It is fair to say that the year 2024 was a ‘dramatic’ one, in which two major life-threatening epidemics were recorded but safely controlled and key achievements were registered in Rwanda's efforts to improve healthcare service delivery. By far, the Marburg viral disease was the most news-dominating topic for Rwanda in 2024, in relation to health, with the deadly haemorrhagic fever, which was first reported in the country at the end of September, becoming a topic of global interest, given how fatal it is. Rwanda declared the Marburg outbreak over on Friday, December 20, after 42 days since the last patient was discharged. The viral disease, which was confirmed to be in the country on September 27, claimed 15 lives out of 66 reported cases, mainly among healthcare workers. ALSO READ: How Rwanda detected the first marburg virus cases The Government was commended for its quick efforts to contain the disease, working alongside the World Health Organisation (WHO) and the African Centre for Disease Control (Africa CDC), as well as support from other regional and international partners. Rwanda’s quick action to stop the spread of the disease, which was previously known to kill 9 out 10 people who contract it, meant that travel restrictions and other precautions for travellers were avoided or removed, with things going back to normal quickly. It was no ordinary feat. The Ministry of Health indicated that in other places where Marburg was previously recorded, the mortality rate was as high as 90 per cent but Rwanda was able to keep it at 22.7 per cent fatality rate for the recorded cases. The Mpox Outbreak The Marburg outbreak came at the time the country was still dealing with yet another outbreak- Mpox, also previously known as Monkeypox, which was first confirmed to be in Rwanda on July 24, 2024. As of December 15, 2024, Rwanda had confirmed 74 cases of mpox, with 5,364 suspected cases recorded. While the spread of Mpox has been tamed, the country is yet to declare the epidemic over, as it has with Marburg viral disease. ALSO READ: Rwanda well prepared to handle mpox outbreak, says health official The Ministry of Health released event-based surveillance guidelines to improve the country's preparedness and response capabilities to tame the spread of Mpox, while the WHO and Africa CDC continue to support the country’s efforts by providing technical assistance, mobilizing funds, and backing cross-border surveillance activities. Mpox is a viral disease that causes flu-like symptoms, including fever and chills, and a rash that can take weeks to clear. There is no proven treatment for mpox, but it usually goes away on its own. Following the outbreak, Rwanda embarked on a vaccination drive in September, targeting high risk groups. At least 10,000 doses were administered, as part of efforts to prevent and combat the Mpox epidemic. Speaking at the press conference to announce the end of Marburg, the Minister of Health, Dr. Sabin Nsanzimana, said that majority of the people who have been diagnosed with Mpox in Rwanda are mainly from neighbouring countries, and belong to specific groups of people, which can be traced. Away from the outbreaks that characterised the end of the year, 2024 began on a better note, with the government announcing in February plans to include kidney transplant services under Mutuelle de Santé cover, marking a major milestone in healthcare. The government said specialised medical services including cancer treatment and kidney transplant would be put under the community-based health insurance scheme (CBHI) commonly known as Mutuelle de Santé, but beneficiaries would have to wait until 2025 for some of the services to be fully integrated. Nevertheless, the development revealed by the Ministry of Health and the Rwanda Social Security Board (RSSB) on February 5, 2024, while appearing before a Parliamentary committee, was a relief to many, who had to fork out deep from the pockets to pay for the said services. ALSO READ: Cancer, Kidney transplant services to be covered under Mutuelle de Sante It was in February the same year that RSSB confirmed that patients suffering from chronic renal failure could get kidney transplant procedures covered by Mutuelle de Santé, in yet another major breakthrough in access to healthcare services. The announcement followed King Faisal Hospital (KFH) confirming that it has conducted 18 Kidney transplants, since May 2023, when the country’s biggest referral hospital conducted its first transplant- a treatment which Rwandans often sought abroad. A couple of months after Rwanda launched BioNTech’s first mRNA vaccine manufacturing plant in Africa, the government in February 2024 announced that it will host the International Vaccine Institute’s (IVI) Africa regional office. In yet another milestone, the Seoul-based organisation, on February 27, confirmed that Rwanda was picked out of five African countries that had expressed interest in hosting the regional office. In another landmark move, In April President Paul Kagame approved the establishment of the Rwanda Defence Force (RDF) military health service and also promoted its leadership. The move was part of the reforms made in the RDF health establishment to improve its leadership and how it executes its mandate of strengthening the country’s healthcare system. Maj Gen Ephraim Rurangwa, who was the Commandant of Rwanda Military Hospital (RMH), was appointed as the Chief of Staff of the Medical Health Service, a position he would be deputised by Col. Dr John Nkurikiye, a seasoned ophthalmologist. In the same light, Brig Gen Eugene Ngoga, was named the new Commandant Rwanda Military Referral and Teaching Hospital, among other appointments to strengthen the top leadership of the medical establishment within RDF ranks. The reforms were aimed at ensuring that the RDF continues to play its role in contributing to the growth of the country’s health sector and the socioeconomic development of the country in general. Recognising the role of community health workers 2024 also marked 30 years since Rwanda introduced the Community Health Workers program, which was launched in 1995. The number of community health workers has since grown from 12,000 to nearly 60, 000 CHWs, operating in rural and peri-urban areas of the country. On June 15, 2024, President Kagame met more than 8,000 