Citizens’ access to information plays a vital role in promoting the realization of their right to health. It facilitates freedom of choice and quality of public education. It enables citizens to be aware of the medicine, treatment, and services available to them in the health sector. Access to information allows them to know what to pay for, how much, and what the government has already paid for through their tax money. Access to information is essential in the health policy formulation and prevention aspects. The private sector plays a significant role in the health services chain, yet without access to information, citizens are unable to understand existing relationships and how these impact them. The health sector is one of the most challenged by corruption, including amongst others, through sometimes credible allegations of bribery, theft, fraud, falsification of information and undue influence among others. According to Transparency International, corruption manifests at all stages of the health system, including research and development, manufacturing, registration, marketing, selection, procurement, distribution, and delivery.
In carrying out its recent evaluation of the scope of implementation of the Access to Information Act, AFIC listed institutions relevant to the health sector, including the Ministry of Health, Uganda Blood Transfusion Services (UBTS), Central Public Health Laboratory (CPHL), National Medical Stores (NMS), National Drug Authority (NDA), Uganda National Health Research Organization (UNHR).
The findings from the survey demonstrate that, although Uganda has a robust legal framework to support the right of access to information and the citizens ‘ growing interest in participating in development projects which affect them, the most significant challenge is the effective implementation of this legal framework. It should be noted that the Access to Information Act, 2005 allows the disclosure of information within 21 days upon request, but this was not the case for most national institutions.
AFIC noted that in Uganda, there is a steady rise in demand for information. However, disclosure remains challenged in all government agencies.
Despite the citizens’ desperate need for data, they seem to have lost trust and confidence in public institutions. They also can not address the existing bureaucratic process gaps and shortcomings, as only very few of them can afford the cost of litigation to seek rectification of existing deficiencies, ultimately preventing them from accessing their inalienable right of access to information.
To this effect, AFIC recommended that public health institutions should ensure that proactive disclosure is implemented, to enable citizens to access critical health care and health sector-specific/related information, without having to request for it, most of the time. All health sector institutions interviewed as part of this research exercise highlighted the lack of funding as a significant challenge for the effective implementation of the ATI Act. Consequently, dedicated funding for ATI implementation should be provided to facilitate critical activities such as staff training on ATI obligations, establishing and implementing procedures for receiving and responding to them.
The Ministry of Health and respective departments and agencies in the sector should scale up citizen awareness-raising on ATI to ensure that every citizen understands their right to information and how to exercise it. The government should also prioritize the implementation of the Access to Information Act and compel all public bodies to comply with the Act. Particular attention should be paid to the publication of manuals of functions and index, proactive disclosure, production of information directory and annual reporting. Stringent sanctions for non-compliance should also be enforced.
Previous civil society awareness efforts have been limited to large urban centres like Kampala, Mbarara, and Gulu, leaving out the vast majority who live in rural and are most disadvantaged by lack of access to information. Civil society organizations should increase their attention to ATI in the health sector with a particular focus on awareness-raising, training other CSOs, public officials and citizens on ATI, monitoring the implementation and compliance of public institutions, conducting information request campaigns and engaging Parliament to strengthen their oversight by requiring ministers to comply.
Parliament should play its oversight role under Section 43 of the ATIA by requiring every minister to comply with the submission of annual reports. When submitted, Parliament should consider submitted reports and provide the necessary determinations and recommendations.
Uganda Human Rights Commission should prioritize the promotion of citizens’ right of access to information by; training public officials on their obligations to implement the Access to Information Act, commission a study of the status of ATI in critical sectors like health, education, natural resources, establish a Desk to handle violations related to ATI and Include a section on the right to information in its Annual Reports to Parliament.
AFIC will continue to engage different stakeholders to share findings and mobilize support and commitment towards the improved implementation of the Access to Information Act in the Health sector in Uganda