care, Rwanda holds a Mother and Child Health Week twice a year. It offers a range of health services; vaccination campaigns such as rubella and HPV for adolescent girls, the provision of iron tablets for pregnant and lactating women to prevent anaemia, vitamin A supplements for all children under five years and a family planning campaign for women of reproductive age.

A mother and baby at the launch of rotavirus vaccine in Rwanda in 2012, which protects against a leading cause of diarrhoea. Photo: Gavi/Diane Summers.

3. Forging national partnerships

Vaccination programmes have fostered new working relations between different governmental and non-governmental organisations. This was evident with the rollout of the HPV vaccine in schools in Rwanda which involved a partnership between the Ministry of Health, Ministry of Education, Ministry of Gender and Family Promotion and the Ministry of Local Government in order to reach adolescent girls in schools and communities. 

4. Strengthening healthcare infrastructure

Adequate health system infrastructure is essential for the effective rollout of vaccines. In Rwanda this has included improved waste disposal facilities for contaminated materials, new cold rooms for temperature-controlled storage and increased medical storage capacity. 

5. Sustainability

Currently, the Rwandan government self-finances all traditional vaccines, such as the tuberculosis vaccine BCG, and co-finances with international partners to provide new and under-utilised vaccines. This trend has been demonstrated with the pneumococcal vaccine and is currently unfolding with the HPV vaccine, which protects against major causes of cervical cancer. Looking ahead, we hope that as demand increases, vaccine prices will be driven down, thereby creating a sustainable future for vaccine provision. 
Globally, there is still a way to go. One in five children in Gavi supported countries still miss out on the basic package of childhood vaccines; around the world about 1.5 million children die from vaccine-preventable diseases each year. But as our country has shown, immunisation can sustainably address this inequity, and so much more besides. With immunisation as part of the next set of development goals, we can help all countries make the most of these vital tools, and we should — because life, whether lived in the remote areas of Rwanda or the suburbs of London, deserves a fighting chance.

Sunday, August 30, 2015

Angus Deaton’s Cartoonish Moral Calculus

In July of 2015, I posted this article in the Boston Review to address not only the absurd comments from Angus Deaton, but also the shocking, pervasive racism that is so often expressed by intellectual yet arrogant people. 

I spend a lot of time explaining and promoting Rwanda’s record on public health to audiences around the world. Together with our research and funding partners, Rwanda has made unprecedented strides on almost every health measure. We are one of the few developing countries that will meet all MDG targets. All Rwandans have access to health insurance, and maternal mortality has fallen at historically unprecedented rates.

For Angus Deaton, these gains only served to entrench dictatorship and repression in Rwanda. How? By threatening to let our children die unless altruistic and gullible Westerners pay our government to keep them alive.

Deaton believes that we ‘provide health care for Rwandan mothers and children’ in order to ‘insulate ourselves from the needs and wishes of our people’. I can’t tell if he means that Rwandans don’t wish for good health, or that our country would be more democratic if we neglected basic needs.

As a Rwandan, and as a physician, I have heard a lot of outrageous statements in my life. But Professor Deaton has invented an entirely new level of absolutism.

How does one begin to reply? More facts and figures about Rwanda’s progress would only reinforce Deaton’s grotesque logic. Testimonials from the donors and researchers who know Rwanda best would be dismissed as compromised.

Moreover, Rwanda is not the issue here, and I would feel no satisfaction if Deaton apologized to Rwanda and then went to pick on a different country that better exemplifies his stereotypes.

The issue is moral, and it concerns all of us. Deaton’s theory rests on the assumption that Africans don’t feel love for their children. It follows that President Kagame, being an African, sees children as a commodity, like copper or sweet potatoes, to be sold to people in the West who value their lives more highly.

Angus Deaton doesn’t know Paul Kagame from Kunta Kinte. The president is just a cartoon character he uses to argue against foreign aid. Deaton isn’t referring to the real Paul Kagame or the real Rwanda, but to a generic ‘other’ whose moral inferiority is so self-evident that it requires no elaboration.

In other words, Deaton knew his readers would share in the contempt. In point of fact, Paul Singer replied complaining about Deaton’s criticisms of his work; but he made no mention of the scandalous libel of President Kagame.

This is neither ignorance or carelessness. It is an ideology of moral superiority, a form of racism that is all the more pernicious because it has no name and leaves no marks on its victims. Eventually the victims internalize it and come to despise themselves.

By dropping the mask a little, perhaps Angus Deaton has done us all a favor. We need to have more honest conversations about the assumptions implicit in judgments we make about each other.

Rwanda’s story is tragic and hopeful in equal measure. Maybe the first step is for Angus Deaton, Paul Singer, and anyone else who feels concerned by this exchange, to visit Rwanda and see for themselves what kind of people we are, and how we care for our children. They would not be the first visitors to Rwanda who left with a deeper appreciation for our common humanity.

Thursday, July 9, 2015

Rwanda's Quest for Universal Health Coverage

The following essay on Rwanda's Quest for Universal Health Coverage was featured in the Commonwealth Health Partnerships annual booklet, which is now available online:

I encourage you to look over the various essays on topics related to UHC, ageing, governance, NCDs, and much more throughout this publication.