

Zimbabwe: A letter to a Nurse which is dissmissed – “Re: Dissmissal from the Health Services in Terms of Section 58 of the Health Service Regulation” (17.04.2018)










Yesterday was supposed to be celebrated, but however, I can’t. Not honestly, not, no, not knowing that this process of procurement and knowledge of possible unnecessary demise of dozens of cancer patients, while waiting between March 2016 to January 2018 for possible treatment. It is insane.
Therefore, when I read crap like this yesterday, when the Machine was launched by Prime Minister Ruhakana Rugunda, I don’t celebrate:
“The Prime Minister Ruhakana Rugunda has commissioned the new radotherapy machine at the Uganda Cancer Institute Mulago. This follows the purchase of a new radiotherapy machine after the old one crushed in April 2016. According to Dr Daniel Kanyike the head of the radiotherpay department at Mulago, 80 patients are attended to per day and they suspect the number will increase after the commissioning today” (Sudhir Byaruhanga, 19.01.2018)
Because, I have a letter dated back to IAEA from Dr. Byahagaba from 28th May 2013, where the funding of 325,297 Euros was deposited to the UniCredit Bank, Austria, Vienna on the 22nd May 2013. To start the procurement of a new Cobalt 60 Cancer Machine to Uganda Cancer Institute at Mulago Hospital. However, this has been lost in the story, that suddenly NRM moved swiftly in 2017 and got it ready for 2018.
It might be true that old one from 1995 – finally gave way and broke down in April 2016 before the General Election, the same fall. However, that doesn’t mean, they started procurement and facilitating the funds for a new one. They used longer time and awaited the destruction of the old one, before getting a newer model that actually worked.
They didn’t act quickly or swiftly in this affair. They moshed it together in a stew and hope to get gold, instead they are boiling bones and hope to taste the real deal. It is a mess and was a mess.
Because I still remember this:
“Cancer patients receiving radiotherapy treatment at Mulago hospital may have to wait until next year when the new cobalt 60 radiation machine will be installed, after the old one broke down three weeks ago. According to Dr Jackson Orem, the director of Cancer Institute at Mulago hospital, it may be difficult to repair the radiotherapy machine, procured in 1995, to render efficient results” (EA BIZ INFO, 08.04.2016).
Secondly, when NRM says April 2016, well, Dr. Orem speaks about three weeks before April, that means it broke down in March 2016. So the NRM cannot hold one piece of the story correct. Not even when it breaks down!
Therefore, the promise waited on results because of hardships to make a new space and have a new machine in where the old one was. The Uganda Cancer Institute had to wait and secure funding for a new one, even if they had already started procurement in 2013. Something they should have focused one, before making sure the old one crashed. This has clearly cost lives, since the Cancer patients have not been sent in drones in Kenya. They got some promises to Aga Khan in Kenya, but that was only for a few lucky ones. We can imagine how many cancer patients lost their ability for treatment between March 2016 and January 2018. It is insane, but also the structure and carelessness the National Resistance Movement (NRM) is known for.
So this has been a long await, which could have fixed before and was already in the making. Who knows why the authorities and the NRM didn’t fix it in advance, when they already paid partial payment in 2013. Years before it broke down. It is foolish and nonsense, when this is the only type of this machine in the whole Republic. Then, not being able to for-see its demise.
Well, NRM can think of this a propaganda victory, since no-one is questioning much and just is happy. The public shouldn’t be, because why didn’t they fix it earlier and made sure for a transition from one machine to another? Peace.

