Why Uganda needs sh300b urgently for HIV/AIDS fight

KAMPALA - The Uganda Aids Commission (UAC) has appealed to the Government to allocate an additional shillings 300 billion for funding HIV/AIDS prevention and treatment activities.

According to Dr Vincent Bagambe, the entity’s director in charge of planning and strategic information, the funds are essential in plugging a gaping hole that was left by a freeze of crucial donor support.

Late last month, it should be noted that US President Donald Trump temporarily suspended operations of the US Agency for International Development (USAID) activities for 90 days. The move caused shockwaves and panic in Uganda’s healthcare system.

While appearing before Parliament's health committee on February 11, 2025, Bagambe said as a result, critical President’s Emergency Plan for AIDS Relief (PEPFAR) programmes, including the supply of antiretroviral drugs (ARVs), HIV testing kits and prevention initiatives, have been severely disrupted.

So, how much has PEPFAR been injecting and what impact does it have?

Funding cut

Findings from a National AIDS Spending Assessment (NASA) report indicate that HIV funding in Uganda increased to shillings 1.928 trillion between 2021 and 2022. This covered comprehensive services such as prevention, treatment, psychosocial support and healthcare workforce training.

Sixty per cent of this amount, approximately $323 million (about shillings one trillion), was dedicated to ARV procurement. However, the Ugandan government contributed shillings 230 billion ($62 million), meaning three-quarters of the funding came from external partners, including the Global Fund and the US government.

“In addition to treatment, PEPFAR has been providing about shillings 340 billion (equivalent to $91 million) for health systems strengthening and this includes support for human resources. PEPFAR has been providing salaries, recruiting and deploying 4,333 clinical workers,” Bagambe cited.

Clinical workers include doctors, pharmacists, lab technicians, midwives, nurses and mental health workers.

“In addition to these, PEPFAR has been supporting 16,690 community health workers and lay workers. These have been deployed across 2,000 health facilities in Uganda. Some of the Government, others private and not for profit and others stand-alone clinics which are supported by implementing partners of PEPFAR,” he added.

Numbers

Uganda’s HIV and AIDS response has gained global recognition, but experts worry that the loss of funding could reverse these achievements.

As of December 2023, the estimated number of people living with HIV in Uganda stood at 1.492 million. While the HIV prevalence has declined to 5.1%, women remain disproportionately affected. Additionally, 38,000 new infections are recorded annually, with a third occurring among youth aged 15 to 24 years.

Despite progress, Uganda’s HIV epidemic remains severe.

“The estimated number of people living with HIV is 1.492million and this is as of December 2023. The burden of HIV is still higher in females than males. The HIV prevalence is coming down, currently averaging at 5.1 per cent, but still higher among women than men and new HIV infections are now 38,000. Again, the bulk of HIV infections occurs in women compared to men,” he noted.

Youth aged 15-24 years account for a third of new HIV infections.

“To give you an example, out of 100 people living with HIV in the world, four are Ugandans. We derive this considering the fact that Uganda has a population of only 46 million people and it has 3.8 % of people living with HIV in the world,” he emphasized.
Moreover, an estimated 200,000 people remain undiagnosed and untreated each year.

BUBU

Trevor Emojel, the youth co-ordinator at AHF Uganda Cares, argues that Uganda must break its dependence on foreign aid by investing in local pharmaceutical production of ARVs.

“The challenge has been that they have been faced with high competition from low-cost ARVs imported into the country. We request that they are provided with incentives such as tax breaks, low-interest financing and infrastructure to give them a conducive environment,” he said.

However, much like Lugaflow rapper GNL Zamba’s verse in Luka, health committee chairperson Joseph Ruyonga (Hoima West, NRM) warns that while HIV/AIDS remains an enigma, the country cannot afford to let its guard down at this critical juncture.

“All of us have been affected by HIV/AIDS. I usually give an example of when I was in A’level when HIV had just come in the country, I had a sister who continued getting infections, then they tested her and said she was positive but we wouldn’t tell her,” Ruyonga narrated.

“So, we lived with her for some time. There was that lady called Nanyonga in Masaka, she wanted to go there, so we took her there and she ate the soil. She never improved and at the end of the day, she lost the battle,” he added.