healthcare providers, mainly Community Health Workers, where he recognised the invaluable contribution that they have made to the country’s health sector over the past three decades, without expecting much in return. ALSO READ: Kagame mulls remuneration of community health workers Among other things, he said that over the past three decades, community health workers worked without remuneration and sacrificed themselves to ensure that Rwandans get the health services they desire, promising that the government would do what it takes to support their efforts. Kagame noted that much of the achievements the country registered were mainly thanks to community health workers who play a critical role of providing primary healthcare services at the grassroots. At the same time, the Ministry of Health announced another key milestone, where 246 new ambulances would be added to the existing fleet of 247 ambulances, to ease the movement of patients at the time of need. It was not just Community Health Workers. The year 2024 also marked 30 years of rebuilding the country’s health systems from scratch, after the 1994 Genocide against the Tutsi, which left the already weak healthcare in shambles. Thirty years later, Rwanda is among developing countries pioneering efficient and functional healthcare systems, albeit with limited resources, exemplary cutting maternal and infant mortality rates and improving access to services, right from the health post to the referral level. In June 2024, the Ministry of Health announced that the country had received its largest consignment of medical imaging equipment purchased by the Government of Rwanda, in a move to strengthen the capacity of health facilities to diagnose and treat different diseases. The milestone was achieved through a strategic partnership with Siemens Healthineers, a German company that provides healthcare services including medical technology. The new equipment included computerised tomography scanners (CT scanners), fixed X-rays and mobile X-rays machines; and mammography machines used to examine the breast for the early detection of cancer and other breast diseases; as well as medical echographs (ultrasound machines), among others. The Ministry said that the diagnostic equipment would allow doctors to accurately detect and identify diseases before treating them, and at the same time address gaps in diagnostics in public hospitals across the country. Expansion of King Faisal Hospital In July, expansion works for King Faisal Hospital kicked off, with ambitious plans to upgrade the country’s largest referral hospital to an international standard facility that would serve Rwandans and Africans better. The groundbreaking ceremony was officiated by President Kagame on July 22, who called for the fast-tracking of the expansion works by partners who include the Ministry of Health, King Faisal Hospital Rwanda Foundation and Shelter Group Africa. Once complete, the expansion works will see the hospital triple its bed capacity from 157 to 557 beds and add modern, state-of-the art facilities as well as dedicated units for different conditions, such as stroke, spine, and neurology, and expand existing ones such as oncology cardiology, cardiothoracic surgery, and orthopaedic surgery services. A teaching hospital will also be introduced, while the hospital will have the capacity to treat most of the conditions people travel abroad to seek treatment for. ALSO READ: What to know about King Faisal hospital expansion plan The months between July and October were mainly about containing the two outbreaks, Marburg Virus and Mpox, with the government and partners scaling up efforts to contain the two diseases. Rwandans were yet again reintroduced to handwashing and hygiene practices in public spaces, reminiscent of the Covid-19 pandemic, but as the two viral diseases were brought under control, the situation slowly went back to normal, allaying fears of other possible tough measures being taken. It is also a year Rwanda registered high profile visits linked to the outbreaks, including that of Dr. Tedros Adhanom Ghebreyesus, WHO Director General, who arrived in Rwanda on October 19, to see firsthand how the country was dealing with the Marburg virus disease outbreak. The WHO head, who met President Kagame during his visit, commended Rwanda’s rapid and effective response to the Marburg virus outbreak, noting the important role of leadership in managing such health crises. His visit followed that of Africa CDC Director General, Dr. Jean Kaseya, who also came to Rwanda a couple of times to ramp up efforts to contain the two outbreaks. He was also at the forefront of challenging unfair restrictions targeting Rwanda, including by the U.S, saying that the country had contained a possible spread of the virus and therefore should not be punished with crippling restrictions. Rwanda hosting African Medicines Agency (AMA) Another big story that emerged in 2024, was the opening of the African Medicines Agency (AMA) head office in Kigali. AMA is a specialised African Union (AU) agency aimed at harmonizing medical regulations across the continent. On November 1, the Ministry of Health handed over the magnificent building located in the central business district, along with 10 vehicles, in a landmark move to support the operations of the continental medicines’ agency. The establishment of AMA in Rwanda followed an agreement signed between the Government of Rwanda and the African Union Commission in June 2023, setting the foundation for the agency’s operations in Africa. AMA’s mission is to improve access to quality, safe, and effective medical products across the continent, addressing public health needs and bolstering pharmaceutical standards. December came with more good news as Rwanda become the eighth country in Africa to reach Maturity Level 3 (ML3) global classification of national regulatory authorities, according to an announcement made by the WHO on December 5. The level indicates a stable, well-functioning, and integrated regulatory system for medical products. It precedes Maturity Level 4, the highest level, which signifies an advanced regulatory system. The global health agency indicated that the designation followed its formal benchmarking, demonstrating significant progress toward regulatory system strengthening on the continent.
