Dressed in a white coat with a mask on her face, Dr. Susan Adakun Akello moves through Uganda’s Mulago National Referral Hospital without fear of infection. She had just returned from making rounds in the tuberculosis (TB) ward at the hospital. Her smile is warm and welcoming as she invites visitors into her well-aerated office within the ward that is supported through the USAID Defeat TB Activity.

Dr. Akello is a wife, mother, lecturer, researcher, and head of the TB ward at Mulago Hospital. She has been at the frontline in the fight against TB since 2015. With support from USAID’s Defeat TB Activity, Dr. Akello leads 34 staff members and treats approximately 800 patients for TB per year. Another 160 patients are treated for hard-to-treat multi-drug resistant TB. Her choice to specialize in TB treatment was not by accident. “When I was a postgraduate student at Mbarara University, I saw patients die of TB meningitis. It was difficult to diagnose. Doctors didn’t know whether to start patients on treatment or not to. This gave me a challenge to do my research on TB and save lives.” 

Dr. Akello’s interest in medicine goes back to her childhood. She was inspired by a female clinical officer in her village, who was highly respected, drove a car, and was perceived to be rich. “She  even had a special seat at church,” she remembers with a smile, noting that the reality of a doctor’s life is very different from what she imagined it as a child. But after joining the medical profession, she found that none of those things really mattered. “I don’t earn a lot of money but I’m happy I can save lives,” she says. 

Worldwide, TB is the deadliest communicable disease. It infects 10.4 million people each year and claims 1.7 million lives annually. Uganda continues to have some of the world’s highest rates of TB , and recent surveys have shown that the epidemic is worse than had been imagined. Some 89,000 new infections occur every year—far more than HIV—of which at least 40,000 go undetected. However, Uganda has shown recent progress in the fight against TB, with a case detection rate improvement from 60 percent in 2018 to 80 percent in 2019. 

TB is an obstacle to development and prosperity. It reduces productivity and  strains the delivery of health care and social services. The disease affects the poorest of the poor and drives the impoverished further into poverty. When people suffer from TB, they lose three to four months of work, significantly cutting down their income. The financial burden is even greater for individuals with multi-drug resistant TB, who must undergo treatment for far longer. Stigma is a major problem for tuberculosis patients, especially women, as fear of being shunned by family and community discourages them from seeking treatment and complicates their recovery. 

Through USAID’s Defeat TB Activity, USAID supports increased screening and detection of all forms of tuberculosis in infants, children, adolescents and adults. After diagnosis, patients begin treatment right away and follow the treatment through to the end. USAID also invests in strengthening community systems to support ongoing TB treatment interventions. 

Among the key successes, Dr. Akello highlights early detection, improved linkage to care, and retention. “At Mulago we are [at] 83 percent success rate. Case detection rate is at 70 percent, but we can do better. We need the community to help identify and report suspected patients,” she says. She adds that increased case-finding and follow-up of patients through community workers is crucial. “If we continue strengthening community linkage and retention in care, scale up human resources, and provide transport to community workers, we will win the fight against TB.”

Efforts to fight against TB in Uganda continue to focus on building resilient and sustainable programs so that they can contribute to transforming families and communities to thrive and prosper. This is achieved with a dedicated, passionate, and committed workforce including unsung heroes like Dr. Akello.