The Covid-19 pandemic has shaken the core of our entire existence and a great public health threat. At the peak of the pandemic, there was a lot of uncertainty as to whether a vaccine would be created to stop the disease and luckily now the vaccine is available on the market. There have been many issues in relation to the distribution of the vaccine where manufacturers and rich countries are hoarding the vaccine for profit and their populations while poor countries are struggling to get enough vaccines for their population. The Ministry of Health in Uganda announced plans to commence vaccination in March 2021 and the Permanent Secretary of the Ministry of Health in a tweet stated that for accountability purposes, only those with National Identification Cards or National Identification Numbers will have access to the vaccine. In this article, we discuss why it is important for everyone registered or unregistered to be vaccinated.
In 2015, the Government of Uganda passed the Registration of Persons Act with its objectives as to harmonizing and consolidating the law on registration of persons; providing for registration of individuals; establishing of a national identification register; establishing a national identification and registration authority and; providing for the issue of national identity cards and aliens identification cards among others. Section one of the Act provides that it does not apply to persons visiting Uganda for a period not exceeding ninety days and to a refugee recognized by the government and the United Nations High Commissioner for Refugees which means that the Act applies to citizens of the Republic of Uganda and Foreign Nationals who are staying in Uganda for a period exceeding 90 days.
Section 65(1)(J) provides that the information in the National Identification Register shall be used in the provision of social services including social security services, health, education and welfare benefits. Section 66 provides that a ministry or government agency providing a public service shall require a person accessing the service to produce a national identification number or a national ID or an alien’s identification number. This requirement is problematic and an impediment to the realization of the right to health and detrimental to the public health benefit arising from the universal access of the covid-19 Vaccine. The provisions under Section 66 and the directive by the Ministry of Health also largely ignore the realities of marginalized groups like disabled persons, women and minorities who may not have been registered under the Act as a result of circumstances completely outside their control.
The preamble of the WHO constitution provides that “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.” The right to health is also provided for under several international instruments which Uganda is a party to like the Universal Declaration of Human Rights, the International Convention on Economic, Social and Cultural Rights and the African Charter on Human and Peoples Rights. The right to health is not explicitly provided for in the Bill of Rights of the constitution of the republic of Uganda but the constitution has a wide range of provisions with a bearing on health. The Constitution creates an obligation on the state to promote the social well-being of the people and to ensure that all Ugandans enjoy rights, opportunities and access, amongst other things, to education, health services, clean and safe water, food security and adequate housing. The state also has a responsibility under the Constitution to take all practical measures to ensure the provision of basic medical services to the population. The right to health is a human right and in ensuring the realization of this right principles of interdependence of rights, non-discrimination and equality, and indivisibility should be observed.
The requirement for one to possess a national ID or NIN to gain access to social services and in particular health services like covid-19 vaccination is at the face of it discriminatory to persons who to their legal status may not be able to register with National Identification and Registration Authority or as a result of the system’s inefficiency and slow processes. The exclusion of unregistered persons from being vaccinated undermines the realization of the right to health and is in contravention to several international instruments that Uganda is party to.
Another argument that could be made in support of the vaccination of unregistered persons is a moral argument based on the Ubuntu philosophy. The term Ubuntu is often translated to mean humanity or “I am because you are” has its roots from the Zulu but is universally accepted in many African Countries. Ubuntu dictates the belief in a universal bond of sharing that connects all humanity and through this bond, a moral obligation is created in a way that the wellbeing of the people we live with in our communities is prioritised if we are to co-exist. Africans came together in the fight against Covid-19 and this unity against the virus should not be undermined by excluding unregistered deserving sections of the population from being vaccinated.
For the fight against covid-19 to be successful and effective, efforts should be made by the government to ensure that everyone despite of their legal status gets access to the vaccine because denying unregistered persons access to the vaccine will increase the public health threat arising from unimmunized persons.
Peter Classic Nvigyi