Interview. On Friday December 1, Uganda will join the rest of the world in celebrating World Aids Day. Sunday Monitor’s Rachel Mabala caught up with Prof Vinand Nantulya’s, a leading figure in the fight against HIV/Aids. The medical doctor, academician and former professor at Harvard School of Public Health recently resigned as chairman of the Uganda Aids Commission and the Country Coordinating Mechanism (CCM) amid fights at the commission.
You recently resigned from the Uganda Aids Commission and retired as chair of the Country Coordinating Mechanism (CCM). These two are quite confusing
I have been with the CCM for the last six years and the interestingly that is the same period, of six years, I was the chairperson of Uganda Aids Commission so people sometimes confuse one for the other but I have been running both.
The CCM was started by the Global Fund. Immediately after our independence, development aid by our partners was in form of government support to our Budget… but we didn’t see impact and after decades donors started asking questions. All kinds of arguments were advanced that may be government agencies were not efficient, some said may be the funds were being misused. So the development aid paradigm changed to a new one which was that development agencies started dealing more with NGOs.
Again, it was realised that passing resources through NGOs was not having impact either and the question was what next. During that debate is when the Global Fund was formed and it came in with the third paradigm that in fact you need both that the government and the NGOs work together.
There have been complaints about the structural system, that CCM and Uganda Aids Commission are actually placed wrongly and that is why some people stay away or don’t play a role they should
Let us separate the CCM from Uganda Aids Commission. The CCM is an independent organ which brings in all organs to sit together. Where they sit doesn’t matter, they can seat anywhere. The secretariat of CCM at present is situated here at the commission but it is independent of the commission. It is funded differently, part of the resources that come to it from the ministry of Finance are channelled through Uganda Aids Commission just for convenience but the governance of those resources is by the CCM not the commission, and the secretariat could be placed anywhere.
What about the issue of UAC being under the Ministry of Health?
That is a different matter which was advanced over the last couple of years but it is misplaced because when HIV/Aids struck in this country, the Ministry of Health is mandated to look after the health of all Ugandans by Constitution. They attempted to do that but they faced challenges because if you use what we call biomedical model for health care what you do is if you have a disease problem, you diagnose and treat and if you know the cause, you prevent. When HIV/Aids struck, the medical field was challenged because that model could not work. There was no treatment for HIV/Aids let alone the facts that the ARVs were not available.
The patients were received and observed going down until they died. The running of the control programme for HIV/Aids, therefore, became a huge challenge. The President in his wisdom stepped and asked what we can do. When he got the answers, in his practical manner he proposed a solution.
At what point was this?
He [President Museveni] decided that the approach must be multisectoral and so a commission was formed with him as the chairman and ministers of the key ministries as commissioners. He did this and quickly realised he didn’t have enough time and neither did the ministries have the same. It was delegated to the permanent secretaries of those ministries but they too did not have enough time and that is how an Act of Parliament came about to say that the commissioners of the Aids Commission could be drawn from anywhere and so the secretariat of the commission was set up and I pay credit to Dr Appuli because where the commission was located in Mengo was a dilapidated building but he was able to mobilise working with the Africa Development Bank to establish these offices here.
Should the commission go back to the Ministry of Health?
I think for me that begs the question, the job of the commission is not implementation; it is just coordinating all the other implementers, the biggest of them being the Ministry of Health, including faith-based organisations, NGOs. Trying to get the commission to move to the Ministry of Health would be a bad idea.
Along the way you seem to have had a not so smooth ride at the UAC. What happened?
Unfortunately in the second term, Dr Appuli left, he retired and we got a different director general and a different board and this one did not work well. The years, 2014, 15 and 16 were a bad period, very bad period. We had a very divisive period in the commission which you probably know about. I think we lost ground, we could better than this if we didn’t have these internal problems.
It is said you had fights with technocrats at UAC. Is that so especially as board chair you weren’t expected to be there but only come in and chair meetings?
It was very unfortunate that we had a colleague who at the time was minister of Health, we had very good working relations and she came in here and had fights with everybody and unfortunately we missed the opportunity. It was claimed that I didn’t know governance and that is of course nonsense. I have been on boards of very many organisations both here and outside the country. We had problems and that is why I resigned. I told the President I was not prepared to continue in December last year but it is unfortunate.
Are you leaving the field completely?
No I am not. I am a patriot. You can’t believe it but I left an extremely well-paying job outside this country and accepted to come back. Everyone said I was mad. Yes, I was mad but I love my country (laughs).
I didn’t have any challenges in the Global Fund/CCM. Not at all, that is why it has developed into a model for the whole world. The challenge was really at Uganda Aids Commission which was extremely unfortunate because we had taken off very well in the first years but in the last three years we lost ground, we could have had better results than we got and that is all I can say.
Did your departure do a service or disservice to Uganda Aids Commission?
I thought it was a disservice to me for the sacrifice I made to come and to take up the challenge with the President to guide this and put in all my efforts and then someone comes to disrupt it. I thought it was a disservice and that is why I left. It wasn’t a protest against HIV/Aids fight.
Oh no, I still want to continue to fight HIV/Aids just like I want to support CCM. My only regret is that I wasted the last three years because if those three years were used to drive the response we would have had different results.