There has been a draft release Executive Order without a date, but planned for June 2017 by the Trump Administration. The United States Government and soon the American Health Care Act (AHCA) or the Trump Care is run through the Senate after the amendments for the law after the vote in the Representatives House. So it seems like the Trump Administration trying to patch the ill-will and the gained reputation for draconian laws with a medicine and a remedy. Still, if people cannot afford health care plans or afford health-care insurance, what help is in making medicine and pills cheaper. When you cannot afford to get to the doctor, what help is that the pills and medicine cost less. Needs help from the doctor to find the needed treatment. That is simple, but forgotten math by the Republicans and the Congress these days. Not like President Trump understands that, unless tanning became more expensive for him.
While we’re at it, let’s look into major quotes from the Draft Executive Order:
“Section 1 Policy:
b) Reduce burdens caused by regulatory and administrative actions that inflate or distort prices for beneficiaries of Federal health programs or that provide more favorable pricing for intermediate actors in the medical product supply chain than the prices available to beneficiaries” (Executive Order, 2017).
So the Trump Administration plans to put down the prices and control the prices of medicine. It is special that the Administration cares about the Federal Health Programs, when the new TrumpCare laws want to relief the state of Medicaid and other supplementary subsidized programs through the Affordable Health Care Act (AHCA) or ObamaCare. Health Care News Emily Kopp: “This probably refers to the 340B program, which provides hospitals that serve low-income patients with a discount on intravenous drugs, anti-nausea drugs for cancer patients and some other outpatient drugs. Donald Trump’s interagency working group on drug prices has weighed scaling back the 340B program, KHN reported earlier this month. Critics say the discounts don’t truly benefit patients, including PhRMA, the influential pharmaceutical lobby” (Kopp, 2017). Certainly, the repeal will make sure these sort of programs get phased out as well as the pricing on the Health Care plans that the citizens has to get through insurance companies. But this draft plans to take it further do.
“c) Facilitate, where appropriate, the ability of Federal health programs to enter into reimbursement arrangements for medical products that are based on the value of such products to patients rather than the volume of such products purchased” (Executive Order, 2017).
That the State will have value-based pricing, which means that the States and Federal Government have decided prices depending on the needs and than that the patients has to cover the cost of the medicine. Which is a nice idea, but I am skeptical as before, since the reality doesn’t change, even if the State and Federal Government can control the buying-in and the prices of it. The rising prices of insurance under new law will not be helped by this remedy. Neither is this too.
“d) Ensure that the laws intended to help lower-income or vulnerable Americans and strengthen the safety net healthcare providers that serve them are carried out in such a way, that the benefits of such programs accrue primarily to the intended populations, including by the rescinding or revising of regulatory or administrative actions” (Executive Order, 2017).
This here is main reason for it in a way, if the Trump Administration did care, but if they though the world works like that and these provisions would change the ways of buying-in and research of medicine would change. Still, Health Care News Emily Kopp says this: “This probably refers to the 340B program, which provides hospitals that serve low-income patients with a discount on intravenous drugs, anti-nausea drugs for cancer patients and some other outpatient drugs. Donald Trump’s interagency working group on drug prices has weighed scaling back the 340B program, KHN reported earlier this month. Critics say the discounts don’t truly benefit patients, including PhRMA, the influential pharmaceutical lobby” (Kopp, 2017).
Again, Trump Presidency has to be self involved and not understanding the world order, therefore, this had to be inside the EO: “e) Ensure that American citizens do not disproportionately subsidize medical product innovation for the rest of the world, or allow foreign governments to unfairly devalue American innovation” (Executive Order, 2017). Again, let me quote Emily Kopp: “The Trump administration is making the implicit argument that longer monopoly rights for drugs and higher drug costs in foreign markets will lead to lower prices in the U.S. Not so, according to James Love, director of Knowledge Ecology International” (Kopp, 2017). So, in Alice in Wonderland, this sort of provision might work, even in Narnia, but I am sure it has the same effect as Wall towards Mexico or the sudden love for Solar Panel on the wall, which is insane in it self. That Trump Administration believes in this wouldn’t surprise anyone and that Sean Spicer would defend it would be field day for journalists.
Las piece of the Executive Order, that I will put forward is this one: “f) Rescind, revise or simplify regulations and other administrative actions that inappropriately or unfairly contribute to higher prices or cost-sharing for medical products for American patients” (Executive Order, 2017). Just as before, kind of hard to get lower prices if the repealing of Obama-Care law gets into effect. It like thinking you get lower cost, when the insurance sky-rockets and the 1 percent of American citizens get a giant tax-break. The relief again would only suit the ones without already hard-earned pockets, the rich would earn more and the R&D of medical suppliers would secure more funding. This would not earn the citizens in the United States.
This is maybe why this law hasn’t been signed and hasn’t been enacted, as the Senate are working on their bill and this would counter it. Secondly, the lesser prices for medicines wouldn’t help the provisions in the new Health Care law. United States would really be a place for the wealthy and the poor would suffer more. That is reality of the Health Care bill that the Senate are putting forward. This Executive Order wouldn’t help, but be a field day for the Big Pharma to get new system for subsidized medicine, so the people wouldn’t feel this. Unless, the Health Care plans inside the Senate bill would actually serve the public and not just the wealthy. Peace.
Reference:
Donald J. Trump – ‘Executive Order – REDUCING THE COST OF MEDICAL PRODUCTS AND ENHANCING AMERICAN BIOMEDICAL INNOVATION’ (Draft Paper for June 2017).


