HEALTH PARTNERSHIP BETWEEN THE UGANDA MINISTRY OF HEALTH, UGANDA BLOOD TRANSFUSION SERVICE AND NHS BLOOD AND TRANSPLANT

In the bid to foster shared learning, joint working and co-development, the Uganda UK Health Alliance facilitated recent meetings in Kampala between representatives from NHS Blood and Transplant (NHSBT), Transplant Community Links (TCL), Uganda Blood Transfusion Service (UBTS), Mulago Hospital and the Permanent Secretary, Uganda Ministry of Health (MoH). The purpose was two fold:

1. To agree an outline Memorandum of Understanding, under which NHSBT may offer support and advice to the MoH in respect of organ donation and transplantation.
2. To progress the current health partnership between UBTS and NHSBT, identifying those strategic issues where the MoH might lend support.

These collaborations provide mutual benefit to the participating organisations. For NHSBT, greater insight is provided into the reasons why adult black Africans do or don’t donate their blood, organs and tissues. This is important in the fight to obtain sufficient BAME donations in the UK to treat sickle cell anaemia and thalassemia. The partnerships also offer excellent personal and leadership development opportunities for NHSBT staff, and enhance NHSBT’s global reputation.

The meetings, combined with a tour of the proposed organ unit at Mulago, proved highly successful. On the organ side, a number of activities were identified, all designed to aid the development of a living kidney donation and transplantation service at Mulago Hospital in Kampala. These included:

• Support development of the Ugandan legislation and regulatory framework, in particular from an ethical standpoint.
• Sharing of standards and guidelines between the two organisations
• Exploration of the affiliation of the Uganda organs service with the British Transplant Association
• Development of a Specialist Nurse role in support of living kidney donation.
• Establish a training programme with TLC (this is dependent upon the identification of funding streams)
• Support development of a post donation and transplant registry, and develop databases to support living donor kidney data
• Share learning about patient, family, community & media engagement

A number of risks and challenges were also identified, including:

• Funding / sustainability of the programme
• The impact of having multiple international partners
• Ensuring consistency of standards & protocols
• Safeguarding against organ trafficking
• Reputational risk 

The UBTS – NHSBT health partnership is entering its 2^nd year. Good progress has been made on a number of fronts, including:

1. The provision of surplus to requirement vehicles, consumables and equipment, and the identification of biomedical engineering support networks to minimise downtime. Two bloodmobiles have been gifted with the support of Global Blood Fund, the 2^nd of which arrives in Kampala on 29^th August
2. The provision of leadership development for UBTS’ national and regional teams. Analysis of the blood supply chain, and the emerging identification of opportunities for performance improvement in the form of efficiency and cost-effectiveness.
3. Advocacy with the MoH regarding more sustainable long term funding options for the Uganda blood system, especially important given the recent withdrawal of PEPFAR funding.
4. Identification of tactics to improve adult blood donor recruitment, including a potential partnership with the Ministry of Defence, and the use of “Know Your Type” recruitment initiatives.
5. Support of better blood utilisation in Uganda (the demand side of the supply chain) through audits of blood use, review of adherence to protocols, and support of courses in Transfusion Medicine with Mbarara University and BTS.

The Permanent Secretary was asked for her support in the following areas:

• The undertaking of a consultation process in respect of alternative blood system funding mechanisms and income generation options, in light of the progressive work done by other African countries in the wake of PEPFAR withdrawal.
• The hastening of key appointments within UBTS, including a Biomedical Engineer.
• The support of a collaboration between the MoH and MoD
• The support of Better Blood Transfusion guidelines for hospital clinicians who are failing to adhere to accepted protocols.