Uganda: Mildmay’s double impact on vital Early Infant Diagnosis programme

Early Infant Diagnosis (EID) was a critical pillar of Uganda’s HIV response, enabling services to work with mothers and families to decide promptly on the care needed for babies. The Ugandan government launched its EID programme in late 2006 to encourage early testing and reduce mother‑to‑child transmission.

The United States Centers for Disease Control and Prevention (CDC) began supporting the initiative in 2007, and seven regional testing laboratories were established. However, the network proved fragmented and costly to administer, prompting a search for a more efficient model.

Led by Dr Charles Kiyaga, an alumnus of Mildmay’s diploma in A Health Systems Approach to HIV and AIDS Care and Management, the Ministry of Health shifted to a single, centralised laboratory with state‑of‑the‑art, government‑run facilities in Kampala to improve efficiency and turnaround. Mildmay’s role was to act as a clearing centre for CDC funding, leveraging trusted financial systems to move funds quickly to the programme where timing was critical. “Having studied at Mildmay Uganda, I knew their financial systems,” said Dr Kiyaga. “I suggested money for this programme should be channelled through Mildmay.”

The improved EID programme began in 2011 and gathered momentum. Civil works to set up the central lab took place in March and April; staff were recruited, and testing commenced in July at eight regional hospitals and additional district hospitals, with an initial target of 90,000 babies. The lab ran nearly around the clock to manage high sample volumes. Results were returned to hospitals via mobile technology using an SMS printing system, avoiding reliance on internet connectivity.

Implementation rolled out gradually, with the aim of nationwide testing by 2014. A cooperative agreement between partners was established for five‑year renewals. Transport remained a challenge, so plans were made for 15 transport hubs to serve 20 health facilities, each with a motorbike and rider to carry EID samples, as well as CD4 and viral load specimens.

Dr Kiyaga stated that the programme would directly reduce Uganda’s HIV rate and praised Mildmay’s education programmes: “It was hands‑on… a course to improve performance for managers—doctors, health professionals and those from social care backgrounds.” In July 2011, he advanced to the Mildmay degree programme in A Health Systems Approach to HIV Care and Management, delivered in East Africa and affiliated to the University of Manchester (UK).