UGANDA: Funding shortages threatening HIV programmes

Kampala, 17 August 2006 (PlusNews) - Public health programmes in Uganda are seriously short of money, putting the lives of tens of thousands of HIV-positive people at risk, says a new report.

'Funding the Promise: Monitoring Uganda's Health Sector Financing from an HIV/AIDS Perspective', published in July by Health Promotion Services-Uganda (HEPS-Uganda), a health consumers' organisation, claimed that the government allocated only US$5 per capita annually to health and questioned its commitment to funding the sector.

HEPS-Uganda said Ugandans contributed US$9 per year to healthcare themselves, putting the total spent per capita at just half the government's policy benchmark, and the UN World Health Organisation's recommended minimum, of US$28.

The shortage was most acutely felt by thousands of HIV-positive Ugandans who needed antiretroviral (ARV) treatment but could not afford it and were not covered by free, donor-funded ARV programmes. Government estimates put the number of people in need of ARVs at 150,000 to 200,000 but existing programmes have only managed to put 78,000 people on treatment.

Dr Apuuli Kihumuro, director general of the Uganda AIDS Commission, conceded that limited funding had curtailed efforts to reduce the spread of the virus. "It seems our programmes have failed to taper the cycle of infection, with rates of between 100,000 and 130,000 new infections recorded per year. More money has been invested in treatment and capacity building instead of prevention."

HIV prevalence has remained stable at about six percent for the past five years, and observers have questioned whether this was the result of pouring too much money into treatment and not enough into prevention: according to the Uganda AIDS Commission, in 2005 just 12 percent of HIV-positive pregnant women received ARVs to prevent transmission of the virus to their unborn children.

Arguments for emphasising treatment maintained that ARVs allowed parents to stay alive to look after their families, and people in their prime could remain productive.

However, Dr Sam Onkware, another senior health official, said that while having so many people on treatment was a positive development, the presence of healthy HIV-positive people in society could reinforce the idea that treatment was a solution in and of its own, leading the rest of the population to become complacent.

"This is a challenge, because we could end up with more infected people - the use of condoms is more important now that it has ever been," he said.

The threat of a possible rise in HIV prevalence due to limited funding for prevention has prompted health officials to call for a "rapid assessment" of Uganda's prevention strategy in 2006. Kihumuro said the country was "going back to the drawing board" to create a new five-year plan to address areas not given enough attention in the past.

Theme (s): Care/Treatment - PlusNews,

[This report does not necessarily reflect the views of the United Nations]