By Kizito Khalid Ssekabembe 

According to World Health Organization, “Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease. The virus is most transmitted from mother to child during birth and delivery, in early childhood, as well as through contact with blood or other body fluids during sex with an infected partner, unsafe injections or exposures to sharp instruments. The WHO estimates that 240 million people were living with chronic hepatitis B infection in 2024, with 0.9 million new infections each year. In 2024, hepatitis B resulted in an estimated 1.1 million deaths, mostly from cirrhosis and hepatocellular carcinoma (primary liver cancer).  

In Uganda, approximately 1.845 million Ugandans are chronically infected with the virus and liver cancer caused by HBV contribute 5.1% of all cancer deaths. 

According to the 2016 Uganda Population based HIV Impact assessment survey, prevalence of Hepatitis B infection among adults stands 4,3% (5,6% among men and 3.1% among women). The survey indicates that Hepatitis B prevalence is highest in Northern region with 4.6% in mid North ,4.4% in Northeast and 3.8% in West Nile.  Hepatitis B infection was lower in the rest of the country with a range of 0.8% in the Southwest region to 2.7% in East Central region. 

Laws and Policies on Right to Health and Hepatitis B in Uganda and gaps that need to be addressed. 

Although the constitution is not so clear on the right to health, there are laws and policies that have been put in place: Uganda guidelines for prevention, testing, care and treatment of hepatitis B and C virus 2024, Public Health act 2023, National immunization Strategy (2024-2028), immunization act 2017, public health rules 2014. 

Gaps that need to be addressed  

Financial gaps: financial disparity needs to be given attention because financial allocations are more given to HIV than Hepatitis B; Hepatitis B remains underfunded despite its high disease burden. Financing structures must be reevaluated for purposes of equity and fairness. 

Implementation and sensitization: there is an urgent need to bridge the persistent and sensitization gaps in Uganda’s public health response to Hepatitis B. While the Uganda guidelines for prevention, testing, Care and treatment of Hepatitis B 2024 offer a robust framework, a disconnect between these clinical standards and public understanding. The government must effectively engage the public by educating high risk groups such expectant mothers and sex workers on Hepatitis B prevention and procedures. 

Human rights and stigma protection on Hepatitis B patients: government policy must protect the rights  of Hepatitis B patients and one of the ways should be guaranteed confidentiality by strictly enforcing medical confidentiality laws, workplace equality like banning mandatory screening at places of work to prevent unfair termination or exclusion. 

The battlefield as an eco-system our focus being prevention 

Since hepatitis B is incurable, we can work on control and prevention as our mode of fighting, one of the ways we can do this to make sure we do regular checkups.  

Diagnosis: This involves the steps that your health care professional takes to find out if you have hepatitis B. Your healthcare professional gives you a physical exam and looks for symptoms of liver damage. These symptoms can include yellow skin and stomach pain. Tests that can help diagnose hepatitis B or its complications are Blood tests that can detect the hepatitis B virus in your body. They can also tell your health care professional if the infection is acute or chronic. A simple blood test also can find out if you are immune to the condition this is according www.mayoclinic.com 

Vaccination: hepatitis B is preventable with a vaccine. All babies should receive hepatitis B as soon as possible after birth (within 24 hours). This is followed by two or three doses of hepatitis B vaccine at least four weeks apart. Hepatitis B can be passed from mother to child. this can be prevented by taking antiviral medicines to prevent transmission, in addition to the vaccine shortly after birth. The pentavalent vaccine to infants at 6,10 and 14 weeks. Adult vaccination may also be offered as long as there is no evidence of chronic infection. This vaccine should be given at 0,1and 6-month intervals. 

Public campaigns and addresses especially among the Youth on Hepatitis B prevention, especially on regular condom use: To effectively eliminate the spread of Hepatitis B, we must promote safe sex practices such as consistent condom use. The phrase of ‘’eating a sweet in polyethene bag ‘’ is a commonly slang term used by young people   to express that using condoms reduces sexual pleasure and intimacy during sex.  Public health campaigns frequently fail to address this mindset because they heavily focus on clinical facts rather than addressing consistent use of condoms. 

