UGANDA: Will credit crunch affect HIV/AIDS funding?

Kampala, 23 October 2008 (PlusNews) - Developing countries like Uganda, which is seeking funds for its HIV/AIDS programmes, could find themselves even more cash-strapped as donors caught up in the global economic crisis become more conservative in their spending.

Last week, Uganda launched a five-year national strategic plan worth an estimated US$2 billion, aimed at decreasing the rate of new infections by 40 percent increasing access to HIV/AIDS services.

It remains to be seen whether the country's AIDS programme, heavily supported by donors in the past, will be able to raise the money. Governments in the US and European Union have diverted trillions of dollars of public money into their ailing banking systems.

"I would be surprised if they got all the funds. Where is ... [the money] going to come from, especially now that the budget has been quadrupled? Uganda gets much more than any other country for HIV programmes," UNAIDS country coordinator Mai Harper told IRIN/PlusNews.

Uganda has some of the highest allocations from the US President's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to fight AIDS, Tuberculosis and Malaria.

Under PEPFAR, Uganda's programme received at least $240 million in 2007/08, while in the seventh round of funding the Global Fund approved $70 million for HIV programmes. The Ugandan government also put aside 60 billion Ugandan shillings ($4million) for antiretroviral therapy and malaria drugs in the 2008/09 financial year.

"This is the last window of opportunity and we ought to get things right, and to get them done. Countries like Uganda should set their priorities very clearly," warned Harper.

Focus on prevention

None of the donors have so far indicated that they would be unable to meet their pledges as a result of the financial crisis, said James Kigozi, information officer at the Uganda AIDS Commission. "Unless they give us notification, we expect to get the $2 billion over five years as planned."

He told IRIN/PlusNews that the country has been considering the formation of a national fund to create sustainable support for HIV/AIDS programmes, which the parliamentary committee on HIV/AIDS was viewing favourably because donor funding was sometimes unpredictable.

Jim Arinaitwe, the Global Fund coordinator at the Uganda AIDS Commission, commented that there was no indication yet from donors that they would cut funding, but there was mounting pressure on governments to become more sustainable and he expected a global shift in interest away from HIV/AIDS to other areas.

Harper suggested that the current financial climate was an opportunity for Uganda to "set out its priorities" and begin implementing more effective HIV prevention programmes, using resources more efficiently, and reducing corruption.

Arinaitwe agreed that the country would now have to pay more attention to its prevention programme, because "When we prevent infection we have less people to treat."

Dr Alex Coutinho, executive director of the Infectious Disease Institute (IDI) an NGO in the capital, Kampala, owned by Makerere University, said although a large chunk of the country's AIDS response was funded by PEPFAR, all prevention strategies had to be included in the national strategic plan.

We should keep morality out of HIV programming ... we should give condoms to prisoners, we should kick morality out of public health programmes

The government has been criticised for shifting the emphasis of its fight against the pandemic from condom use to abstinence and fidelity, under the perceived influence of the US and evangelical churches.

"We should keep morality out of HIV programming. People around do not want to critique marriages, and they say men having sex with men (MSM) does not exist. We should give condoms to prisoners, we should kick morality out of public health programmes. Leave public health as public health," said Coutinho.

The infection rate was particularly high among prisoners, the military, MSM, new-born babies and migrant populations like fishermen, according to Coutinho. The HIV prevalence rate among fishermen is one of the highest at 28 percent.

Dr David Kihumuro Apuuli, director general of the Uganda AIDS Commission (UAC), said the five-year plan would also reduce mother-to-child transmission of HIV by 50 percent by 2012, as an estimated 42 percent of all new infections were caused by children being born with the virus.

Uganda's HIV prevalence of 5.4 percent declined from over 20 percent in the 1990s to about six percent in 2000, but has recently crept up again.

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Theme (s): HIV/AIDS (PlusNews),

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