Uganda: HIV Crisis - Over 1.2 Million At Risk As Facility Closures and Funding Cuts Loom

The World Food Programme, a USAid partner, distributes food to people in South Sudan.
29 January 2025

Activists are raising alarms that these closures could lead to an increase in HIV infections, while some patients are already rushing to Mulago's Infectious Diseases Institute (IDI) for their medication, fearing service disruptions.

More than 1.2 million people currently relying on life-saving HIV treatment in Uganda face an uncertain future as numerous treatment centres begin closing, leaving many patients vulnerable.

Activists are raising alarms that these closures could lead to an increase in HIV infections, while some patients are already rushing to Mulago's Infectious Diseases Institute (IDI) for their medication, fearing service disruptions.

Kruish Mubiru, head of Uganda Young Positives, an advocacy group for young people living with HIV, highlighted the urgency of the situation.

"Many people living with HIV are scared and confused," Mubiru explained. "The closure of these centers could lead to a surge in infections, especially in rural areas where access to care is limited.

"Some are even being told to collect three months' worth of medication, fearing they might soon go without. This could lead to drug resistance and further complications."

The closures coincide with cuts in PEPFAR funding, a major source of support for HIV treatment programs in Uganda.

With PEPFAR no longer providing financial backing for critical services such as viral load monitoring, PrEP, and Voluntary Medical Male Circumcision (VMMC), the future of HIV care in the country has been placed in jeopardy.

However, some relief has come from TASO (The AIDS Support Organization), which has assured the public that its services will continue despite the financial challenges.

Dr. Micheal Etukoit, Executive Director of TASO, stated, "We are a going concern. Our clients have enough medication to last at least nine months while we mobilize funds and engage other partners."

Dr. Etukoit emphasized TASO's continued commitment to supporting its clients. "We urge people living with HIV to reach out to our centers and stay in contact with us as we work to secure additional resources," he added.

Despite these efforts, the overall HIV response in Uganda faces challenges. The AIDS Trust Fund, a key component of the national HIV prevention strategy, has yet to be implemented, leaving a gap in funding and further jeopardizing the country's ability to combat the virus.

Dr. Etukoit expressed concern over the lack of an operational HIV Prevention and Control Act, calling it a major setback.

"Without the AIDS Trust Fund, the future of HIV treatment and prevention in Uganda is uncertain," Dr. Etukoit said. "This is something the government must address immediately."

Mubiru also pointed out the ripple effects of these closures, with USAID and PEPFAR-funded medical workers receiving immediate stop-work orders across 16 regional referral hospitals. This could leave more than 60,000 patients without vital HIV care.

"The shutdowns mean that over 60,000 patients who were receiving HIV care at these facilities will face disruption, and they may not receive the medication they need. This is a critical situation that could set us back years in our efforts to control HIV," Mubiru warned.

As Uganda grapples with the growing crisis, activists and health officials are calling on the government to intervene urgently to ensure the continuity of HIV treatment and related services such as PrEP and VMMC.

With PEPFAR funding now uncertain and essential services under threat, Uganda is at a crossroads in its battle against HIV. The government must take swift action to prevent further setbacks and protect the gains made in the country's HIV response over the past two decades.

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