Currently public health awareness is overwhelmingly focused on HIV but it’s high time we also intentionally focus on Hepatitis B. Targeted intervention is urgent in transit and the areas around Busega and  Nateete are well known hubs for nighttime, trade, transport and informal businesses which correlate with high levels of commercial sex. Introducing focused Hepatitis B awareness and its prevention is essential in these communities and many other communities. 

According to the world health organization we should also avoid sharing needles or any equipment used for injecting drugs, piercing or tattooing, wash your hands thoroughly with soap and water after coming into contact with blood, body fluids, or contaminated surfaces and get a hepatitis B vaccine if working in a health care setting. 

Conclusion

The World Health Assembly called for governments and populations to take action to prevent diagnosis and treat viral hepatitis. Globally, 90% of people living with viral Hepatitis B and C do not know they have it, leading to an average of 3000 deaths every day. It is important to remember that the fight against Hepatitis B cannot be won in isolation, we must recognize that eliminating this disease requires a fully integrated ecosystem rather than leaving the government to carry the burden alone. 

The Author is a Lawyer and an Intern as Center for Health, Human Rights and Development (CEHURD).

Men continue to experience lower uptake of HIV and TB services due to barriers such as limited health-seeking behaviour, competing work commitments, and restricted access to health facilities. To address this challenge, the Centre for Health, Human Rights and Development (CEHURD) introduced the Male Action Groups (MAGs) strategy an innovative community-led model designed to bring integrated HIV and TB services directly to men in Gulu, Lira, and Arua Cities.

With support from TASO and MOH the initiative began with district microplanning meetings involving City Health Teams, health facilities, and implementing partners to identify priority hotspots and coordinate implementation. Community dialogue meetings followed, engaging local leaders, employers, and community members to discuss barriers to men’s health-seeking behaviour and build local ownership of the intervention. To strengthen community mobilization, 69 Male Champions were identified, trained, and equipped to provide peer education, mobilize men for services, and facilitate referrals within their communities.

Working alongside health workers, the Male Champions led integrated outreach activities in locations where men spend most of their time, including boda boda stages, markets, construction and welding sites, workplaces, and fishing communities. Services were delivered using a Mobile TB Van Clinic equipped with Digital Chest X-ray technology alongside HIV counselling and testing services, making screening and diagnosis more accessible.

Since the rollout of the strategy in February 2026, the intervention has reached 2,548 men with integrated HIV and TB prevention, screening, and referral services across the three cities. Of these, 370 men accepted HIV testing, leading to the identification of 16 previously undiagnosed HIV-positive men, all of whom were successfully linked to HIV care and treatment. The intervention achieved an HIV positivity yield of 4.3%, exceeding the national community HIV testing yield of 2–3%, demonstrating the value of targeted, male-focused outreach.

The strategy has also delivered impressive TB outcomes. All 2,548 men were screened for TB symptoms, while 1,256 underwent Digital Chest X-ray screening. This resulted in the identification of 455 presumptive TB cases, with 117 men diagnosed with TB (115 drug-susceptible and 2 drug-resistant TB). Of those diagnosed, 115 (98%) were initiated on treatment. The 25.7% TB positivity rate among presumptive cases investigated significantly exceeds the national average for routine TB investigations, highlighting the effectiveness of targeted screening in high-risk male populations.

The early success of the Male Action Groups strategy demonstrates that combining district-led planning, community engagement, trained Male Champions, and mobile diagnostic technologies can effectively overcome barriers that prevent men from accessing essential health services. By strengthening community ownership, improving early HIV and TB case detection, and ensuring timely linkage to treatment, the model offers a promising and scalable approach for reaching underserved men and accelerating Uganda’s HIV and TB response.

– Compiled by Community Empowerment Programme