How US aid cuts threaten care for HIV-infected patients in Uganda

Yahoo

05-03-2025

At first glance, the two Ugandan women engaged in quiet conversation seem to have little in common.
However, beneath this surface lies a shared reality marked by profound challenges: both are grappling with the heavy burdens of widowhood, grief and are infected with HIV.
They are distressed over US President Donald Trump's recent announcement that the US will withhold international assistance, causing shock waves around the world.
Molly, 39 and the younger of the two women, is vital and energetic. She tells dpa, "When I heard about America suspending giving drugs to people with AIDS, I cried and said 'God save us'."
The US aid agency USAID is one of the largest aid agencies in the world, employing around 10,000 people, two-thirds of whom work outside the United States.
It is responsible for doling out much of the US government's humanitarian assistance to developing countries and countries in crisis. It is also a key donor to fund the medicines both women and other HIV-infected patients need.
"I am still crying because I had thought I would live longer. Now I am not sure it will happen," Molly says.
Her comments echo the panic and desperation among the hundreds of thousands people in this East African country who have the HIV virus.
Molly tested HIV-positive eight years ago. Since then, she has been taking antiretroviral (ARV) medication to keep the virus under control and her health stable.
So far, she has not developed the disease that can result from the virus without treatment, known as AIDS. She earns her living by selling fried bananas on the street in her home village. This is enough to make a very modest living, but not enough to buy medication privately.
ARV drugs are an important aid to survival
In Uganda alone, there are hundreds of thousands of patients living with HIV/AIDS. The disease is particularly widespread in the southern and eastern African regions.
However, while in the 1990s an HIV diagnosis was tantamount to a death sentence, patients who receive the necessary ARV medication are able to live with the disease.
Now, there is great concern in the countries affected by the US funding freeze that tens of thousands of people could be plunged into poverty.
"There is fear and panic among policy makers and people who have AIDS. The fear is that the ARVs are running out. Any disruption can cause problems," the head of the state-run Uganda AIDS Commission (UAC), Nelson Musoba, tells dpa.
Musoba says that due to the aid suspension, he urgently needs approximately $85 million to procure HIV/AIDS treatment drugs, laboratory testing equipment and patient monitoring.
Patients fear for their chances of survival
Molly's friend, 70-year-old Jane Francis Kannyange, also wonders how long she can survive without medication. The retired nurse has been HIV-positive since the late 1990s.
It was only when her husband died of AIDS-related causes in 2002 that she was given access to medication. The medication helped her to survive, but the 70-year-old is emaciated and frequently ill because her immune system is weakened.
After Trump's announcement, she says "my doctor called me and asked me 'how are you doing? Do you have enough drugs?'"
"He told me that the clinic where I get the drugs was closing down. I fainted soon after," Kannyange tells dpa.
Meanwhile, many of the health workers are now just as helpless as their patients.
A young doctor who worked at the Institute of Infectious Diseases in the Ugandan capital Kampala, which relied heavily on US funding to pay staff, says he lost his job following Trump's announcement.
"The announcement was very ... traumatic ... I am now on unpaid leave for 90 days. Without pay, I don't know how I'm going to look after my family, my children," the doctor told dpa on condition of anonymity.
The Trump administration's push to overhaul the development aid agency has placed nearly all employees of the agency worldwide on furlough and effectively halts most of the organization's operations.
Some 1,600 jobs are also being cut in the United States. Trump has claimed several times that USAID was being run by "radical lunatics" who were wasting taxpayers' money.
Successes in the fight against AIDS are now under threat
Uganda was one of the hardest-hit nations in the global AIDS crisis during the 1990s with an infection rate of about 30% at the time.
However, thanks to support from donors, the country embarked on a world-acclaimed ambitious AIDS control programme that brought infections down to the current 5%.
While 53,000 people in Uganda died from the deadly immunodeficiency disease and its consequences in 2010, this figure had fallen to 20,000 by 2023, according to the UAC.
Almost 1.5 million people in Uganda are living with the virus and around 1.3 million are receiving ARV medication.
But Musoba says that due to the funding freeze, there is a risk that the successes will be undone. "If the changes are not well-addressed, the achievements especially in the area of stigma control maybe reversed," Musoba tells dpa.
The Ugandan AIDS program, with an annual budget of $500 million, is 70% financed by US funds. According to the UAC, the US aid programme has not only supplied ARV drugs and HIV test kits but has also funded the salaries of over 4,300 Ugandan clinic staff and 16,000 community health workers.
Other African countries face cuts too
Uganda is not an isolated case. According to Médecins Sans Frontières (MSF), many health facilities in South Africa that relied on US-funded organizations for HIV programs - including testing, treatment and prevention - have been forced to shut down.
In Mozambique, a key MSF partner organization providing comprehensive HIV services had to cease operations entirely.
And in Zimbabwe, most organizations offering HIV programs have reportedly halted their work due to funding shortages and the inability to procure essential medicines. Other donors have been unable to fill the gaps quickly enough.
"The government is in urgent need of funds to offset the likely shortage and is quickly mobilizing resources," UAC boss Musoba says.
"We still need international assistance and we need to see how to manage the disruptions."