Uganda Faces HIV/AIDS Funding Crisis Following USAID Withdrawal; Calls for Shs300 Billion Allocation

Vincent Bagambe, Director of Planning and Strategic Information at UAC, warned that the withdrawal of U.S. funding could reverse the significant progress Uganda has made in combating HIV/AIDS.

The Uganda AIDS Commission (UAC) and AHF Uganda Cares have jointly appealed to Parliament for an urgent allocation of Shs300 billion to maintain the supply of essential HIV/AIDS drugs and laboratory services. This request was made during a session before the Committee on Health, chaired by Hon. Joseph Ruyonga.

The plea comes in the wake of the United States' recent executive orders leading to the suspension of USAID funding, which has historically been a cornerstone of Uganda’s HIV/AIDS response through the President's Emergency Plan for AIDS Relief (PEPFAR).

Dire Consequences of Funding Cuts

Vincent Bagambe, Director of Planning and Strategic Information at UAC, warned that the withdrawal of U.S. funding could reverse the significant progress Uganda has made in combating HIV/AIDS.

“We are at a critical juncture. Uganda has made significant strides in reducing new infections and AIDS-related deaths, but the sudden cut in funding puts these gains at risk. We need an additional Shs300 billion to ensure uninterrupted access to treatment, laboratory monitoring, and other essential services,” Bagambe stated.

Uganda currently spends approximately Shs1.9 trillion annually on HIV services, with 60 percent sourced from international donors, primarily the U.S. government. The abrupt halt in grant disbursements has already led to clinic closures and staff layoffs among implementing partners.

Potential Public Health Crisis

Bagambe emphasized that without swift action, thousands of people living with HIV could face medication shortages, increasing the risk of drug resistance and new infections.

The UAC has also called for an increase in the HIV Mainstreaming allocation from 0.1 percent to 0.5 percent of the national budget, generating an additional Shs200 billion.

“The current allocation is inadequate. Increasing it to 0.5 percent will ensure that critical interventions such as viral load monitoring, counseling services, and logistics for antiretroviral distribution continue without disruption,” Bagambe explained.

Impact on Vulnerable Groups

According to the latest statistics from the UAC, Uganda has 1.49 million people living with HIV, with a prevalence rate of 5.1 percent. In 2023 alone, there were 38,000 new infections and 20,000 AIDS-related deaths. Young people aged 15-24, particularly adolescent girls and young women, remain the most affected demographic.

Flavia Kyomukama from the National Forum of People Living with HIV highlighted that the funding freeze threatens to phase out standalone ART clinics, youth centers, shelters, and safe spaces, limiting access to medication and counseling, and exacerbating stigma.

“The USAID exit is not just a freeze on funding—it’s a freeze on our lives, a freeze on our bloodline. We are slowly dying, and we are asking our Parliament to represent us,” Kyomukama pleaded.

Proposed Solutions and Local Strategies

Trevor Emojel, a Youth Officer at Uganda Cares, urged Parliament to support local manufacturers of antiretroviral therapy (ART) by providing tax breaks, low-interest financing, and waivers. He also called for the fast-tracking and full financing of a sustainable HIV strategy.

Jacqueline Makokha, UNAIDS Country Director, stressed the importance of homegrown solutions, advocating for a collaborative strategy between the government, partners, and civil society.

“Solutions will not come from outside. It has to come from us internally who are facing this situation,” Makokha stated.

Parliamentary Response and Recommendations

Hon. Lulume Bayigga (Buikwe County South MP) emphasized that Uganda must take responsibility for addressing the HIV/AIDS crisis following USAID’s exit. He highlighted the need for local investment in pharmaceutical manufacturing and stressed the importance of clear strategies for medicine access and stigma reduction.

“If we cut down on our expenditure and provide a basket fund, we can purchase the medicines,” Bayigga suggested.

Hon. Sarah Netalisire (Namisindwa District Woman Representative) warned of increased stigma under the proposed integration of HIV services into general outpatient departments, raising concerns about rural patients' access to treatment.

“We have people who have lived HIV positive for over 10 years but have never declared their status… they wait for drugs to find them where they are,” Netalisire noted.

She called for the operationalization of the AIDS Trust Fund to replace lost donor funding. Ruyonga appealed to the Ministry of Health to convene a comprehensive meeting with stakeholders to address the funding crisis.

“We may not be able to raise all the funds to run the activities as you have been doing. Can the Ministry of Health address all the stakeholders in a single meeting and see how to resolve this,” Ruyonga concluded.

The appeal underscores the urgency for Uganda to mobilize domestic resources and implement sustainable strategies to safeguard the health and well-being of millions living with HIV/AIDS.