Health sector buckling under Trump’s aid freeze

KAMPALA - Uganda's HIV and AIDS funding crisis can best be summed up in three words: Fear, uncertainty and despair.

Late last month, after US President Donald Trump reinstated the Mexico City Policy and temporarily froze USAID funding pending alignment with his 'America First' agenda, stakeholders were left in confusion.

While Trump is known for his unconventional approach, few anticipated the timelines of this boomerang.

Not even, Jackline Makokha, the United Nations Programme on HIV/AIDS (UNAIDS) country director for Uganda.

“I think everyone in the world knew that something would happen but we didn’t expect it to be very sudden,” Makokha says.

Although some waivers have since been issued, she told MPs on the health committee on February 11, 2025, that the reality on the ground is different.

“We are particularly concerned and I think the Ministry of Health has mentioned this, civil society and the Uganda AIDS Commission as well. The impact on human resources for health. We know that about 31,000 Ugandans are being supported through the PEPFAR,” she said.

Adding that their staying at home means that critical services are not being provided.
Additionally, Makokha expressed worry that the pandemonium might have a domino effect on data gathering as far as assessing the HIV and AIDs burden.

Recent statistics show that Uganda, which boasts a population of 46 million, has 1.429 million people living with HIV. Although new HIV infections have dropped to 38,000, concerns abound that this funding cut might exacerbate them.

Apparently, Dr Peter Mudiope of the AIDs control programme says: "Voluntary male circumcision is on hold. Fifty to 60 per cent of our condoms have been through USAID, UNFPA and 100% of female condoms have been through USAID funding".

“We have 850 people who use or inject drugs that are treated in Butabika and Mbale regional referral hospitals on Methadone and Prednisone. That is on hold for now because it is not among the critical services highlighted in the second memo of PEPFAR although it is a critical service,” he added.

Terrifying

Parliament health committee chairperson Joseph Ruyonga (Hoima West, NRM) called the situation deeply unfortunate and terrifying.

“It’s a crisis, we never expected this and as key stakeholders, we have to look for a way of how we are going to continue serving our people. Uganda as a country had made a lot of progress in the prevention of HIV AIDS but when we got this executive order from the President of the US, it is going to affect the way how we have been delivering services and also that has a big implication on the fight against HIV,” Ruyonga said.

Although the current state of affairs is scary, he said the country has to fight harder since it cannot afford to let its guard down. He rallied all and sundry to work towards this collective objective.

“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 into the country, I had a sister who continued getting infections, and so many things, when they tested her, 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, 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.

MPs respond

However, Gweri County MP Tom Julius Ekudo (FDC) argues that instead of blaming Trump, Uganda should use this crisis as a wake-up call to wean itself off foreign aid.

“What I know is that a lot of money has been misappropriated in Uganda. Uganda is known for corruption issues,” Ekudo argued.

“Trump was right to slash those things. Because why do you need to depend on other people? You have a home and don’t want to be strong in your home,” he posed.

That said, Ekudo says he will support any move aimed at finding funds to support HIV/AIDS prevention and treatment activities.