By Lawrence Kooko
Kampala – The Joint United Nations Programme on HIV/AIDS (UNAIDS) has called on the Ugandan government to take greater ownership of its HIV/AIDS response by realigning domestic resources in the face of declining donor support, particularly from the United States.
During a recent interview, Jacqueline Makokha, UNAIDS Uganda Country Director, emphasized that while life-saving HIV treatment programs have resumed following temporary disruptions, the broader funding landscape remains unstable.
“Donor funding has been steadily declining since 2016,” Makokha said.
“We are looking at a future where international funding will not be as readily available. That’s why we’re working with governments, including Uganda, to develop sustainability roadmaps and strengthen domestic financing.”
Makokha also noted that Uganda has made progress, noting productive discussions with Parliament’s Health and HIV Committees.
“Government is ready to step up, and our role as development partners is to provide technical support to ensure that services are not disrupted,” she said.
Despite encouraging steps, Makokha cautioned that shifting to full domestic financing would take time.
“That’s why we are still calling on global partners — not just the US — to support the government in the interim.”
Government’s Domestic Funding Strategy
Responding to the same challenge, Dr Vincent Bagambe, Director of Planning and Strategic Information at the Uganda AIDS Commission, detailed the country’s two-tier strategy to sustain HIV services domestically.
“Each year, the government spends about Shs320 billion on HIV services, with the Ministry of Finance committing Shs50 billion annually to strengthen the response,” Dr. Bagambe said.
“Additionally, all government agencies are required to allocate 0.1% of their budgets toward HIV prevention and control activities.”
These efforts collectively generate an extra Shs40-50 billion annually, used directly within institutions for interventions such as policy development, community sensitization, and prevention messaging.
Dr. Bagambe also pointed at the potential role of the private sector in filling funding gaps through in-kind contributions such as airtime, logistics, or distribution channels for HIV messages and commodities.
However, he acknowledged the immediate impact of the funding freeze by the US government earlier this year, which temporarily forced thousands of health and support staff in standalone HIV clinics to stop working.
“Roughly 4,000 to 5,000 health workers and up to 25,000 when you include lay workers were affected,” he said.
“Thankfully, some resumed work after waivers were issued, though not all funding streams—like those through USAID—have been cleared.”
Beyond Health: Tackling Root Causes of HIV
Looking ahead, both officials underscored the need for addressing root causes of HIV transmission such as poverty and gender inequality.
Makokha reiterated the importance of integrating HIV into broader development goals and working with partners like UNDP, WFP, and FAO.
“Ending AIDS as a public health threat by 2030 means drastically reducing new infections and ensuring people living with HIV are on treatment and productive,” she said.
Dr Bagambe added that societal issues—such as child marriage, transactional s€x due to poverty, and gender-based discrimination—must be tackled through multi-sectoral interventions, mindset change, and economic empowerment.
“If people’s income increases, they can make safer choices,” he said.
“For some girls, sex is exchanged just for sanitary pads. Providing those basic needs could delay risky behavior.”
Relatedly, while addressing a press conference in Kampala earlier this week, the chairperson of Uganda AIDS Commission, Canon Dr Ruth Senyonyi, called for a holistic approach to HIV prevention, one that includes empowering women and girls, providing them with economic opportunities, and addressing social norms that perpetuate inequality and vulnerability.
“This is a societal issue that requires the collective effort of everyone: the government, civil society, the private sector, and the communities themselves,” Dr Senyonyi emphasized.
“We need to create an enabling environment where people can live without fear of stigma or discrimination and can access the services they need to protect themselves from HIV.”
As the country sets targets for a 2030 free HIV Uganda, there is much urgently shift toward sustainable, locally funded HIV responses while addressing the root causes of new infections, including stigma, gender inequality, and youth vulnerability.
Uganda’s HIV/AIDS stastistics
As of the latest national estimates, a about 1.492 million people are living with HIV in Uganda.
HIV prevalence is at 5.1 %
In 2024, Uganda registered 38000 new infections and 20000 deaths, with men contributing to the majority of the AIDS related deaths
Children (0–14 years) account for about 72,000 of all people living with HIV.
Over 90 per cent of people diagnosed with HIV are on antiretroviral therapy.
The Pearl Times recently reported of tough times ahead after reports that ARVs — which are supposed to be given free of charge — were being sold to patients after USAID stopped buying AIDS drugs for Uganda. (See Details Here).
Years earlier, The Pearl Times also reported about ARVs which were found Ugandan chicken, pork. (See Details Here.
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