US Aid Freeze: Uganda AIDS Commission Seeks UGX 300 Billion To Address HIV Funding Gap

By Spy Uganda

The Uganda AIDS Commission (UAC) has called on Parliament and the Ministry of Finance to realign the country’s budget priorities and allocate an additional UGX 300 billion to address the funding gap left by the United States government’s decision to freeze foreign aid. This follows an Executive Order signed by former President Donald Trump imposing a complete ban on foreign aid.

The appeal was made by Dr. Vincent Bagambe, the Director of Planning and Strategic Information at the UAC, who appeared before Parliament’s Health Committee on February 11, 2025. Dr. Bagambe presented a policy brief outlining the potential consequences of the US aid freeze on Uganda’s national HIV response. In his remarks, he emphasized the urgent need for increased budgetary allocation, particularly for essential commodities.

“We urge Parliament to redirect budget priorities and increase funding for HIV services with an additional UGX 300 billion to cover medicines, laboratory supplies, and other resources previously provided by PEPFAR. This should be in addition to the current UGX 50 billion annual increments in budget support. Our long-term goal is to fully cover antiretroviral (ARV) and other commodity costs, allowing partners to focus on capacity building, social support, and technical assistance,” Dr. Bagambe said.

The call for increased funding comes in response to the US Executive Order, which was issued on January 24, 2025. The order resulted in a 90-day freeze on aid, with the US government suspending all grants to implementing partners and agreements with contractors. The UAC noted that this freeze has caused panic among HIV patients and health workers and poses a serious threat to Uganda’s efforts to end AIDS as a public health threat by 2030.

In its policy brief, the Commission provided an update on the current HIV/AIDS trends in Uganda. As of December 2023, the number of people living with HIV in Uganda was 1.492 million, with 910,000 females, 520,000 males, and 72,000 children affected.

During the same period, Uganda recorded 38,000 new HIV infections, with 22,000 among females, 11,000 among males, and 4,700 among children. Additionally, 20,000 AIDS-related deaths were recorded, with 8,200 females, 8,400 males, and 3,200 children succumbing to the disease.

Despite Uganda’s progress in combating HIV, Dr. Bagambe cautioned that the epidemic remains generalized and severe. He compared the global statistics, noting that out of every 100 people living with HIV worldwide, four are Ugandans.

“To give you an example, Uganda, with a population of 46 million, accounts for about 3.8% of the global HIV burden. This means nearly four out of every 100 people living with HIV are Ugandans,” Dr. Bagambe explained.

Flavia Kyomukama, Executive Director of the Network of Persons Living with HIV, emphasized that the current crisis is unprecedented, even worse than the COVID-19 pandemic. She highlighted the struggles faced by female sex workers, 56% of whom are HIV positive, as they lose access to treatment, PrEP (pre-exposure prophylaxis), and other essential services.

“This isn’t just about a freeze; it’s a freeze on our lives. They are closing our blood,” Kyomukama said. “We need Parliament to understand that our lives are at stake. We are the ones who vote, and dead people don’t vote. The crisis demands that we have a supplementary budget.”

MPs were informed that Uganda spends UGX 1.928 trillion annually on HIV services, with 60% (UGX 1 trillion) dedicated to treatment and laboratory monitoring. Of this, the Ugandan government contributes UGX 230 billion, while the balance is provided by international donors, particularly the US government and the Global Fund. PEPFAR alone contributes about UGX 340 billion for health systems strengthening, including salaries for 4,333 clinical workers and 26,690 community health workers.

Dr. Bagambe warned that if PEPFAR’s funding is reduced or stopped, the country could face shortages in essential commodities, and the human resource gap in health facilities and community organizations would compromise the quality of HIV prevention and treatment services.

Kyomukama also pointed out the financial strain on those working in HIV/AIDS projects, noting that many health workers and organizations are already facing salary cuts and reduced income. “Our salaries have been shut down. We can’t sleep because we don’t know what happens next. We can’t pay taxes, and if we can’t pay taxes, what happens to the health facilities?” she asked.

Dr. Bagambe further warned that the aid freeze would hinder Uganda’s efforts to reach the estimated 200,000 people living with HIV who remain undiagnosed and untreated. “Unless a vaccine or cure for HIV is found soon, we must continue to provide effective HIV prevention services to prevent new infections. The current donor-dependent emergency model needs to be reviewed to prioritize prevention as well as treatments,” he said.

In response to the crisis, the US government relaxed its total aid ban on February 6, 2024, but limited PEPFAR-funded treatment to pregnant women and breastfeeding mothers.

Meanwhile, Uganda’s Ministry of Finance and the Ministry of Health are working closely together to develop measures to mitigate the effects of the aid freeze. During a discussion in Parliament, Minister of State for Planning Amos Lugoloobi assured MPs that the government is considering appropriate recommendations to safeguard Uganda from the shocks of the suspension of US foreign aid.

“We are deeply concerned, and the Ministry of Finance is working with the Ministry of Health to develop recommendations for Cabinet and, if necessary, Parliament,” Lugoloobi said in January 2025.

Secretary to Treasury Ramathan Ggoobi also assured Parliament that the government is committed to keeping Ugandans safe, just as it did during the previous foreign aid freeze following the passing of the Anti-Homosexuality Act. “The risks will be analyzed, and we will ensure that Uganda is protected,” Ggoobi said.