By The future of over 1.2 million people living with HIV/AIDS in Uganda was yesterday thrown into uncertainty after the government confirmed that the United States, one of its largest development partners, had suspended funding for 90 days.
The freeze will affect thousands of malnourished children in Karamoja and tens of thousands of Ugandans employed under U.S.-funded projects. This decision follows an Executive Order signed by U.S. President Donald Trump on January 20, shortly after his inauguration as the 47th president, halting all foreign aid for three months pending a review.
Key among the affected programs is the President’s Emergency Plan for AIDS Relief (PEPFAR), which has funded 80% of Uganda’s HIV/AIDS budget since its inception in 2004. The suspension has raised concerns about the continuity of antiretroviral therapy (ART) for the majority of Uganda’s HIV patients who depend on PEPFAR support.
In 2024, the U.S. allocated $471 million (about UGX 1.7 trillion) to Uganda’s health sector, with $426 million (about UGX 1.5 trillion) directed to PEPFAR. Additionally, $182 million (about UGX 671.5 billion) was earmarked for other humanitarian projects.
Impact Across Health and Humanitarian Sectors
The funding freeze is set to disrupt numerous projects, including the three-year $1 billion (UGX 3.6 trillion) Mental Health Integration Project, the $1 billion Commodity Cooperation Funding Program, and the $20 million (UGX 73.7 billion) civil society support initiative. Other affected projects include the Uganda Health Activity (UHA) in Karamoja, the USAID Integrated Child and Youth Development Activity, and humanitarian aid for the ongoing food crisis.
The news came as a shock to implementing partners such as the Infectious Diseases Institute (IDI), Family Health International 360, Makerere University School of Public Health, and Youth Alive. Dr. Andrew Kambugu, IDI’s Executive Director, described the situation as dire, stating, “We are going into an emergency meeting with stakeholders to plan our next steps.” He instructed IDI teams to halt PEPFAR-related activities following the U.S. government directive.
Uganda’s Health Sector Struggles to Cope
Uganda’s health sector heavily relies on foreign aid, and PEPFAR alone employs over 320,000 staff and health workers providing HIV care and preventive services. The Uganda Medical Association Secretary General, Dr. Joel Mirembe, called the U.S. decision “catastrophic,” noting that it jeopardizes training, medicine supply, and prevention campaigns targeting new HIV infections.
Despite a slight increase in Uganda’s domestic funding for HIV/AIDS from $80.6 million (UGX 298 billion) in 2020 to $100.4 million (UGX 371 billion) in 2024, the gap remains vast. Current needs stand at $851.5 million (UGX 3.16 trillion), leaving a significant shortfall as international support falters.
U.S. Foreign Aid Under Scrutiny
President Trump’s Executive Order reflects a shift in U.S. foreign aid priorities. U.S. Secretary of State Marco Rubio emphasized that every dollar spent must align with American interests, focusing on safety, strength, and prosperity. The U.S. Agency for International Development (USAID) has suspended obligations and instructed contractors and partners to halt activities, limiting costs to expenses incurred before January 24, 2024.
Government Seeks Solutions Amid Crisis
Uganda’s Ministry of Health is now reassessing priorities to mitigate the impact. Permanent Secretary Dr. Diana Atwiine assured the public that contingency measures are in place, saying, “We still have drugs in stock, and services will continue. This situation will drive us to reorganize and work towards greater independence.”
While discussions are ongoing between Ugandan authorities and U.S. officials, experts warn that the suspension could have long-lasting effects on Uganda’s health and humanitarian sectors. Urgent action is needed to address the funding gaps and ensure that life-saving programs are not permanently disrupted.
