Trump order bites as over 500 Uganda church medics laid off

The ramifications of American president Donald Trump's immediate orders after taking office are starting to bite and being felt over 11,000km away in Uganda.

President Donald Trump on returning office last week ordered a 90-day pause to review assistance by the US, the world's largest donor in dollar terms.

US Secretary of State Marco Rubio followed up by freezing virtually all funding, though he specified exemptions for emergency food as well as military assistance to Israel and Egypt.

As a result of the move, Uganda has started feeling the pinch under the US Agency for International Development (USAID).

According to the Church of Uganda, over 500 medical workers from its medical facilities have been laid off, which it says is likely to create a health crisis in the country. The Church relies heavily on external funding to support its health programmes.

The Uganda Protestant Medical Bureau (UPMB) which operates a network of hospitals and health centres across the country was among the hardest hit with many facilities complaining over specialist health workers whose work was curtailed by the pronouncement.

“The bureau’s work in HIV prevention, care and treatment was particularly affected as it had been receiving significant funding from the US President’s Emergency Plan for AIDS Relief (PEPFAR),” UPMB chairperson Dr Tonny Tumwesigye says.

Closing a one-day medical directors COU hospitals and health facilities meeting at the Provincial Fellowship Hall in Namirembe Kampala, Tumwesigye said if not revised after 90 days, it is likely to affect patients living with HIV and AIDS and other chronic diseases.

“The layoffs not only affected the livelihoods of the medical workers but also compromised the delivery of essential health services to vulnerable communities in hard-to-reach areas, especially people living with HIV - AIDS,” he added.

Dr. Joyce Nannozi, the medical superintendent of Mukono Church of Uganda Hospital, said that over 60 health workers were dropped.

According to COU provincial secretary the Rev. Can. William Ongeng, the body currently oversees 256 health facilities across the country, including Sir Albert Cook Hospital in Mengo—the first hospital ever established in Uganda.

These facilities comprise 15 hospitals, six Health Centres (HCs) IV, 119 HCs III and 114 HCs II, strategically distributed across various regions. Additionally, the Church supports 33 community-based HIV/AIDS and health initiatives in 39 dioceses.

Mukono Church of Uganda Hospital medical superintendent Dr Joyce Nannozi said over 60 health workers who have been part of their staff supported by US aid have been dropped.

“We can no longer give HIV/ART (Antiretroviral therapy) services to patients promptly because we are not in a position to take on the dropped staff. People living with HIV who have been getting care are going to suffer as a result of Trump’s decision,” she said.

Mengo Hospital director Dr Simon Peter Singo said this is likely to cause a health crisis and increase HIV prevalence rates due to its direct impact on the USAID-implemented projects.

“The donor money has been used to pay salaries of the HIV staff team where 50 have been employed to run the programme on a full-time basis. We do not have the money to pay contracts of such workers including community programmes of male circumcision, Tuberculosis (TB) follow-ups, community drug distribution to prevent HIV mother-to-child transmission and cancer disease,” Singo said.

The 2024 estimates show that the national HIV prevalence is 5.1%, and new infections have reduced from 83,000 in 2021 to 38,000 in 2024. AIDS-related deaths reduced from 53,000 to 19,000 and babies with HIV have reduced from 30,000 to 4,700 in just over a decade.

Kisiizi Hospital director Dr Henry Lukabwe said it has been challenging running normally because they stopped offering some free services like Absolute Neutrophil Count (ANC).

“Kisiizi has been receiving between 30 to 40% donor support but we cannot afford to give such services due to the Trump directive,” he said.

Amudat Hospital medical superintendent Dr Patrick Sagaki said the withdrawal has affected most of their services with the latest being the suspended activities in controlling HIV/TB affecting health system strengthening activities, he observed.

Archbishop calls for research

COU archbishop Dr Stephen Kaziimba Mugalu challenged medical workers to invest in research if they are to support their health facilities in providing quality services at all times.

“Now that the funding is stopped, you need to think about growing the Good Samaritan Fund to be able to support the healthcare needs of vulnerable communities. I emphasize the importance of research in improving healthcare outcomes and I implore you to innovate solutions to address the crisis,” he advised.

Kaziimba’s proposal would provide financial support to patients who can’t afford medical care encouraging medical workers to contribute to the fund and identify other sources of support to ensure its sustainability.